The role of lipoprotein(a) in the pathogenesis of atherosclerotic cardiovascular disease and its utility as predictor of coronary heart disease events

2001 ◽  
Vol 3 (5) ◽  
pp. 385-390 ◽  
Author(s):  
Angelo M. Scanu
Keyword(s):  
Cardiovascular Disease ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Atherosclerotic Cardiovascular Disease ◽  
Lipoprotein A

scholarly journals Lipoprotein(a): An update on its role in human health and disease

2021 ◽  
Vol 12 (3) ◽  
pp. 92-102
Author(s):  
Amalia-Despoina Koutsogianni ◽  
Evangelos Liberopoulos ◽  
Alexandros D. Tselepis
Keyword(s):  
Cardiovascular Disease ◽  
Atherosclerotic Cardiovascular Disease ◽  
Main Question ◽  
Lipoprotein A ◽  
The Past ◽  
Causal Risk Factor ◽  
Potential Clinical Benefit ◽  
Pathophysiological Role ◽  
Health And Disease

Over the past few years, there has been an undiminished interest on lipoprotein(a) [Lp(a)]. High Lp(a) levels have been proposed as an independent causal risk factor for atherosclerotic cardiovascular disease (CVD). The main question that remains to be answered, however, is the potential clinical benefit of Lp(a) reduction. This will contribute to the enrichment of our knowledge on the exact pathophysiological role of this lipoprotein. This narrative review aims to summarize currently available data on the structure, metabolism, and pathogenicity of Lp(a).

scholarly journals Estimation of the 10-Year Atherosclerotic Cardiovascular Disease and The Framingham Risk Score Among Adults Living with HIV/AIDS in Addis Ababa, Ethiopia: A Hospital-Based, Observational Study.

2021 ◽  
Author(s):  
Minyahil Woldu ◽  
Omary Minzi ◽  
Workineh Shibeshi ◽  
Aster Shewaamare ◽  
Ephrem Engidawork
Keyword(s):  
Cardiovascular Disease ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
High Risk ◽  
Risk Score ◽  
Significant Contribution ◽  
Framingham Risk Score ◽  
Atherosclerotic Cardiovascular Disease ◽  
Framingham Risk ◽  
Living With Hiv

Abstract Background With a much improved ART of the present day, most morbidities and mortalities in people living with HIV/AIDS (PLWHA) are associated with factors such as non-infectious diseases (NIDs) in the form of coronary heart disease (CHD). This study aimed at determining the prevalence and predictors of coronary heart disease (CHD) using the 10-year atherosclerotic cardiovascular disease (ASCVD) and Framingham risk score (FRS) tools among PLWHA. Methods A hospital-based, observational study was carried out from January 2019 to February 2020 in HIV infected adults. Prevalence of FRS (age 20 to 79) was determined using the National, Heart, Lung and Blood Institute (NHLBI) and prevalence of ASCVD (age 40 to 79) was determined using the peer-reviewed online (ClinCalc.com) tool. Results Using the 10-years ASCVD risk estimation 27.3% of the study participants had an elevated risk > 7.5 % CHD. Similarly using the 10-year FRS, 1.4 % had high-risk score of developing CHD. Using multiple linear regression analysis age (β = .061, p < .001), gender (β = .816, p < .001), systolic blood pressure (β = .21, p < .001), total cholestrol (β = .002, p = .001), high density lipoprotein (β = − .02, p < .001), and Tobacco use (β = .559, p < .001) had significant contribution to the risk of CHD using the ASCVD tool, while using binary logistic regression for the FRS tool, gender (OR = 26.105, 95% C.I. [6.110, 111,543], p < 0.001), age (OR = 1.293, 95% C.I. [1.181, 1.415], P < 0.001), and low HDL-C (OR = 0.887, 95% C.I. [.786, .979], P = 0.19) had significant contribution. Conclusions The prevalence of high-risk CHD among PLWHA using the FRS and ASCVD tools were 1.4 & 27.3 percent respectively. In both the tools advanced age, male gender, and low level HDL were significant contributor for the risk of CHD in PLWHA.

Cardiovascular disease and trace metals

1979 ◽  
Vol 205 (1158) ◽  
pp. 135-143 ◽  
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Trace Metals ◽  
Developed Countries ◽  
Environmental Lead ◽  
The Past ◽  
Cadmium And Lead

Cardiovascular disease is a major cause of morbidity and mortality in the U. K. and other developed countries. In the U. K., mortality from coronary heart disease has increased progressively over the past 25 years, particularly in males. This paper examines the possible role of trace metals in the development of cardiovascular disease, with particular reference to the effects of cobalt, cadmium and lead in myocardial disease, atherosclerosis and hypertension. It is concluded that cobalt is an unimportant factor in community levels of cardiovascular disease, that cadmium has striking effects on blood pressure in animals and that there is some evidence for an association between environmental lead and high blood pressure.

scholarly journals Intensified lipid-lowering treatment with alirocumab in patients with coronary heart disease

Open Heart ◽  
2021 ◽  
Vol 8 (1) ◽  
pp. e001572
Author(s):  
Daniel Steffens ◽  
Peter Bramlage ◽  
Julia Müller ◽  
Cornelia Dorn ◽  
W Dieter Paar ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Real World ◽  
Familial Hypercholesterolaemia ◽  
Phase Iii ◽  
Lipid Lowering ◽  
Atherosclerotic Cardiovascular Disease ◽  
Statin Intolerance ◽  
Real World Setting

BackgroundAtherosclerotic cardiovascular disease is the leading cause of death and disability in the Western world.ObjectiveTo characterise adults with confirmed coronary heart disease (CHD) and primary heterozygous familial or non-familial hypercholesterolaemia or mixed dyslipidaemia who received alirocumab in a real-world setting.MethodsThis open, prospective, multicentre, non-interventional study, conducted in Germany, enroled patients with confirmed CHD who were treated with alirocumab according to its summary of product characteristics. Prescription was at the physician’s discretion and independent of study participation. Patients were followed for 12 weeks after alirocumab initiation.ResultsIn total, 245 patients (mean age 62.2 years; 34.0% female) were documented at 90 sites. Overall, 47.7% had familial hypercholesterolaemia, 48.9% non-familial hypercholesterolaemia and 43.8% mixed dyslipidaemia; 74.6% had hypertension and 29.2% diabetes mellitus. The most common lipid-lowering therapy in the 12 months preceding alirocumab was a statin, often in combination with ezetimibe (73.5%). Statin contraindications were documented for 46.2% patients and statin intolerance for 63.8%. The mean low-density lipoprotein cholesterol (LDL-C)-level prior to alirocumab was 150.5±51.6 mg/dL. Alirocumab prescription was in compliance with German national recommendations and/or European guidelines. The most common starting dose was 75 mg every other week. Overall, 57% patients reached target LDL-C levels (<70 mg/dL) after 12 weeks of treatment. Alirocumab was generally well tolerated.ConclusionIn a real-world setting in Germany, alirocumab was prescribed for patients with atherosclerotic cardiovascular disease who had high baseline LDL-C levels with or without statin intolerance. Efficacy and safety were consistent with findings observed in the ODYSSEY Phase III programme.

scholarly journals Association between prediabetes and risk of all cause mortality and cardiovascular disease: updated meta-analysis

BMJ ◽  
2020 ◽  
pp. m2297 ◽  
Author(s):  
Xiaoyan Cai ◽  
Yunlong Zhang ◽  
Meijun Li ◽  
Jason HY Wu ◽  
Linlin Mai ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
General Population ◽  
Confidence Interval ◽  
Absolute Risk ◽  
Meta Analysis ◽  
Atherosclerotic Cardiovascular Disease ◽  
Increased Risk ◽  
All Cause Mortality

Abstract Objective To evaluate the associations between prediabetes and the risk of all cause mortality and incident cardiovascular disease in the general population and in patients with a history of atherosclerotic cardiovascular disease. Design Updated meta-analysis. Data sources Electronic databases (PubMed, Embase, and Google Scholar) up to 25 April 2020. Review methods Prospective cohort studies or post hoc analysis of clinical trials were included for analysis if they reported adjusted relative risks, odds ratios, or hazard ratios of all cause mortality or cardiovascular disease for prediabetes compared with normoglycaemia. Data were extracted independently by two investigators. Random effects models were used to calculate the relative risks and 95% confidence intervals. The primary outcomes were all cause mortality and composite cardiovascular disease. The secondary outcomes were the risk of coronary heart disease and stroke. Results A total of 129 studies were included, involving 10 069 955 individuals for analysis. In the general population, prediabetes was associated with an increased risk of all cause mortality (relative risk 1.13, 95% confidence interval 1.10 to 1.17), composite cardiovascular disease (1.15, 1.11 to 1.18), coronary heart disease (1.16, 1.11 to 1.21), and stroke (1.14, 1.08 to 1.20) in a median follow-up time of 9.8 years. Compared with normoglycaemia, the absolute risk difference in prediabetes for all cause mortality, composite cardiovascular disease, coronary heart disease, and stroke was 7.36 (95% confidence interval 9.59 to 12.51), 8.75 (6.41 to 10.49), 6.59 (4.53 to 8.65), and 3.68 (2.10 to 5.26) per 10 000 person years, respectively. Impaired glucose tolerance carried a higher risk of all cause mortality, coronary heart disease, and stroke than impaired fasting glucose. In patients with atherosclerotic cardiovascular disease, prediabetes was associated with an increased risk of all cause mortality (relative risk 1.36, 95% confidence interval 1.21 to 1.54), composite cardiovascular disease (1.37, 1.23 to 1.53), and coronary heart disease (1.15, 1.02 to 1.29) in a median follow-up time of 3.2 years, but no difference was seen for the risk of stroke (1.05, 0.81 to 1.36). Compared with normoglycaemia, in patients with atherosclerotic cardiovascular disease, the absolute risk difference in prediabetes for all cause mortality, composite cardiovascular disease, coronary heart disease, and stroke was 66.19 (95% confidence interval 38.60 to 99.25), 189.77 (117.97 to 271.84), 40.62 (5.42 to 78.53), and 8.54 (32.43 to 61.45) per 10 000 person years, respectively. No significant heterogeneity was found for the risk of all outcomes seen for the different definitions of prediabetes in patients with atherosclerotic cardiovascular disease (all P>0.10). Conclusions Results indicated that prediabetes was associated with an increased risk of all cause mortality and cardiovascular disease in the general population and in patients with atherosclerotic cardiovascular disease. Screening and appropriate management of prediabetes might contribute to primary and secondary prevention of cardiovascular disease.

scholarly journals Role of lipoprotein(a) in the development of coronary heart disease in patients with essential hypertension

2003 ◽  
Vol 22 (4) ◽  
pp. 341-346 ◽  
Author(s):  
Zorica Caparevic ◽  
Nada Kostic ◽  
Sinisa Dimkovic ◽  
Branislava Brkic ◽  
Radojka Cvetkovic
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Essential Hypertension ◽  
Cardiovascular Risk ◽  
Hdl Cholesterol ◽  
Serum Samples ◽  
Hypertensive Patients ◽  
Lipoprotein A ◽  
Fresh Serum

Lipoprotein(a) [Lp(a)] is an important and independent cardiovascular risk factor, but its role in the development of coronary heart disease (CHD) in hypertensives have had conflicting results. In order to study the possible role of Lp(a) in the development of coronary heart disease in hypertensive patients, we evaluated Lp(a) levels in 45 (younger than 50 years) CHD hypertensive patients, 45 patients with essential hypertension with?out CHD and 64 healthy controls. Lp(a) was measured by nephelometric assays in fresh serum samples. The levels of Lp(a) were significantly greater in CHD hypertensive patients (0.33 ?0.17 g/L) than in controls (0.18 ? 0.08 g/L) or patients with essential hypertension (0.20 ? 0.05 g/L). The levels of Lp(a) were increased more than 0.30 g/L in 46.6% of CHD hypertensive patiens, in 17.7% of hypertensive patiens and in 8.8% of controls. CHD hypertensive patients had also greater levels of total cholesterol, LDL-cholesterol and triglycerides than hypertensive patients and controls. HDL-cholesterol levels were significantly lower in CHD hypertensive patients. This study indicates that high Lp(a) levels can play a major role in the development of CHD in patients with essential hypertension. These findings suggest the great importance of identifying, among hypertensive patients, subjects with higher levels of Lp(a), who belong to a group with cardiovascular risk on the basis of their hypertension.

Cardiovascular disease

2015 ◽  
Author(s):  
Derek W. Johnston
Keyword(s):  
Cardiovascular Disease ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Angina Pectoris ◽  
Stress Management ◽  
Primary Hypertension ◽  
Behavioural Medicine ◽  
Future Developments

Chapter 14 explores the role of behavioural medicine in the treatment of cardiovascular disease. It discusses stress management in the treatment of primary hypertension, coronary heart disease, and angina pectoris, along with rehabilitation, and future developments for research and treatment.

scholarly journals What explains the effect of education on cardiovascular disease? Applying Mendelian randomization to identify the consequences of education inequality

2018 ◽  
Author(s):  
Alice R Carter ◽  
Dipender Gill ◽  
Neil M Davies ◽  
Amy E Taylor ◽  
Taavi Tillmann ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Body Mass Index ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Systolic Blood Pressure ◽  
Body Mass ◽  
Mendelian Randomization

Key PointsQuestionWhat is the role of body mass index, systolic blood pressure and smoking in mediating the effect of education on cardiovascular disease risk?FindingWe find consistent evidence that body mass index, systolic blood pressure and smoking mediate the effect of education, explaining up to 18%, 27% and 33% respectively. Including all three risk factors in a model together explains around 40% of the effect of education.MeaningIntervening on body mass index, systolic blood pressure and smoking would lead to reductions in cases of CVD attributable to lower levels of education. Over half of the effect of education on risk of cardiovascular disease is not mediated through these risk factors.ImportanceLower levels of education are causally related to higher cardiovascular risk, but the extent to which this is driven by modifiable risk factors also associated with education is unknown.ObjectiveTo investigate the role of body mass index, systolic blood pressure and smoking in explaining the effect of education on risk of cardiovascular disease outcomes.DesignMultivariable regression analysis of observational data and Mendelian randomization (MR) analysis of genetic data.SettingUK Biobank and international genome-wide association study consortia.ParticipantsPredominantly individuals of European ancestry.Main outcomes and measuresThe effects of education (per 1-standard deviation increase, equivalent to 3.6 years) on coronary heart disease, cardiovascular disease (all subtypes), myocardial infarction and stroke risk (all measured in odds ratio, OR), and the degree to which this is mediated through body mass index, systolic blood pressure and smoking.ResultsEach additional standard deviation of education associated with 13% lower risk of coronary heart disease (OR 0.87, 95% confidence interval [CI] 0.84 to 0.89) in observational analysis and 37% lower risk (OR 0.63, 95% CI 0.60 to 0.67) in Mendelian randomization analysis. As a proportion of the total risk reduction, body mass index mediated 15% (95% CI 13% to 17%) and 18% (95% CI 14% to 23%) in the observational and Mendelian randomization estimates, respectively. Corresponding estimates for systolic blood pressure were 11% (95% CI 9% to 13%) and 21% (95% CI 15% to 27%), and for smoking, 19% (15% to 22%) and 33% (95% CI 17% to 49%). All three risk factors combined mediated 42% (95% CI 36% to 48%) and 36% (95 % CI 16% to 63%) of the effect of education on coronary heart disease in observational and Mendelian randomization respectively. Similar results were obtained when investigating risk of stroke, myocardial infarction and all-cause cardiovascular disease.Conclusions and relevanceBMI, SBP and smoking mediate a substantial proportion of the protective effect of education on risk of cardiovascular outcomes and intervening on these would lead to reductions in cases of CVD attributable to lower levels of education. However, more than half of the protective effect of education remains unexplained and requires further investigation.

THE ROLE OF LIPOPROTEIN (A) AND PREGNANCY ASSOCIATED PLASMA PROTEIN A IN DIAGNOSTICS CORONARY HEART DISEASE IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE

2020 ◽  
Vol 73 (11) ◽  
pp. 2489-2493
Author(s):  
Valentyna K. Sierkova ◽  
Valentyna О. Romanova ◽  
Anastasiia A. Lilevska ◽  
Olena O. Savytska
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Protein A ◽  
Clinical Manifestations ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Lipoprotein A ◽  
Chd Risk ◽  
Definition Of

The aim: To identify the significance of biomarkers characterizing the role of lipid disorders and the processes of destruction atherosclerotic plaque for the early diagnosis of CHD in patients with COPD. Materials and methods: There were examined 153 patients, men aged 40-70 years, including 53 patients with COPD, 56 with a combination of COPD and CHD and 44 patients with stable CHD. The level of LP (a) and PAPP-A in the serum was determined by ELISA. Results: There was increased level of LP (a) and PAPP-A in patients with CHD and with a combination of COPD and CHD. This increased level of LP (a) and PAPP-A was associated with the level of C-reactive protein. The mid level of LP (a) and PAPP-A in patients with COPD did not significantly differ from the reference values. Conclusions: The increase level of lipoprotein (a) more than 18 mg/dl in patients with COPD may be regarded as a predictor of the development of CHD. The level PAPP-A more than 5 mIU/L in plasma of patients with COPD makes it possible to isolate the groups for CHD risk. The definition of LP (a) and PAPP-A in patients with COPD may contribute to the early diagnostics of coronary heart disease in the absence of its pronounced clinical manifestations.

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