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Koba S, Satoh N, Ito Y, Yokota Y, Tsunoda F, Sakai K, Nakamura Y, Shoji M, Hirano T, Shinke T. Impact of Direct Measurement of Small Dense Low-Density Lipoprotein Cholesterol for Long-Term Secondary Prevention in Patients with Stable Coronary Artery Disease. Clin Chem 2024:hvae061. [PMID: 38757272 DOI: 10.1093/clinchem/hvae061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 03/25/2024] [Indexed: 05/18/2024]
Abstract
BACKGROUND This study investigated whether directly measured small dense low-density lipoprotein cholesterol (D-sdLDL-C) can predict long-term coronary artery disease (CAD) events compared with low-density lipoprotein cholesterol (LDL-C), non-high-density lipoprotein cholesterol (non-HDL-C), apolipoprotein B (apoB), and estimated small dense low-density lipoprotein cholesterol (E-sdLDL-C) determined by the Sampson equation in patients with stable CAD. METHODS D-sdLDL-C measured at Showa University between 2010 and 2022, and E-sdLDL-C were evaluated in 790 male and 244 female patients with stable CAD. CAD events, defined as sudden cardiac death, onset of acute coronary syndrome, and/or need for coronary revascularization, were monitored for 12 years. Cutoff lipid levels were determined by receiver operating characteristic curves. RESULTS CAD events were observed in 238 male and 67 female patients. The Kaplan-Meier event-free survival curves showed that patients with D-sdLDL-C ≥32.1 mg/dL (0.83 mmol/L) had an increased risk for CAD events (P = 0.007), whereas risk in patients with E-sdLDL-C ≥36.2 mg/dL (0.94 mmol/L) was not increased. In the group with high D-sdLDL-C, the multivariable-adjusted hazard ratio (HR) was 1.47 (95% CI, 1.15-1.89), and it remained significant after adjustment for LDL-C, non-HDL-C, or apoB and in patients treated with statins. HRs for high LDL-C, non-HDL-C, or apoB were not statistically significant after adjustment for high D-sdLDL-C. Higher D-sdLDL-C was associated with enhanced risk of high LDL-C, non-HDL-C, and apoB (HR 1.73; 95% CI, 1.27-2.37). CONCLUSIONS Higher D-sdLDL-C can predict long-term recurrence of CAD in stable CAD patients independently of apoB and non-HDL-C. D-sdLDL-C is an independent risk enhancer for secondary CAD prevention, whereas E-sdLDL-C is not. UMIN-CTR Clinical Trial Number: UMIN000027504.
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Affiliation(s)
- Shinji Koba
- Department of General Medicine, Showa University Graduate School of Dentistry, Tokyo, Japan
- Department of Medicine, Division of Cardiology, Showa University Graduate School of Medicine, Tokyo, Japan
| | - Noriyuki Satoh
- Clinical Diagnostics Development Department, Denka Co. Ltd, Tokyo, Japan
| | - Yasuki Ito
- Clinical Diagnostics Development Department, Denka Co. Ltd, Tokyo, Japan
| | - Yuya Yokota
- Department of Medicine, Division of Cardiology, Showa University Graduate School of Medicine, Tokyo, Japan
| | - Fumiyoshi Tsunoda
- Department of Medicine, Division of Cardiology, Showa University Graduate School of Medicine, Tokyo, Japan
| | - Koshiro Sakai
- Department of Medicine, Division of Cardiology, Showa University Graduate School of Medicine, Tokyo, Japan
| | - Yuya Nakamura
- Department of Medicine, Division of Cardiology, Showa University Graduate School of Medicine, Tokyo, Japan
| | - Makoto Shoji
- Department of Medicine, Division of Cardiology, Showa University Graduate School of Medicine, Tokyo, Japan
| | - Tsutomu Hirano
- Diabetes Center, Ebina General Hospital, Kanagawa, Japan
| | - Toshiro Shinke
- Department of Medicine, Division of Cardiology, Showa University Graduate School of Medicine, Tokyo, Japan
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Yamaji T, Harada T, Kajikawa M, Maruhashi T, Kishimoto S, Yusoff FM, Chayama K, Goto C, Nakashima A, Tomiyama H, Takase B, Kohro T, Suzuki T, Ishizu T, Ueda S, Yamazaki T, Furumoto T, Kario K, Inoue T, Watanabe K, Takemoto Y, Hano T, Sata M, Ishibashi Y, Node K, Maemura K, Ohya Y, Furukawa T, Ito H, Yamashina A, Koba S, Higashi Y. Role of Small Dense Low-density Lipoprotein Cholesterol in Cardiovascular Events in Patients with Coronary Artery Disease and Type 2 Diabetes Mellitus Receiving Statin Treatment. J Atheroscler Thromb 2024; 31:478-500. [PMID: 37926523 PMCID: PMC10999715 DOI: 10.5551/jat.64416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Accepted: 09/26/2023] [Indexed: 11/07/2023] Open
Abstract
AIM There is little information on the relationships of serum small dense low-density lipoprotein cholesterol (sdLDL-C) levels and serum triglyceride (TG) levels with cardiovascular events in patients with coronary artery disease (CAD) and type 2 diabetes mellitus (DM) who are receiving statins. The aim of this study was to evaluate the relationships of serum TG levels and sdLDL-C levels as residual risks for cardiovascular events in patients with CAD and type 2 DM who were being treated with statins. METHODS The subjects were divided into four groups based on TG levels and sdLDL-C levels: sdLDL-C of <40.0 mg/dL and TG of <150 mg/dL, sdLDL-C of ≥ 40.0 mg/dL and TG of <150 mg/dL, sdLDL-C of <40.0 mg/dL and TG of ≥ 150 mg/dL, and sdLDL-C of ≥ 40.0 mg/dL and TG of ≥ 150 mg/dL. During a median follow-up period of 1419 days, cardiovascular events occurred in 34 patients. RESULTS The incidences of cardiovascular events were significantly higher in patients with sdLDL-C of ≥ 40.0 mg/dL and TG of <150 mg/dL and in patients with sdLDL-C of ≥ 40.0 mg/dL and TG of ≥ 150 mg/dL, but not in patients with sdLDL-C of <40.0 mg/dL and TG of ≥ 150 mg/dL, than in patients with sdLDL-C of <40.0 mg/dL and TG of <150 mg/dL. CONCLUSIONS Under the condition of treatment with statins, patients with CAD and type 2 DM who had sdLDL-C levels of ≥ 40.0 mg/dL had a high risk for cardiovascular events even though serum TG levels were controlled at <150 mg/dL.
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Affiliation(s)
- Takayuki Yamaji
- Department of Cardiovascular Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Takahiro Harada
- Department of Cardiovascular Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Masato Kajikawa
- Division of Regeneration and Medicine, Medical Center for Translational and Clinical Research, Hiroshima University Hospital, Hiroshima, Japan
| | - Tatsuya Maruhashi
- Department of Cardiovascular Regeneration and Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
| | - Shinji Kishimoto
- Department of Cardiovascular Regeneration and Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
| | - Farina Mohamad Yusoff
- Department of Cardiovascular Regeneration and Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
| | - Kazuaki Chayama
- Department of Gastroenterology and Metabolism, Institute of Biomedical and Health Sciences, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Chikara Goto
- Department of Physical Therapy, Hiroshima International University, Hiroshima, Japan
| | - Ayumu Nakashima
- Division of Regeneration and Medicine, Medical Center for Translational and Clinical Research, Hiroshima University Hospital, Hiroshima, Japan
| | | | - Bonpei Takase
- Division of Biomedical Engineering, National Defense Medical College Research Institute, Tokorozawa, Japan
| | - Takahide Kohro
- Department of Clinical Informatics, Jichi Medical University School of Medicine, Tochigi, Japan
| | - Toru Suzuki
- Cardiovascular Medicine, University of Leicester, Leicester, UK
| | - Tomoko Ishizu
- Cardiovascular Division, Institute of Clinical Medicine, University of Tsukuba, Ibaraki, Japan
| | - Shinichiro Ueda
- Department of Clinical Pharmacology and Therapeutics, University of the Ryukyu School of Medicine, Okinawa, Japan
| | - Tsutomu Yamazaki
- Department of Clinical Epidemiology and Systems, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Tomoo Furumoto
- Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine, Hokkaido, Japan
| | - Kazuomi Kario
- Division of Cardiovascular Medicine, Jichi Medical University School of Medicine, Tochigi, Japan
| | - Teruo Inoue
- Department of Cardiovascular Medicine, Dokkyo Medical University, Mibu, Tochigi, Japan
| | - Kentaro Watanabe
- Department of Neurology, Hematology, Metabolism, Endocrinology and Diabetelogy (DNHMED), Yamagata University School of Medicine, Yamagata, Japan
| | - Yasuhiko Takemoto
- Department of Internal Medicine and Cardiology, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Takuzo Hano
- Department of Medical Education and Population-based Medicine, Postgraduate School of Medicine, Wakayama Medical University, Wakayama, Japan
| | - Masataka Sata
- Department of Cardiovascular Medicine, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima, Japan
| | - Yutaka Ishibashi
- Department of General Medicine, Shimane University Faculty of Medicine, Izumo, Japan
| | - Koichi Node
- Department of Cardiovascular and Renal Medicine, Saga University, Saga, Japan
| | - Koji Maemura
- Department of Cardiovascular Medicine, Course of Medical and Dental Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Yusuke Ohya
- The Third Department of Internal Medicine, University of the Ryukyus, Okinawa, Japan
| | - Taiji Furukawa
- Department of Internal Medicine, Teikyo University School of Medicine, Tokyo, Japan
| | - Hiroshi Ito
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Japan
| | - Akira Yamashina
- Department of Cardiology, Tokyo Medical University, Tokyo, Japan
| | - Shinji Koba
- Department of Medicine, Division of Cardiology, Showa University School of Medicine, Tokyo, Japan
| | - Yukihito Higashi
- Division of Regeneration and Medicine, Medical Center for Translational and Clinical Research, Hiroshima University Hospital, Hiroshima, Japan
- Department of Cardiovascular Regeneration and Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
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Huang H, Xie J, Hou L, Miao M, Xu L, Xu C. Estimated small dense low-density lipoprotein cholesterol and nonalcoholic fatty liver disease in nonobese populations. J Diabetes Investig 2024; 15:491-499. [PMID: 38108613 PMCID: PMC10981148 DOI: 10.1111/jdi.14133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 11/29/2023] [Accepted: 12/05/2023] [Indexed: 12/19/2023] Open
Abstract
AIMS/INTRODUCTION To explore the association between estimated small dense low-density lipoprotein cholesterol (sdLDL-C) and the risk of incident nonalcoholic fatty liver disease (NAFLD) in nonobese populations. MATERIALS AND METHODS This study included participants who underwent health checkups in 2014 and were followed up until 2019. We carried out Cox proportional hazards regression analyses to evaluate the association of estimated sdLDL-C with NAFLD. Discordance analyses were carried out to estimate the relative NAFLD risk in estimated sdLDL-C versus low-density lipoprotein cholesterol (LDL-C) discordant/concordant groups. Estimated sdLDL-C was calculated by equations based on LDL-C and triglycerides. The diagnosis of NAFLD was based on the presence of abdominal ultrasonography after excluding other causes of chronic liver disease. RESULTS Over a mean follow-up period of 26,694 person-years, 844 incident NAFLD cases were recorded. Compared with the first quartile of estimated sdLDL-C, the fourth quartile was associated with a 2.933-fold increased risk of NAFLD (95% confidence interval 2.095-4.107). With the increase in estimated sdLDL-C, the risk of NAFLD gradually increased both in participants within the normal range of LDL-C (hazard ratio 2.854, 95% confidence interval 1.650-5.617) and beyond the normal range of LDL-C (hazard ratio 2.636, 95% confidence interval 1.263-5.502). In addition, the inconsistent high estimated sdLDL-C/low LDL-C group was associated with an increased risk of NAFLD, but not the low estimated sdLDL-C/high LDL-C group. CONCLUSIONS Estimated sdLDL-C was positively associated with the risk of incident NAFLD in a nonobese population, independent of LDL-C.
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Affiliation(s)
- Hangkai Huang
- Department of Gastroenterology, Zhejiang Provincial Clinical Research Center for Digestive Diseases, The First Affiliated HospitalZhejiang University School of MedicineHangzhouChina
| | - Jiarong Xie
- Department of Gastroenterology, Zhejiang Provincial Clinical Research Center for Digestive Diseases, The First Affiliated HospitalZhejiang University School of MedicineHangzhouChina
- Department of GastroenterologyZhejiang University Ningbo HospitalNingboChina
| | - Linxiao Hou
- Department of Gastroenterology, Zhejiang Provincial Clinical Research Center for Digestive Diseases, The First Affiliated HospitalZhejiang University School of MedicineHangzhouChina
| | - Min Miao
- Department of Internal MedicineZhenhai Lianhua HospitalNingboChina
| | - Lei Xu
- Department of GastroenterologyZhejiang University Ningbo HospitalNingboChina
| | - Chengfu Xu
- Department of Gastroenterology, Zhejiang Provincial Clinical Research Center for Digestive Diseases, The First Affiliated HospitalZhejiang University School of MedicineHangzhouChina
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Liu T, Zhao D, Wang M, Sun J, Liu J, Li J, Duan Y, Sun Z, Hu P, Liu J, Qi Y. Association between Intermediate-Density Lipoprotein Particles and the Progression of Carotid Atherosclerosis: A Community-Based Cohort Study. J Atheroscler Thromb 2023; 30:1644-1660. [PMID: 37045783 PMCID: PMC10627743 DOI: 10.5551/jat.63937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 02/27/2023] [Indexed: 04/14/2023] Open
Abstract
AIM Experimental studies report that intermediate-density lipoprotein (IDL), the precursor of low-density lipoprotein, promotes atherosclerotic plaque formation. However, whether IDL is involved in the development of atherosclerosis in humans is still unclear. The aim of this community-based study is to examine the association between IDL particle (IDL-P) concentrations and the 5-year progression of carotid atherosclerosis. METHODS Baseline IDL-P concentrations were measured using nuclear magnetic resonance spectroscopy in 927 participants aged 45-74 years with no history of cardiovascular disease (CVD) at baseline. To estimate the association between baseline IDL-P concentrations and 5-year progression of carotid atherosclerosis, indicated by atherosclerotic plaque progression and changes in total plaque area (TPA), multivariable-adjusted regression was employed. RESULTS During the 5-year follow-up period, 45.8% of participants developed new plaques. Baseline IDL-P concentrations were significantly associated with the progression of carotid atherosclerosis. Participants in the highest quartile of IDL-P concentrations exhibited 1.36-fold (95% confidence interval [CI]: 1.09-1.68) increased progression of carotid plaque and 1.67-fold (95% CI: 1.04-2.69) higher TPA than those in the lowest quartile. These relationships were independent of baseline concentrations of low-density lipoprotein particles and very-low-density lipoprotein particles and their subclasses. CONCLUSIONS Elevated IDL-P concentrations were independently associated with the progression of carotid atherosclerosis, suggesting that IDL-P is a novel risk factor for the development of atherosclerosis.
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Affiliation(s)
- Tianxiao Liu
- Center for Clinical and Epidemiological Research, Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart,
Lung and Blood Vessel Diseases, The Key Laboratory of Remodeling-Related Cardiovascular Diseases, Ministry of Education,
Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Dong Zhao
- Center for Clinical and Epidemiological Research, Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart,
Lung and Blood Vessel Diseases, The Key Laboratory of Remodeling-Related Cardiovascular Diseases, Ministry of Education,
Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Miao Wang
- Center for Clinical and Epidemiological Research, Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart,
Lung and Blood Vessel Diseases, The Key Laboratory of Remodeling-Related Cardiovascular Diseases, Ministry of Education,
Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Jiayi Sun
- Center for Clinical and Epidemiological Research, Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart,
Lung and Blood Vessel Diseases, The Key Laboratory of Remodeling-Related Cardiovascular Diseases, Ministry of Education,
Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Jun Liu
- Center for Clinical and Epidemiological Research, Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart,
Lung and Blood Vessel Diseases, The Key Laboratory of Remodeling-Related Cardiovascular Diseases, Ministry of Education,
Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Jiangtao Li
- Center for Clinical and Epidemiological Research, Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart,
Lung and Blood Vessel Diseases, The Key Laboratory of Remodeling-Related Cardiovascular Diseases, Ministry of Education,
Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Youling Duan
- Center for Clinical and Epidemiological Research, Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart,
Lung and Blood Vessel Diseases, The Key Laboratory of Remodeling-Related Cardiovascular Diseases, Ministry of Education,
Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Zhaoqing Sun
- Center for Clinical and Epidemiological Research, Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart,
Lung and Blood Vessel Diseases, The Key Laboratory of Remodeling-Related Cardiovascular Diseases, Ministry of Education,
Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Piaopiao Hu
- Center for Clinical and Epidemiological Research, Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart,
Lung and Blood Vessel Diseases, The Key Laboratory of Remodeling-Related Cardiovascular Diseases, Ministry of Education,
Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Jing Liu
- Center for Clinical and Epidemiological Research, Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart,
Lung and Blood Vessel Diseases, The Key Laboratory of Remodeling-Related Cardiovascular Diseases, Ministry of Education,
Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Yue Qi
- Center for Clinical and Epidemiological Research, Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart,
Lung and Blood Vessel Diseases, The Key Laboratory of Remodeling-Related Cardiovascular Diseases, Ministry of Education,
Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
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Vekic J, Stromsnes K, Mazzalai S, Zeljkovic A, Rizzo M, Gambini J. Oxidative Stress, Atherogenic Dyslipidemia, and Cardiovascular Risk. Biomedicines 2023; 11:2897. [PMID: 38001900 PMCID: PMC10669174 DOI: 10.3390/biomedicines11112897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 10/20/2023] [Accepted: 10/23/2023] [Indexed: 11/26/2023] Open
Abstract
Oxidative stress is the consequence of an overproduction of reactive oxygen species (ROS) that exceeds the antioxidant defense mechanisms. Increased levels of ROS contribute to the development of cardiovascular disorders through oxidative damage to macromolecules, particularly by oxidation of plasma lipoproteins. One of the most prominent features of atherogenic dyslipidemia is plasma accumulation of small dense LDL (sdLDL) particles, characterized by an increased susceptibility to oxidation. Indeed, a considerable and diverse body of evidence from animal models and epidemiological studies was generated supporting oxidative modification of sdLDL particles as the earliest event in atherogenesis. Lipid peroxidation of LDL particles results in the formation of various bioactive species that contribute to the atherosclerotic process through different pathophysiological mechanisms, including foam cell formation, direct detrimental effects, and receptor-mediated activation of pro-inflammatory signaling pathways. In this paper, we will discuss recent data on the pathophysiological role of oxidative stress and atherogenic dyslipidemia and their interplay in the development of atherosclerosis. In addition, a special focus will be placed on the clinical applicability of novel, promising biomarkers of these processes.
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Affiliation(s)
- Jelena Vekic
- Department of Medical Biochemistry, University of Belgrade-Faculty of Pharmacy, 11000 Belgrade, Serbia; (J.V.); (A.Z.)
| | - Kristine Stromsnes
- Department of Physiology, Faculty of Medicine, University of Valencia, 46010 Valencia, Spain; (K.S.); (S.M.); (J.G.)
| | - Stefania Mazzalai
- Department of Physiology, Faculty of Medicine, University of Valencia, 46010 Valencia, Spain; (K.S.); (S.M.); (J.G.)
| | - Aleksandra Zeljkovic
- Department of Medical Biochemistry, University of Belgrade-Faculty of Pharmacy, 11000 Belgrade, Serbia; (J.V.); (A.Z.)
| | - Manfredi Rizzo
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, 90100 Palermo, Italy
| | - Juan Gambini
- Department of Physiology, Faculty of Medicine, University of Valencia, 46010 Valencia, Spain; (K.S.); (S.M.); (J.G.)
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Mitsutake Y, Ishii J, Fukumoto Y, Ito S, Kashiwabara K, Uemura K, Matsuyama Y, Sugiyama Y, Ozaki Y, Iimuro S, Iwata H, Sakuma I, Nakagawa Y, Hibi K, Hiro T, Hokimoto S, Miyauchi K, Daida H, Shimokawa H, Saito Y, Kimura T, Matsuzaki M, Nagai R. Differential prediction of high-sensitivity cardiac troponin-I, but not N-terminal pro-brain natriuretic peptide, in different pitavastatin doses on cardiovascular events in stable coronary artery disease. Int J Cardiol 2023; 387:131138. [PMID: 37355235 DOI: 10.1016/j.ijcard.2023.131138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 05/16/2023] [Accepted: 06/20/2023] [Indexed: 06/26/2023]
Abstract
BACKGROUND This study aimed to examine whether high-sensitivity cardiac troponin-I (hsTnI) and N-terminal pro-brain natriuretic peptide (NT-proBNP) could predict future major adverse cardiovascular events (MACE) in stable coronary artery disease (CAD) patients with high- or low-dose of pitavastatin. METHODS This was a case-cohort analysis of the REAL-CAD study, a randomized trial of high- or low-dose (4 or 1 mg/day) pitavastatin therapy in patients with stable CAD. We examined the MACE risk according to the quartile of hsTnI and NT-proBNP at baseline. RESULTS A total of 1336 and 1396 patients including 582 MACE cases were randomly examined into the hsTnI and NT-proBNP cohort, respectively. Both higher levels of hsTnI and NT-proBNP at baseline were significantly associated with increased risk of MACE (p < 0.001, respectively). When separately analyzed in statin dose, the higher marker levels were significantly associated with higher MACE risk in all cohorts (p < 0.001 in all cohorts). After multivariable adjustment, hsTnI levels were significantly associated with MACE risk in low-dose statin group (HR 2.54, p = 0.0001); however, in high-dose pitavastatin therapy, a significant association was diminished in MACE risk among the quartiles of baseline hsTnI levels (p = 0.154). Conversely in the NT-proBNP cohort, the association between NT-proBNP levels and MACE risk was constantly observed regardless of pitavastatin dose even after multivariable adjustment (both p < 0.0001). CONCLUSIONS Patients with high hsTnI levels had high risk of MACE in low-dose statin group, but not in high-dose, suggesting that high-dose statin treatment might decrease MACE risk in stable CAD patients with high hsTnI levels.
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Affiliation(s)
- Yoshiaki Mitsutake
- Division of Cardiovascular Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Junnichi Ishii
- Department of Cardiology, Fujita Health University School of Medicine, Toyoake, Japan; Toyota Auto Body Yoshiwara Clinic, Toyota, Japan
| | - Yoshihiro Fukumoto
- Division of Cardiovascular Medicine, Kurume University School of Medicine, Kurume, Japan.
| | - Sohei Ito
- Division of Cardiovascular Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Kosuke Kashiwabara
- Data Science Office, Clinical Research Promotion Center, The University of Tokyo Hospital, Tokyo, Japan
| | - Kouhei Uemura
- Data Science Office, Clinical Research Promotion Center, The University of Tokyo Hospital, Tokyo, Japan
| | - Yutaka Matsuyama
- Data Science Office, Clinical Research Promotion Center, The University of Tokyo Hospital, Tokyo, Japan
| | - Yoichi Sugiyama
- Division of Cardiovascular Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Yukio Ozaki
- Department of Cardiology, Fujita Health University School of Medicine, Toyoake, Japan
| | - Satoshi Iimuro
- Innovation and Research Support Center, International University of Health and Welfare, Tokyo, Japan
| | - Hiroshi Iwata
- Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Ichiro Sakuma
- Caress Sapporo Hokko Memorial Clinic, Sapporo, Japan
| | - Yoshihisa Nakagawa
- Department of Cardiovascular Medicine, Shiga University of Medical Science, Otsu, Japan
| | - Kiyoshi Hibi
- Division of Cardiology, Yokohama City University Medical Center, Yokohama, Japan
| | - Takafumi Hiro
- Division of Cardiology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan
| | | | - Katsumi Miyauchi
- Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Hiroyuki Daida
- Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | | | | | - Takeshi Kimura
- Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
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Dai R, Zhao X, Zhuo H, Wang W, Xu Y, Hu Z, Zhang T, Zhao J. CYP2C19 metabolizer phenotypes may affect the efficacy of statins on lowering small dense low-density lipoprotein cholesterol of patients with coronary artery disease. Front Cardiovasc Med 2022; 9:1016126. [PMID: 36601065 PMCID: PMC9806256 DOI: 10.3389/fcvm.2022.1016126] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 11/21/2022] [Indexed: 12/23/2022] Open
Abstract
Background Dyslipidemia is a major cause of arteriosclerotic cardiovascular disease (ASCVD), and low-density lipoprotein cholesterol (LDL-C) is the profile to be reduced to prevent disease progression. Small dense low-density lipoprotein cholesterol (sdLDL-C) has been proven to be a more effective biomarker than LDL-C for ASCVD primary and secondary prevention. CYP2C19 is an important drug metabolism gene. This study aimed to investigate the relationship between sdLDL-C and coronary artery disease (CAD) risk factors and explore the influence of CYP2C19 metabolizer phenotypes on the sdLDL-C lowering efficacy of statins. Methods This study recruited 182 patients with CAD and 200 non-CAD controls. Baseline laboratory indices of fasting blood were detected, including blood lipids, glucose, and creatinine. In addition, LDL-C subfractions were separated and quantified. Gene polymorphisms of SLCO1B1 and CYP2C19 were detected in patients with CAD. The LDL-C subfractions levels of patients with CAD were followed up after statin drug treatment. Results Total cholesterol, LDL-C, LDLC-2, LDLC-3, LDLC-4, LDLC-5, LDLC-6, LDLC-7, and sdLDL-C levels of patients with CAD were significantly higher than those in non-CAD controls. Meanwhile, sdLDL-C (AUC = 0.838) and LDLC-4 (AUC = 0.835) performed outstandingly in distinguishing patients with CAD from controls. Based on CYP2C19 metabolizer phenotypes, 113 patients with CAD were divided into the extensive metabolizer (EM, n = 49), intermediate metabolizer (IM, n = 52), and poor metabolizer (PM, n = 12) groups. The patients with IM and PM metabolizer phenotypes had better sdLDL-C lowering efficacy after taking statin drugs than patients with EM phenotype (P = 0.0268, FDR = 0.0536). The SLCO1B1 genotype had no significant impact on the efficacy of statins (P = 0.1611, FDR = 0.1611). Conclusion sdLDL-C and LDLC-4 outperformed other blood lipids such as LDL-C for CAD risk screening. CYP2C19 metabolizer phenotypes had the potential to predict the efficacy of statins in lowering sdLDL-C.
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Affiliation(s)
- Ruozhu Dai
- Department of Cardiology, Quanzhou First Hospital Afliated to Fujian Medical University, Quanzhou, Fujian, China
| | - Xiaoyu Zhao
- Shanghai Biotecan Pharmaceuticals Co., Ltd., Shanghai Zhangjiang Institute of Medical Innovation, Shanghai, China
| | - Huilin Zhuo
- Department of Cardiology, Quanzhou First Hospital Afliated to Fujian Medical University, Quanzhou, Fujian, China
| | - Wei Wang
- Department of Cardiology, Quanzhou First Hospital Afliated to Fujian Medical University, Quanzhou, Fujian, China
| | - Yue Xu
- Shanghai Biotecan Pharmaceuticals Co., Ltd., Shanghai Zhangjiang Institute of Medical Innovation, Shanghai, China
| | - Zixin Hu
- Shanghai Biotecan Pharmaceuticals Co., Ltd., Shanghai Zhangjiang Institute of Medical Innovation, Shanghai, China,Artificial Intelligence Innovation and Incubation Institute, Fudan University, Shanghai, China,Fudan Zhangjiang Institute, Shanghai, China,*Correspondence: Zixin Hu ✉
| | - Tiexu Zhang
- Department of Cardiovascular Medicine, The First People's Hospital of Pingdingshan, Pingdingshan, Henan, China,Tiexu Zhang ✉
| | - Jiangman Zhao
- Shanghai Biotecan Pharmaceuticals Co., Ltd., Shanghai Zhangjiang Institute of Medical Innovation, Shanghai, China,Jiangman Zhao ✉
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8
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Nomura SO, Karger AB, Garg P, Cao J, Bhatia H, Duran EK, Duprez D, Guan W, Tsai MY. Small dense low-density lipoprotein cholesterol compared to other lipoprotein biomarkers for predicting coronary heart disease among individuals with normal fasting glucose: The Multi-Ethnic Study of Atherosclerosis. Am J Prev Cardiol 2022; 13:100436. [PMID: 36545388 PMCID: PMC9760650 DOI: 10.1016/j.ajpc.2022.100436] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Revised: 10/07/2022] [Accepted: 12/02/2022] [Indexed: 12/13/2022] Open
Abstract
Objective This study compared small dense low-density lipoprotein cholesterol (sdLDL-C) with apolipoprotein B (apo B), and low-density lipoprotein particles (LDL-P) in predicting CHD risk in generally healthy adults with normal fasting glucose (NFG). Methods This study was conducted among participants with NFG in the Multi-Ethnic Study of Atherosclerosis (MESA) prospective cohort with measurements of sdLDL-C, LDL-P, and apo B available at baseline (2000-2002) and follow-up CHD data (through 2015) (N = 3,258). Biomarkers were evaluated as quartiles, and in categories using clinically and 75th percentile-defined cut-points. Discordance/concordance of sdLDL-C relative to other biomarkers was calculated using 75th percentile cut-points and linear regression residuals. Associations between individual biomarkers, sdLDL-C discordance and CHD incidence were evaluated using Cox proportional hazards regression. Results There were 241 incident CHD events in this population through 2015. Higher sdLDL-C, apo B, LDL-P were similarly associated with increased CHD in individuals with NFG. Discordance of sdLDL-C with apo B or LDL-P by 75th percentiles was not significantly associated with CHD. Residuals discordantly higher/lower sdLDL-C relative to apo B (discordant high HR=1.26, 95% CI: 0.89, 1.78; discordant low HR=0.94, 95% CI: 0.68, 1.29) and LDL-P (discordant high HR=1.25, 95% CI: 0.88, 1.75; discordant low HR=0.84, 95% CI:0.60, 1.16), compared to those with concordant measures, had non-statistically significant higher/lower risk of CHD. Conclusions Results suggest sdLDL-C, apo B and LDL-P are generally comparable for predicting CHD events in normoglycemic individuals. Larger studies are needed to confirm findings and to investigate whether measurement of sdLDL-C may be beneficial to evaluate as an additional risk-enhancing factor.
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Affiliation(s)
- Sarah O. Nomura
- Department of Laboratory Medicine and Pathology, University of Minnesota, 420 Delaware St SE, Mayo Mail Code 609, Minneapolis, MN 55455, United States
| | - Amy B. Karger
- Department of Laboratory Medicine and Pathology, University of Minnesota, 420 Delaware St SE, Mayo Mail Code 609, Minneapolis, MN 55455, United States
| | - Parveen Garg
- Keck Medicine, University of Southern California, Los Angeles, CA, United States
| | - Jing Cao
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX, United States
| | - Harpreet Bhatia
- Division of Cardiovascular Medicine, University of California San Diego, San Diego, CA, United States
| | - Edward K. Duran
- Department of Medicine, Cardiovascular Division, University of Minnesota, Minneapolis, MN, United States
| | - Daniel Duprez
- Department of Medicine, Cardiovascular Division, University of Minnesota, Minneapolis, MN, United States
| | - Weihua Guan
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, MN, United States
| | - Michael Y. Tsai
- Department of Laboratory Medicine and Pathology, University of Minnesota, 420 Delaware St SE, Mayo Mail Code 609, Minneapolis, MN 55455, United States
- Corresponding author.
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Pradhan A, Kuka R, Vishwakarma P, Ali W, Perrone MA, Iellamo F, Chaudhary G, Chandra S, Sethi R, Dwivedi S, Narain V, Saran RK. Lipid Profile and Small Dense Low-Density Lipoprotein in Acute Coronary Syndrome Patients: Relationships to Demographic, Clinical, Angiographic, and Therapeutic Variables. J Clin Med 2022; 11:jcm11226846. [PMID: 36431323 PMCID: PMC9697552 DOI: 10.3390/jcm11226846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 11/15/2022] [Accepted: 11/16/2022] [Indexed: 11/22/2022] Open
Abstract
Background: Several lines of evidence have supported small dense low-density lipoproteins (sd-LDL) as a marker of cardiovascular disease. The present study assessed the relationship between lipid profile and sd-LDL levels with demographic, clinical, angiographic, and therapeutic variables in acute coronary syndrome (ACS) patients. Methods: This was a single-centre, prospective, cross-sectional study conducted from September 2014 to September 2015. Patients with a diagnosis of ACS were included in this study. High-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) were determined by direct homogenous assay and sd-LDL levels were calculated using an earlier described equation by Srisawadi et al. Results: A total of 200 patients with a diagnosis of ACS were studied. Males constituted 78% of the population cohort and almost 45% of participants were aged <45 years. Patients aged ≤45 years displayed higher mean sd-LDL levels of 30.40 ± 14.18 mg/dL versus patients aged >45 years with mean sd-LDL levels of 28.01 ± 11.58 mg/dL, but the difference was not statistically significant (p = 0.19). Females also displayed higher mean sd-LDL levels, but the difference also failed to achieve statistical significance (30.95 ± 13.44 mg/dL and 28.54 ± 12.64, respectively; p = 0.185). Diabetics had higher mean sd-LDL levels (33.64 ± 13.01 mg/dL and 28.07 ± 12.60 mg/dL; p = 0.273) whilst smokers had lower mean levels (27.21 ± 12.12 mg/dL and 30.51 ± 13.21 mg/dL, respectively; p = 0.071). However, the ratio of sd-LDL/lb-LDL (large buoyant LDL) was significantly higher in diabetics (0.48 vs. 0.39; p = 0.023). In the angiography cohort (n = 88), single-vessel disease was the most predominant overall while among patients aged >45 years, triple-vessel disease was significantly higher (p = 0.005). Similarly, the sd-LDL levels were 33.12 ± 11.13 mg/dL, 27.68 ± 9.80 mg/dL, and 31.65 ± 15.26 mg/dL among patients with single, double, and triple-vessel disease and did not differ significantly (p = 0.262). Prior statin users had significantly lower mean sd-LDL levels of 24.79 ± 12.23 mg/dL compared to statin-naïve patients with a mean sd-LDL of 30.01 ± 12.79 mg/dL (p = 0.027). Non-HDL levels were also significantly lower in prior statin users (112.83 mg/dL vs. 128.9 mg/dL; p = 0.017). Conclusion: In this cohort of ACS patients, age, sex, diabetes, smoking, and the angiographic severity of coronary artery disease had no significant impact on sd-LDL levels, while prior statin usage led to significantly lower sd-LDL levels. Diabetic patients, however, did have significantly higher sd-LDL/lb-LDL ratios.
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Affiliation(s)
- Akshyaya Pradhan
- Department of Cardiology, King George’s Medical University, Lucknow 226003, Uttar Pradesh, India
| | - Ravninder Kuka
- Department of Cardiology, SPS Hospital, Ludhiana 141001, Punjab, India
| | - Pravesh Vishwakarma
- Department of Cardiology, King George’s Medical University, Lucknow 226003, Uttar Pradesh, India
| | - Wahid Ali
- Department of Pathology, King George’s Medical University, Lucknow 226003, Uttar Pradesh, India
| | - Marco Alfonso Perrone
- Department of Cardiology and Cardio Lab, University of Rome Tor Vergata, 00133 Rome, Italy
- Correspondence:
| | - Ferdinando Iellamo
- Department of Cardiology and Cardio Lab, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Gaurav Chaudhary
- Department of Cardiology, King George’s Medical University, Lucknow 226003, Uttar Pradesh, India
| | - Sharad Chandra
- Department of Cardiology, King George’s Medical University, Lucknow 226003, Uttar Pradesh, India
| | - Rishi Sethi
- Department of Cardiology, King George’s Medical University, Lucknow 226003, Uttar Pradesh, India
| | - Sudhanshu Dwivedi
- Department of Cardiology, King George’s Medical University, Lucknow 226003, Uttar Pradesh, India
| | - Varun Narain
- Department of Cardiology, King George’s Medical University, Lucknow 226003, Uttar Pradesh, India
| | - R. K. Saran
- Department of Clinical & Preventive Cardiology, Medanta Hospital, Lucknow 226003, Uttar Pradesh, India
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Zubielienė K, Valterytė G, Jonaitienė N, Žaliaduonytė D, Zabiela V. Familial Hypercholesterolemia and Its Current Diagnostics and Treatment Possibilities: A Literature Analysis. Medicina (Kaunas) 2022; 58:1665. [PMID: 36422206 PMCID: PMC9692978 DOI: 10.3390/medicina58111665] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 10/30/2022] [Accepted: 11/13/2022] [Indexed: 09/30/2023]
Abstract
Familial hypercholesterolemia (FH) is a common, inherited disorder of cholesterol metabolism. This pathology is usually an autosomal dominant disorder and is caused by inherited mutations in the APOB, LDLR, and PCSK9 genes. Patients can have a homozygous or a heterozygous genotype, which determines the severity of the disease and the onset age of cardiovascular disease (CVD) manifestations. The incidence of heterozygous FH is 1: 200-250, whereas that of homozygous FH is 1: 100.000-160.000. Unfortunately, FH is often diagnosed too late and after the occurrence of a major coronary event. FH may be suspected in patients with elevated blood low-density lipoprotein cholesterol (LDL-C) levels. Moreover, there are other criteria that help to diagnose FH. For instance, the Dutch Lipid Clinical Criteria are a helpful diagnostic tool that is used to diagnose FH. FH often leads to the development of early cardiovascular disease and increases the risk of sudden cardiac death. Therefore, early diagnosis and treatment of this disease is very important. Statins, ezetimibe, bile acid sequestrants, niacin, PCSK9 inhibitors (evolocumab and alirocumab), small-interfering-RNA-based therapeutics (inclisiran), lomitapide, mipomersen, and LDL apheresis are several of the available treatment possibilities that lower LDL-C levels. It is important to say that the timeous lowering of LDL-C levels can reduce the risk of cardiovascular events and mortality in patients with FH. Therefore, it is essential to increase awareness of FH in order to reduce the burden of acute coronary syndrome (ACS).
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Affiliation(s)
- Kristina Zubielienė
- Department of Cardiology, Lithuanian University of Health Sciences Kaunas Clinics, LT-50161 Kaunas, Lithuania
- Department of Cardiology, Lithuanian University of Health Sciences Kaunas Hospital, LT-45130 Kaunas, Lithuania
- Kaunas Region Society of Cardiology, LT-44307, Kaunas, Lithuania
| | - Gintarė Valterytė
- Department of Cardiology, Lithuanian University of Health Sciences Kaunas Clinics, LT-50161 Kaunas, Lithuania
| | - Neda Jonaitienė
- Department of Cardiology, Lithuanian University of Health Sciences Kaunas Clinics, LT-50161 Kaunas, Lithuania
| | - Diana Žaliaduonytė
- Department of Cardiology, Lithuanian University of Health Sciences Kaunas Clinics, LT-50161 Kaunas, Lithuania
- Department of Cardiology, Lithuanian University of Health Sciences Kaunas Hospital, LT-45130 Kaunas, Lithuania
- Kaunas Region Society of Cardiology, LT-44307, Kaunas, Lithuania
| | - Vytautas Zabiela
- Department of Cardiology, Lithuanian University of Health Sciences Kaunas Clinics, LT-50161 Kaunas, Lithuania
- Kaunas Region Society of Cardiology, LT-44307, Kaunas, Lithuania
- Institute of Cardiology Kaunas, Cardiology Research Automation Laboratory, Lithuanian University of Health Sciences, LT-44307 Kaunas, Lithuania
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Abstract
PURPOSE OF REVIEW Levels of small, dense low-density lipoprotein (LDL) (sdLDL) particles determined by several analytic procedures have been associated with risk of atherosclerotic cardiovascular disease (ASCVD). This review focuses on the clinical significance of sdLDL measurement. RECENT FINDINGS Results of multiple prospective studies have supported earlier evidence that higher levels of sdLDL are significantly associated with greater ASCVD risk, in many cases independent of other lipid and ASCVD risk factors as well as levels of larger LDL particles. A number of properties of sdLDL vs. larger LDL, including reduced LDL receptor affinity and prolonged plasma residence time as well as greater oxidative susceptibility and affinity for arterial proteoglycans, are consistent with their heightened atherogenic potential. Nevertheless, determination of the extent to which sdLDL can preferentially impact ASCVD risk compared with other apoprotein B-containing lipoproteins has been confounded by their metabolic interrelationships and statistical collinearity, as well as differences in analytic procedures and definitions of sdLDL. SUMMARY A growing body of data points to sdLDL concentration as a significant determinant of ASCVD risk. Although future studies should be aimed at determining the clinical benefit of reducing sdLDL levels, there is sufficient evidence to warrant consideration of sdLDL measurement in assessing and managing risk of cardiovascular disease. VIDEO ABSTRACT https://www.dropbox.com/s/lioohr2ead7yx2p/zoom_0.mp4?dl=0.
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