Stuff lots of heart stuff

Last site is the only one I really think I can understand.

Bill

......................



J Clin Endocrinol Metab. 2007 May;92(5):1581-9.

Update on dyslipidemia.
Garg A, Simha V.
Division of Nutrition and Metabolic Diseases, Center for Human
Nutrition, University of Texas Southwestern Medical Center at Dallas,
5323 Harry Hines Boulevard, Dallas, TX 75390-9052, USA.
abhimanyu.garg@xxxxxxxxxxxxxxxxxx
Recently, considerable progress has been made in understanding the
genetic basis of dyslipidemias and in studying the safety and efficacy
of lipid-lowering drugs for coronary heart disease (CHD) prevention.
Novel loci have been identified for monogenic hypercholesterolemia, such
as low-density lipoprotein (LDL) receptor (LDLR)-associated protein,
proprotein convertase subtilisin-like kexin type 9, and ATP-binding
cassette transporters ABCG5 and ABCG8. LDLR-associated protein promotes
clustering of LDLRs into clathrin-coated pits for LDL uptake; proprotein
convertase subtilisin-like kexin type 9 is involved in LDLR degradation;
and ABCG5 and 8 pump sterols out of the hepatic and intestinal cells
into bile and intestinal lumen, respectively. A novel gene encoding
apolipoprotein AV, an activator of lipoprotein lipase, has also been
linked to familial hypertriglyceridemia. Linkage of familial combined
hyperlipidemia to upstream stimulatory factor 1 remains controversial.
Recent guidelines of the Adult Treatment Panel III emphasize intensive
reduction of LDL or non-high-density lipoprotein cholesterol in patients
at high risk of CHD. However, of the four recently concluded trials
comparing high- vs. low-dose statin therapy, only two showed an
unequivocal reduction in cardiovascular endpoints. Because intensive
statin therapy can increase the risk of myopathy and hepatotoxicity, it
is important to consider its risk-benefit ratio in individual patients.
Restriction of dietary saturated and trans-fat and cholesterol, along
with increased intake of soluble fiber, can also achieve substantial LDL
cholesterol lowering. Fibrates may reduce the risk of acute pancreatitis
in severely hypertriglyceridemic patients and may be beneficial for CHD
prevention. However, the safety and efficacy of combined therapy of
fibrates and statins needs to be established.
PMID: 17483372 [PubMed - indexed for MEDLINE]

.........................
Eur J Hum Genet. 2007 Aug;15(8):872-7. Epub 2007 May 9.

Genetic influences on angina pectoris and its impact on coronary heart
disease.
Zdravkovic S, Wienke A, Pedersen NL, de Faire U.
1Division of Cardiovascular Epidemiology, Institute of Environmental
Medicine, Karolinska Institutet, Stockholm, Sweden.
As functional properties of the coronaries may differ between coronary
heart disease (CHD) patients with or without angina pectoris (AP), it is
possible that different genetic mechanisms could be involved in the
various CHD phenotypes. The primary aim of this study was, therefore, to
determine the relative importance of genetic factors for AP as well as
the impact of AP on CHD death in general. All same-sexed twins born
between 1886 and 1958 included in the Swedish Twin Registry served as a
base for this study. Information from the Swedish Cause of Death
Register was used for diagnosing CHD death. Standard methods applied in
twin research such as survival and quantitative genetic models were
used. The impact of AP on CHD death was significant among both sexes,
with larger estimates for males (hazard ratio and 95% CI 2.0 (1.8-2.3))
than females (1.6 (1.4-1.8)). Probandwise concordances and intraclass
correlations for AP and CHD death were in general greater in monozygotic
than dizygotic twins among both sexes. Heritability analyses resulted in
moderate heritability estimates for AP in both sexes (0.39 (0.29-0.49)
for males and 0.43 (0.08-0.51) for females). The correlation between AP
and CHD was exclusively explained by the influence of familial factors
in both sexes. In conclusion, our data imply genetic influences for AP
and CHD death among both sexes and that AP is important as a risk factor
for CHD death in both males and females, due in part to shared genetic
pathways.European Journal of Human Genetics (2007) 15, 872-877;
doi:10.1038/sj.ejhg.5201846; published online 9 May 2007.
PMID: 17487220 [PubMed - in process]

....................
Kaohsiung J Med Sci. 2007 May;23(5):225-31.

PON1 activity is inversely related to LDL apoB carbonyl content in
patients with coronary artery disease.
Sharma R, Singh B, Mahajan M.
Department of Molecular Biology and Biochemistry, Guru Nanak Dev
University, Amritsar, India. ritu_gmc@xxxxxxxxxxxxxx
The objective of this study was to investigate apolipoprotein B (apoB)
carbonyl content as a parameter for studying low-density lipoprotein
(LDL) oxidation in coronary artery disease (CAD) risk assessment and to
explore the relationship between apoB carbonyl content (an index of
protein oxidation) and paraoxonase 1 (PON1) activity in CAD patients and
controls. A total of 200 patients suffering from CAD and 150 normal
individuals were included in the present study. CAD patients were
classified into two groups on the basis of associated risk factors
(diabetes mellitus, hypertension): group 1 (n = 120; CAD patients with
associated risk factors) and group 2 (n = 80; CAD patients with no
associated risk factors). All subjects were assayed for apoB carbonyl
content, LDL-malondialdehyde (LDL-MDA), PON1 activity, and lipid and
apolipoprotein levels. ApoB carbonyl content was significantly (p <
0.01) raised in CAD patients (with or without associated risk factors)
as compared to controls. Patients also had relatively raised LDL-MDA
levels. Serum PON1 activity was significantly low (p < 0.01) in CAD
patients. A significantly (p < 0.01) negative coefficient of correlation
was observed between apoB carbonyl content and PON1 activity in both
patients and controls. CAD patients with associated risk factors had
highly raised (p < 0.01) apoB carbonyl content and considerably
depressed PON1 activity compared to those with no associated risk
factors. LDL-MDA levels did not differ significantly (p > 0.05) between
the two groups. CAD patients in group 1 also had significantly raised
apoB levels and low HDL-cholesterol and apoA1 levels as compared to
patients in group 2, while the other lipid variables did not show any
significant difference. A significantly negative coefficient of
correlation was observed between apoB carbonyl content and PON1 activity
in both patients and controls. This is a new piece of information that
needs to be further explored. Quantification of apoB carbonyl content
may act as a suitable parameter for studying LDL oxidation in the
evaluation of CAD risk, especially when confounding risk factors are
present.
PMID: 17525004 [PubMed - indexed for MEDLINE]

.....................
Cell Mol Biol (Noisy-le-grand). 2006 Dec 31;52(5):4-10.
Links
The correlation of homocysteine-thiolactonase activity of the
paraoxonase (PON1) protein with coronary heart disease status.
Domaga?a TB, ?acinski M, Trzeciak WH, Mackness B, Mackness MI,
Jakubowski H.
Department of Microbiology & Molecular Genetics, UMDNJ-New Jersey
Medical School, International Center for Public Health, Newark, NJ
07101, USA.
Homocysteine (Hcy)-thiolactonase (HTase) activity of the paraoxonase-1
(PON1) protein detoxifies Hcythiolactone in human blood and could thus
delay the development of atherosclerosis. We investigated a hypothesis
that HTase activity is associated with coronary heart disease. We
studied HTase activities and PON1 genotypes in a group of 475 subjects,
42.5% of whom were healthy and 57.5% had coronary heart disease (CHD).
We found that HTase activity was positively correlated with total
cholesterol (r=0.254, P<0.0001), LDL cholesterol (0.149, P=0.016), ApoB
(r=0.167, P=0.006), ApoA1 (0.140, P=0.023), and HDL cholesterol (0.184,
P=0.002) in a group of CHD cases (n=270) but not in controls (n=202).
Mean HTase activity was significantly higher in CHD cases than in
controls (4.57 units vs. 3.30 units, P <10(-5)). The frequencies of the
PON1-192 genotypes in CHD cases were similar to those in controls. HTase
activity was not different between patients receiving statins and those
not treated with statins. Multiple regression analysis shows that CHD
status, PON1 genotype, and total cholesterol are determinants of HTase
activity in humans. Our results suggest that HTase activity of the PON 1
protein is a predictor of CHD.
PMID: 17543199 [PubMed - indexed for MEDLINE]

.............
Scand J Prim Health Care. 2007 Jun;25(2):112-6.

How do patients at risk portray candidates for coronary heart disease? A
qualitative interview study.

Frich JC, Malterud K, Fugelli P.
Institute of General Practice and Community Medicine, Blindern,
University of Oslo, Oslo, Norway. jancf@xxxxxxxxxxxxxx
OBJECTIVE: To explore how patients at risk of coronary heart disease
(CHD) portray candidates for CHD. DESIGN: Qualitative interview study.
SETTING: Norway. SUBJECTS: A total of 20 men and 20 women diagnosed with
heterozygous familial hypercholesterolemia (FH) recruited through a
lipid clinic. MAIN OUTCOME MEASURES: Participants' beliefs concerning
persons who are considered candidates for CHD. RESULTS: Some
participants believed that CHD could happen to anyone, while the
majority conveyed detailed notions of persons they considered to be
likely victims of CHD. Participants often portrayed the coronary
candidate as someone who was different from themselves. Among those who
mentioned gender, all presented the candidate as a man. Some women said
that they had to reconcile themselves to being at risk of CHD, since
they at first had conceived CHD as a man's disease. While some
participants considered their notions to be valid for assessing people's
risk of CHD, others questioned how valid their notions were. CONCLUSION:
Doctors should recognize that distancing is a way patients cope with
risk and that such a strategy may have psychological and moral reasons.
When communicating about risk, doctors should take into account that
patients' notions of risk may differ from medical notions of risk.
PMID: 17497489 [PubMed - indexed for MEDLINE]

--

S Jersey USA Zone 5 Shade
http://www.ocutech.com/ High tech Vison aid
This article is posted under fair use rules in accordance with
Title 17 U.S.C. Section 107, and is strictly for the educational
and informative purposes. This material is distributed without profit.
.

Relevant Pages

  • Re: Atorvastatin Appears Safe at High Doses
    ... There have been lots of clinical trials related to statins. ... "The role of statins in chronic kidney disease." ... disease is therefore considered a cardiovascular disease risk equivalent. ... cardiovascular events in patients with chronic kidney disease. ...
    (sci.med.cardiology)
  • rheumatoid arthritis and cvd
    ... A chronic autoimmune disease, rheumatoid arthritis is marked by ... The most prevalent cause of death ... To investigate the genetic risk for early death in RA, ... risk of death for RA patients with HLA-DRB1 SE genotypes. ...
    (sci.med.cardiology)
  • Re: A Systematic Review and Meta-Analysis of Statin Therapy in Children With Familial Hyperchole
    ... Global Risk ... early initiation of therapy with statin drugs. ... Only 36.8% of patients with hypertension in the United ... of common risk factors of coronary artery disease may result in a very ...
    (sci.med.cardiology)
  • CRP Confirmed as Independent Risk Factor for Coronary Heart Disease Death in Patients With Diabetes
    ... Patients With Diabetes ... other risk factors..." ... Diabetic patients are known to have a 2- to 4-fold higher risk for coronary ... heart disease (CHD) and to have higher levels of high-sensitivity C-reactive ...
    (sci.med.cardiology)
  • Re: ldl comment is needed
    ... >>>The lower the LDL the lower the risk of heart disease, ... >> where there is a concern for coronary disease. ... the level of concern enough for the goal LDL to be less than 100 mg/dL. ... > concern for coronary disease" but in people with known CHD, ...
    (sci.med.cardiology)