high cardiovascular risk
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Author(s):  
Chengappa Kavadichanda ◽  
K. C. Shanoj ◽  
Sachit Ganapathy ◽  
Sanket I. Shah ◽  
Ramesh Ananthakrishnan ◽  
...  

2022 ◽  
Vol 17 (4) ◽  
pp. 66-73
Author(s):  
O. V. Tsygankova ◽  
O. V. Timoshchenko ◽  
L. D. Latyntseva

Aim of the study was to evaluate the efficacy and safety of the combined use of statins with ezetimibe in patients of various nosological groups of high and very high cardiovascular risk. Material and methods. A prospective interventional non-randomized study included 40 people, mean age 60.7±9.5 years, high and very high cardiovascular risk, who did not receive statin therapy or took statins without reaching the target low density lipoprotein (LDL) cholesterol values. Patients were recommended to receive high-intensity statin therapy in combination with ezetimibe for 3 months. Biochemical parameters were determined by standard enzymatic methods and the beginning of combined lipid-correcting therapy and after 3 months. Results. In patients with high cardiovascular risk, the level of total cholesterol decreased by 39.7 % 3 months after treatment (6.8 ± 2.5 and 4.7 ± 2.5 mmol/L; p = 0.0001), the level of LDL cholesterol by 52.2 % (4.6 ± 2.4 and 2.8 ± 2.2 mmol/L; p = 0.0001), the TG level by 26 % (2.7 ± 1.1 and 2.0 ± 1.0 mmol/L; p = 0.008). In the group of patients with very high cardiovascular risk, we also noted a decrease in the total cholesterol level by 39.1 % (6.4 ± 1.4 and 4.4 ± 1.2 mmol/L; p = 0.0001), the level of LDL cholesterol by 45.5 % (4.4 ± 1.4 and 2.5 ± 0.9 mmol/L; p = 0.0001). We did not find statistically significant changes in the remaining lipid parameters. LDL cholesterol targets were achieved in 64 % of patients with high and 52 % of very high cardiovascular risk. There were no significant changes in activity of alanine and aspartate amino transferases, content creatine phosphokinase, glucose and glycated hemoglobin, glomerular filtration rate. Conclusions. Initial combination therapy with statin and ezetimibe is well tolerated and can reduce LDL cholesterol levels by 2 times within 3 months in various categories of patients with high and very high cardiovascular risk.


Diabetes Care ◽  
2022 ◽  
Author(s):  
Ahmed A. Kolkailah ◽  
Stephen D. Wiviott ◽  
Itamar Raz ◽  
Sabina A. Murphy ◽  
Ofri Mosenzon ◽  
...  

Author(s):  
G. S. Isayeva ◽  
O. O. Buryakovska ◽  
M. M. Vovchenko ◽  
I. R. Komir ◽  
N. Y. Emelyanova ◽  
...  

Objective — to study the relationship between the carriage of polymorphic variants PPARG2 (Pro12Ala), ADRB2 (Gln27Glu), ADRB2 (Agr16Gly), ADRB3 (Trp64Agr), FABP2 (Thr54Ala) and changes in anthropometric parameters under the influence of increased physical activity in individuals with high cardiovascular risk. Materials and methods. In total, 205 people were examined during the period of years 2019 — 2021. Patients were advised to use physical activity frequently in the form of regular exercises. Among patients who passed the 2nd observation point, 60.5 % (124 patients) reported that they expanded their physical activity, 39.5 % (81 patients) began regular exercises. The study included patients with high cardiovascular risk. The International Physical Activity Questionnaire (IPAQ) was used to assess physical activity. Assessments included anthropometric parameters (weight, height, body mass index, waist and hip circumference, body composition (Composition Monitor BF511, Omron, China, 2015)), levels of total cholesterol, triglycerides, low‑density lipoproteins. Muscle strength (kg/cm2) was assessed using an electric dynamometer on the wrist Camry EH101 2013 (2018). Isolation and purification of DNA from the whole blood was carried out using a set of reagents «DNA‑sorb‑B» (Amplisens, RF) according to the manufacturer’s instructions. Amplification of DNA and genotyping at polymorphic sites in the genes PPARG2, ADRB2, ADRB3, FABP2 was performed by real‑time PCR using a set of reagents «SNP‑EXPRESS‑SHOT» («Litech», RF) according to the manufacturer’s instructions using the product detection system real‑time CFX96 Touch (BioRad Laboratories Pte.Ltd.). Results. Depending on the changes in anthropometric parameters, patients were divided into 2 subgroups: in subgroup 1 there was no decrease in BMI before 30.69 ± 7.25 kg/m2, after 29.03 ± 6.84 kg/m2; p = 0.436, and in subgroup 2 a significant decrease in BMI before 31.85 ± 3.68 kg/m2, after 26.79 ± 3.91 kg/m2; p = 0.041. It was revealed that the decrease in BMI in subgroup 2 was accompanied by a statistically significant decrease in the proportion of adipose tissue (р = 0.011) and an increase the proportion of muscle tissue (р = 0.030). In both groups, blood pressure significantly decreased. Heart rate (HR) decreased in both groups, but these changes did not reach statistical significance (p = 0.43). Changes in anthropometric parameters were not accompanied by significant changes in total cholesterol, LDL cholesterol, triglycerides levels. A significant increase in HDL cholesterol levels was revealed. It was found that patients with CC and GG variants of the polymorphic locus PPARG2 (Pro12Ala), CG and GG variants of the polymorphic locus ADRB2 (Gln27Glu) and TT variant of the polymorphic locus ADRB3 (Trp64Agr) prevailed in group 2. No significant differences were found for the FABP2 locus (Thr54Ala). In subgroup 1, there were no significant differences in people with various polymorphic variants of genes. Conclusions. Associations have been established between the carriage of CG/CG + GG PPARG2 (rs1801282), AA/AA + AG ADRB2 (rs1042713) and TT ADRB3 (rs4994) and a decrease in body mass index during exercise expansion in individuals with high cardiovascular risk.  


2021 ◽  
Vol 12 ◽  
Author(s):  
Kristina R. Gopcevic ◽  
Eugenia Gkaliagkousi ◽  
János Nemcsik ◽  
Ömür Acet ◽  
M. Rosa Bernal-Lopez ◽  
...  

Impairment of the arteries is a product of sustained exposure to various deleterious factors and progresses with time; a phenomenon inherent to vascular aging. Oxidative stress, inflammation, the accumulation of harmful agents in high cardiovascular risk conditions, changes to the extracellular matrix, and/or alterations of the epigenetic modification of molecules, are all vital pathophysiological processes proven to contribute to vascular aging, and also lead to changes in levels of associated circulating molecules. Many of these molecules are consequently recognized as markers of vascular impairment and accelerated vascular aging in clinical and research settings, however, for these molecules to be classified as biomarkers of vascular aging, further criteria must be met. In this paper, we conducted a scoping literature review identifying thirty of the most important, and eight less important, biomarkers of vascular aging. Herein, we overview a selection of the most important molecules connected with the above-mentioned pathological conditions and study their usefulness as circulating biomarkers of vascular aging.


2021 ◽  
pp. 000486742110625
Author(s):  
Pao-Huan Chen ◽  
Cheng-Yi Hsiao ◽  
Shuo-Ju Chiang ◽  
Ruei-Siang Shen ◽  
Yen-Kuang Lin ◽  
...  

Objective: Over a half century, lithium has been used as the first-line medication to treat bipolar disorder. Emerging clinical and laboratory studies suggest that lithium may exhibit cardioprotective effects in addition to neuroprotective actions. Fractalkine (CX3CL1) is a unique chemokine associated with the pathogenesis of mood disorders and cardiovascular diseases. Herein we aimed to ascertain whether lithium treatment is associated with favorable cardiac structure and function in relation to the reduced CX3CL1 among patients with bipolar disorder. Methods: We recruited 100 euthymic patients with bipolar I disorder aged over 20 years to undergo echocardiographic study and measurement of plasma CX3CL1. Associations between lithium treatment, cardiac structure and function and peripheral CX3CL1 were analyzed according to the cardiovascular risk. The high cardiovascular risk was defined as (1) age ⩾ 45 years in men or ⩾ 55 years in women or (2) presence of concurrent cardiometabolic diseases. Results: In the high cardiovascular risk group ( n = 61), patients who received lithium as the maintenance treatment had significantly lower mean values of left ventricular internal diameters at end-diastole (Cohen’s d = 0.65, p = 0.001) and end-systole (Cohen’s d = 0.60, p = 0.004), higher mean values of mitral valve E/A ratio (Cohen’s d = 0.51, p = 0.019) and superior performance of global longitudinal strain (Cohen’s d = 0.51, p = 0.037) than those without lithium treatment. In addition, mean plasma levels of CX3CL1 in the high cardiovascular risk group were significantly lower among patients with lithium therapy compared with those without lithium treatment ( p = 0.029). Multiple regression models showed that the association between lithium treatment and mitral value E/A ratio was contributed by CX3CL1. Conclusion: Data from this largest sample size study of the association between lithium treatment and echocardiographic measures suggest that lithium may protect cardiac structure and function in patients with bipolar disorder. Reduction of CX3CL1 may mediate the cardioprotective effects of lithium.


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