Background: The atherogenic LDL is an impor-tant generative cause for the endothelial dys-function and the configuration of the athero-sclerotic lesions. CRP is a sensitive marker of inflammation on the vascular wall,...Background: The atherogenic LDL is an impor-tant generative cause for the endothelial dys-function and the configuration of the athero-sclerotic lesions. CRP is a sensitive marker of inflammation on the vascular wall, but also seems to participate in the atheromatic process. The correlation between LDL and CRP could form valuable guidelines for the initiation of a treatment with statins for individuals with an increased risk of ischemic incidents. Objectives: The aim of the study was to investigate a pos-sible correlation between LDL and CRP in an important number of apparently healthy indi-viduals. Methods: The study material consisted of the test results of 260 male and 484 female adults with normal LDL levels who were clini-cally healthy. The correlation between the LDL and the CRP values of this group was investi-gated in this group and CRP was compared with the respective values of a group of 60 male and 204 female adults with elevated LDL levels. Re-sults: It was ascertained that there is not a sta-tistically important correlation between LDL and CRP values in all groups (men, women, total) of the population with normal LDL levels. Addi-tionally, the CRP mean values were not statisti-cally different between the individuals with normal and raised LDL. Conclusion: A number of causes are incriminated for the results. More studies are definitely needed for the confirma-tion of the results, particularly if the findings could lead to the formation of guidelines for the application of a treatment in people with normal LDL levels but increased CRP levels.展开更多
Aims: Small dense LDL (sdLDL) cholesterol is considered a cardiovascular risk. Our purpose in this study was to evaluate the efficacy of rosuvastatin in reducing sdLDL and large buoyant LDL (lbLDL-C) in hypercholester...Aims: Small dense LDL (sdLDL) cholesterol is considered a cardiovascular risk. Our purpose in this study was to evaluate the efficacy of rosuvastatin in reducing sdLDL and large buoyant LDL (lbLDL-C) in hypercholesterolemia. Methods: Fifty-six patients with a mean baseline LDL-cholesterol (LDL-C) concentration of 173.9 ± 40.5 mg/dL were treated with rosuvastatin 2.5 mg/day for 12 weeks. LDL-C, sdLDL-C, and apolipoprotein (apo) B were assessed and l lbLDL-C was calculated (LDL-C minus sdLDL-C). Results: After 12-week treatment with rosuvastatin 2.5mg, sdLDL-C and lbLDL-C were significantly reduced from 62.1 ± 23.8 mg/dL to 34.0 ± 13.4 mg/dL, p <0.001 and 112.7 ± 34.9 mg/dL to 77.2± 29.2 mg/dL, p < 0.001 respectively, and sdLDL-C/lbLDL-C ratio and apo B also decreased significantly, from 0.36 ± 0.02 to 0.32 ± 0.02, p < 0.005 and 134.2 ± 4.3 to 93.6 ± 3.5 mg/dl, p < 0.001, respectively. In diabetic subjects there was significant correlation between percent reductions in the plasma triglyceride and sdLDL-C/ lbLDL-C ratio (r = 0.58, p < 0.005), but not between the percentage decrease in plasma triglyceride and sdLDL-C. Conclusions: Treatment with rosuvastatin is associated with significant reduction in sdLDL, lbLDL and sdLDL/lbLDL ratio.展开更多
The LDL Principle has recently been invoked to describe the observation that lowering the LDL cholesterol (by whatever means) results in a lowering of atherosclerotic cardiovascular events. The scientific basis of the...The LDL Principle has recently been invoked to describe the observation that lowering the LDL cholesterol (by whatever means) results in a lowering of atherosclerotic cardiovascular events. The scientific basis of the LDL Principle dates back to the discovery that the LDL receptor is the prime determinant of the circulating LDL-c concentration. Since that time, major advances have been made at both the basic and clinical science level in our understanding of the pathogenesis and reversal of atherosclerosis. The incorporation of atherogenic lipoproteins plus inflammatory mediators into plaque formation permits the targeted intervention into preventing plaque rupture. In addition, genetic studies identifying individuals with unique phenotypes of either abnormally high or low LDL-c concentrations have provided insight into possible therapeutic modalities that have recently provided the physician with the tools necessary to apply the LDL Principle to achieve reversal of atherosclerosis. The epidemic of atherosclerotic cardiovascular disease has resulted in numerous randomized controlled intervention trials in an attempt to identify approaches to reduce ASCD morbidity and mortality. Recently published data indicate that circulating LDL-c levels of 50 mg/dl or less are not only physiologic at birth but also effective in greatly reducing cardiovascular disease. In addition, the recent availability of two PCSK9 inhibitors provides the primary care physician with the possibility of achieving this low level of LDL-c even in statin intolerant patients. The widespread availability of the coronary artery calcium scan plus the inclusion of traditional cardiovascular risk factors in risk assessment has enabled the physician to readily identify asymptomatic individuals at high risk for cardiovascular events. Aggressively applying the LDL Principle to these individuals has the potential of greatly reducing cardiovascular mortality. This review will document the scientific basis for this principle and provide the arguments in favor of its aggressive application.展开更多
文摘Background: The atherogenic LDL is an impor-tant generative cause for the endothelial dys-function and the configuration of the athero-sclerotic lesions. CRP is a sensitive marker of inflammation on the vascular wall, but also seems to participate in the atheromatic process. The correlation between LDL and CRP could form valuable guidelines for the initiation of a treatment with statins for individuals with an increased risk of ischemic incidents. Objectives: The aim of the study was to investigate a pos-sible correlation between LDL and CRP in an important number of apparently healthy indi-viduals. Methods: The study material consisted of the test results of 260 male and 484 female adults with normal LDL levels who were clini-cally healthy. The correlation between the LDL and the CRP values of this group was investi-gated in this group and CRP was compared with the respective values of a group of 60 male and 204 female adults with elevated LDL levels. Re-sults: It was ascertained that there is not a sta-tistically important correlation between LDL and CRP values in all groups (men, women, total) of the population with normal LDL levels. Addi-tionally, the CRP mean values were not statisti-cally different between the individuals with normal and raised LDL. Conclusion: A number of causes are incriminated for the results. More studies are definitely needed for the confirma-tion of the results, particularly if the findings could lead to the formation of guidelines for the application of a treatment in people with normal LDL levels but increased CRP levels.
文摘Aims: Small dense LDL (sdLDL) cholesterol is considered a cardiovascular risk. Our purpose in this study was to evaluate the efficacy of rosuvastatin in reducing sdLDL and large buoyant LDL (lbLDL-C) in hypercholesterolemia. Methods: Fifty-six patients with a mean baseline LDL-cholesterol (LDL-C) concentration of 173.9 ± 40.5 mg/dL were treated with rosuvastatin 2.5 mg/day for 12 weeks. LDL-C, sdLDL-C, and apolipoprotein (apo) B were assessed and l lbLDL-C was calculated (LDL-C minus sdLDL-C). Results: After 12-week treatment with rosuvastatin 2.5mg, sdLDL-C and lbLDL-C were significantly reduced from 62.1 ± 23.8 mg/dL to 34.0 ± 13.4 mg/dL, p <0.001 and 112.7 ± 34.9 mg/dL to 77.2± 29.2 mg/dL, p < 0.001 respectively, and sdLDL-C/lbLDL-C ratio and apo B also decreased significantly, from 0.36 ± 0.02 to 0.32 ± 0.02, p < 0.005 and 134.2 ± 4.3 to 93.6 ± 3.5 mg/dl, p < 0.001, respectively. In diabetic subjects there was significant correlation between percent reductions in the plasma triglyceride and sdLDL-C/ lbLDL-C ratio (r = 0.58, p < 0.005), but not between the percentage decrease in plasma triglyceride and sdLDL-C. Conclusions: Treatment with rosuvastatin is associated with significant reduction in sdLDL, lbLDL and sdLDL/lbLDL ratio.
文摘The LDL Principle has recently been invoked to describe the observation that lowering the LDL cholesterol (by whatever means) results in a lowering of atherosclerotic cardiovascular events. The scientific basis of the LDL Principle dates back to the discovery that the LDL receptor is the prime determinant of the circulating LDL-c concentration. Since that time, major advances have been made at both the basic and clinical science level in our understanding of the pathogenesis and reversal of atherosclerosis. The incorporation of atherogenic lipoproteins plus inflammatory mediators into plaque formation permits the targeted intervention into preventing plaque rupture. In addition, genetic studies identifying individuals with unique phenotypes of either abnormally high or low LDL-c concentrations have provided insight into possible therapeutic modalities that have recently provided the physician with the tools necessary to apply the LDL Principle to achieve reversal of atherosclerosis. The epidemic of atherosclerotic cardiovascular disease has resulted in numerous randomized controlled intervention trials in an attempt to identify approaches to reduce ASCD morbidity and mortality. Recently published data indicate that circulating LDL-c levels of 50 mg/dl or less are not only physiologic at birth but also effective in greatly reducing cardiovascular disease. In addition, the recent availability of two PCSK9 inhibitors provides the primary care physician with the possibility of achieving this low level of LDL-c even in statin intolerant patients. The widespread availability of the coronary artery calcium scan plus the inclusion of traditional cardiovascular risk factors in risk assessment has enabled the physician to readily identify asymptomatic individuals at high risk for cardiovascular events. Aggressively applying the LDL Principle to these individuals has the potential of greatly reducing cardiovascular mortality. This review will document the scientific basis for this principle and provide the arguments in favor of its aggressive application.