What Causes Premature Coronary Artery Disease?
AbstractPurpose of ReviewThis review provides an overview of genetic and non-genetic causes of premature coronary artery disease (pCAD).Recent FindingspCAD refers to coronary artery disease (CAD) occurring before the age of 65 years in women and 55 years in men. Both genetic and non-genetic risk factors may contribute to the onset of pCAD. Recent advances in the genetic epidemiology of pCAD have revealed the importance of both monogenic and polygenic contributions to pCAD. Familial hypercholesterolemia (FH) is the most common monogenic disorder associated with atherosclerotic pCAD. However, clinical overreliance on mono...
Source: Current Atherosclerosis Reports - April 4, 2024 Category: Cardiology Source Type: research
Cardiovascular Effects of Stimulators of Soluble Guanylate Cyclase Administration: A Meta-analysis of Randomized Controlled Trials
AbstractPurpose of reviewHeart failure (HF) is one of the main causes of cardiovascular mortality in the western world. Despite great advances in treatment, recurrence and mortality rates remain high. Soluble guanylate cyclase is an enzyme which, by producing cGMP, is responsible for the effects of vasodilation, reduction of cardiac pre- and after-load and, therefore, the improvement of myocardial performance. Thus, a new therapeutic strategy is represented by the stimulators of soluble guanylate cyclase (sGCs). The aim of this meta-analysis was to analyze the effects deriving from the administration of sGCs, in subjects a...
Source: Current Atherosclerosis Reports - April 2, 2024 Category: Cardiology Source Type: research
Oral PCSK9 Inhibitors
AbstractPurpose of ReviewIn this review, we will discuss the data from early clinical studies of MK-0616 and summarize clinical trials of other oral proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors.Recent FindingsThe success of PCSK9 inhibition with monoclonal antibody injections has fueled the development of additional therapies targeting PCSK9, including oral formulations, the most advanced of which is MK-0616. MK-0616 is a novel, orally administered macrocyclic peptide that binds to PCSK9 and inhibits binding of PCSK9 to the LDL receptor, thereby decreasing plasma levels of LDL-C.SummaryClinical trial da...
Source: Current Atherosclerosis Reports - March 27, 2024 Category: Cardiology Source Type: research
Gene Editing for the Treatment of Hypercholesterolemia
AbstractPurpose of ReviewHere, we summarize the key findings from preclinical studies that tested the concept that editing of hepatic genes can lower plasma low-density lipoprotein (LDL)-cholesterol levels to subsequently reduce atherosclerotic cardiovascular disease risk.Recent FindingsSelective delivery of clustered regularly interspaced short palindromic repeats (CRISPR)/CRISPR-associated protein 9 (Cas9)-mediated gene editing tools targeting proprotein convertase subtilisin/kexin type 9 (PCSK9) to hepatocytes, i.e., through encapsulation into N-acetylgalactosamine-coupled lipid nanoparticles, is able to induce a stable...
Source: Current Atherosclerosis Reports - March 18, 2024 Category: Cardiology Source Type: research
The Role of Genetics in Advancing Cardiometabolic Drug Development
The objective of this review is to explore the role of genetics in cardiometabolic drug development. The declining costs of sequencing and the availability of large-scale genomic data have deepened our understanding of cardiometabolic diseases, revolutionizing drug discovery and development methodologies. We highlight four key areas in which genetics is empowering drug development for cardiometabolic disease: (1) identifying drug candidates, (2) anticipating drug target failures, (3) silencing and editing genes, and (4) enriching clinical trials.Recent FindingsIdentifying novel drug targets through genetic discovery studie...
Source: Current Atherosclerosis Reports - March 7, 2024 Category: Cardiology Source Type: research
Highlights of Cardiovascular Disease Prevention Studies Presented at the 2023 American Heart Association Scientific Sessions
AbstractPurpose of ReviewFocused review highlighting ten select studies presented at the 2023 American Heart Association (AHA) Scientific Sessions.Recent FindingsIncluded studies assessed semaglutide and cardiovascular outcomes in overweight or obese patients without diabetes (SELECT); dapagliflozin in patients with acute myocardial infarction without diabetes (DAPA-MI); effects of dietary sodium on systolic blood pressure in middle-aged individuals (CARDIA-SSBP); long-term blood pressure control after hypertensive pregnancy with physician guided self-management (POP-HT); effect and safety of zilebesiran, an RNA interferen...
Source: Current Atherosclerosis Reports - March 5, 2024 Category: Cardiology Source Type: research
European Lipid Guidelines and Cardiovascular Risk Estimation: Current Status and Future Challenges
AbstractPurpose of ReviewGenetic, experimental, epidemiologic, and clinical data support the causal role of elevated levels of low-density lipoprotein cholesterol (LDL-C) in atherosclerosis and cardiovascular disease (CVD). The recommendations of the 2019 European guidelines are based on the concept of differential CV risk, which in turn defines the LDL-C goals that should be achieved.Recent FindingsThe 2019 ESC/EAS guidelines for dyslipidaemia use the Systematic COronary Risk Evaluation (SCORE) model to assess CV risk, which provides a 10-year risk of fatal CV event. The SCORE model has recently been updated to reflect cu...
Source: Current Atherosclerosis Reports - March 2, 2024 Category: Cardiology Source Type: research
Implications of Bias in Artificial Intelligence: Considerations for Cardiovascular Imaging
AbstractPurpose of ReviewBias in artificial intelligence (AI) models can result in unintended consequences. In cardiovascular imaging, biased AI models used in clinical practice can negatively affect patient outcomes. Biased AI models result from decisions made when training and evaluating a model. This paper is a comprehensive guide for AI development teams to understand assumptions in datasets and chosen metrics for outcome/ground truth, and how this translates to real-world performance for cardiovascular disease (CVD).Recent FindingsCVDs are the number one cause of mortality worldwide; however, the prevalence, burden, a...
Source: Current Atherosclerosis Reports - February 16, 2024 Category: Cardiology Source Type: research
Novel Therapies for Lipoprotein(a): Update in Cardiovascular Risk Estimation and Treatment
AbstractPurpose of ReviewLipoprotein(a) is an important causal risk factor for cardiovascular disease but currently no available medication effectively reduces lipoprotein(a). This review discusses recent findings regarding lipoprotein(a) as a causal risk factor and therapeutic target in cardiovascular disease, it reviews current clinical recommendations, and summarizes new lipoprotein(a) lowering drugs.Recent FindingsEpidemiological and genetic studies have established lipoprotein(a) as a causal risk factor for cardiovascular disease and mortality. Guidelines worldwide now recommend lipoprotein(a) to be measured once in a...
Source: Current Atherosclerosis Reports - February 5, 2024 Category: Cardiology Source Type: research
How Will Our Practice Change After the CLEAR Outcomes Trial?
AbstractPurpose of ReviewBempedoic acid is a novel therapeutic agent that is designed to reduce levels of low-density lipoprotein cholesterol (LDL-C). The purpose of this review is to provide the background for development of bempedoic acid, findings from clinical trials and to discuss clinical implications.Recent FindingsBempedoic acid inhibits ATP citrate lyase within the liver and reduces cholesterol synthesis, with the potential to avoid muscle symptoms experienced by patients treated with statins. Early clinical studies demonstrated that administration of bempedoic acid resulted in lowering of LDL-C by 20 –30% as mo...
Source: Current Atherosclerosis Reports - January 31, 2024 Category: Cardiology Source Type: research
Increased Cardiovascular Risk in Young Patients with CKD and the Role of Lipid-Lowering Therapy
AbstractPurpose of ReviewChronic kidney disease (CKD) is associated with a significantly increased risk of cardiovascular disease (CVD). This review summarizes known risk factors, pathophysiological mechanisms, and current therapeutic possibilities, focusing on lipid-lowering therapy in CKD.Recent FindingsNovel data on lipid-lowering therapy in CKD mainly stem from clinical trials and clinical studies.SummaryIn addition to traditional CVD risk factors, patients with CKD often present with non-traditional risk factors that include, e.g., anemia, proteinuria, or calcium-phosphate imbalance. Dyslipidemia remains an important ...
Source: Current Atherosclerosis Reports - January 30, 2024 Category: Cardiology Source Type: research
Lipoprotein(a): from Causality to Treatment
AbstractPurpose of ReviewThis paper reviews the evidence why lipoprotein(a) (Lp(a)) is a causal risk factor for cardiovascular disease and how high Lp(a) concentrations should be managed now and with an outlook to the future.Review FindingsNo optimal and widely available animal models exist to study the causality of the association between Lp(a) and cardiovascular disease. This has been a major handicap for the entire field. However, genetic studies turned the page. Already in the early 1990s, the principle of Mendelian randomization studies was applied for the first time ever (even if they were not named so at that time)....
Source: Current Atherosclerosis Reports - January 22, 2024 Category: Cardiology Source Type: research
Correction to: Whether and Why Do We Need a Vaccine Against Atherosclerosis? Can We Expect It Anytime Soon?
(Source: Current Atherosclerosis Reports)
Source: Current Atherosclerosis Reports - January 22, 2024 Category: Cardiology Source Type: research
Psychological Health and Ischemic Heart Disease in Women: A Review of Current Evidence and Clinical Considerations across the Healthspan
AbstractPurpose of ReviewPsychological health encompasses a constellation of negative and positive factors —i.e., psychosocial stress, depression, anxiety, trauma, loneliness and social isolation, anger and hostility, optimism, and a sense of purpose. This narrative review presents current evidence at the intersection of psychological health, risk of ischemic heart disease (IHD), and IHD-related outcom es, with an emphasis on associations in women.Recent FindingsFor women, relations between psychological health and IHD reflect important sex and gender differences in biological and psychosocial factors. Although efforts d...
Source: Current Atherosclerosis Reports - January 19, 2024 Category: Cardiology Source Type: research
Targeting the Gut Microbiome to Treat Cardiometabolic Disease
AbstractPurpose of ReviewCardiometabolic diseases, which include obesity, type 2 diabetes, and cardiovascular diseases, constitute a worldwide health crisis of unparalleled proportions. The human gut microbiota has emerged as a prominent topic of inquiry in the search for novel treatment techniques. This review summarizes current research on the potential of addressing the gut microbiota to treat cardiometabolic disease.Recent FindingsRecent studies have highlighted a complex link between the gut microbiota and host physiology, shedding light on the several processes through which gut microorganisms impact metabolic health...
Source: Current Atherosclerosis Reports - January 5, 2024 Category: Cardiology Source Type: research
