Coronary risk factors update:
Gespeichert in:
| 1. Verfasser: | |
|---|---|
| Format: | Buch |
| Sprache: | English |
| Veröffentlicht: |
Philadelphia, Pa.
Saunders
2012
|
| Schriftenreihe: | Medical clinics of North America
96,1 |
| Schlagworte: | |
| Online-Zugang: | Inhaltsverzeichnis |
| Beschreibung: | Includes bibliographical references and index Preface: Risk factor update: old wine in a new bottle? -- Are novel serum biomarkers informative? -- LDL cholesterol: the lower the better -- HDL-cholesterol: perfection is the enemy of good? -- Trigylcerides: how much credit do they deserve? -- Atherosclerosis in chronic kidney disease: lessons learned from glycation in diabetes -- "My parents died of myocardial infarction: is that my destiny?" -- Age as a risk factor -- Coronary artery disease in aging women: a menopause of endothelial progenitor cells? -- Imaging for prevention -- Genomics: is it ready for primetime? -- Statins personalized -- Childhood cholesterol disorders: the iceberg base or nondisease? |
| Beschreibung: | XIV, 164 S. Ill., graph. Darst. 24 cm |
| ISBN: | 9781455738892 1455738891 |
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| 490 | 1 | |a Medical clinics of North America |v 96,1 | |
| 500 | |a Includes bibliographical references and index | ||
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| adam_text | Titel: Coronary risk factors update
Autor: Fuster, Valentin
Jahr: 2012
Coronary Risk Factors Update
Contents
Preface: Risk Factor Update: Old Wine in a New Bottle? xiii
Valentin Fuster and Jagat Narula
Are Novel Serum Biomarkers Informative? 1
John T. Wilkins and Donald M. Lloyd-Jones
To justify use in routine coronary heart disease (CHD) risk assessment,
a novel serum biomarker must be specifically associated with future
CHD events and add information beyond techniques currently available.
Current risk assessment techniques are probabilistic and imperfect; how-
ever, to date, no novel serum biomarker has improved substantially on the
current population-based risk stratification approach. Although limited
trial-based data are available to assess the utility of biomarkers, insights
gained from biomarkers may enhance clinical decision making. Continued
basic science and population-based research into CHD biomarkers may
help to further the capacity for CHD risk assessment.
LDL Cholesterol:The Lower the Better 13
Seth S. Martin, Roger S. Blumenthal, and Michael Miller
High cholesterol is often a prerequisite for atherosclerotic plaque. Low-
density lipoprotein cholesterol (LDL-C) is the focus of the National Choles-
terol Education Program Adult Treatment Panel guidelines. LDL-C ranges
from 50 to 70 mg/dL in native hunter-gatherers, healthy human neonates,
free-living primates, and other wild mammals, who are notably free of ath-
erosclerotic vascular disease. Multiple statin trials and meta-analyses sup-
port a treatment target of LDL-C levels less than 70 mg/dL, as this is
associated with improved clinical outcomes and atherosclerosis regres-
sion. In fact, no threshold has yet been identified below which patients
do not benefit from lowering of LDL-C.
HDL-Cholesterol: Perfection is the Enemy of Good? 27
Ragavendra R. Baliga
An inverse relationship between the plasma concentration of high-density
lipoprotein (HDL)-cholesterol and the risk of having a cardiovascular event
has been shown in several epidemiologic studies. It is likely that this rela-
tionship is causal because HDL has several intrinsic properties that can
potentially reverse atherosclerosis. However, this has not been conclu-
sively shown in humans, and trying to achieve perfection with pharmaco-
therapy is possibly the enemy of good (ie, a healthy lifestyle). Patients with
low HDL should be advised to change their lifestyle, including smoking
cessation, weight reduction, and regular exercise.
Triglycerides: How Much Credit Do They Deserve? 39
Payai Kohli and Christopher P. Cannon
In the modern era of statin therapy, major advances have been made in treat-
ing coronary heart disease. However, despite intensive treatment with statin
Contents
therapy, residual cardiovascular risk persists and has been attributed to the
persistence of atherogenic dyslipidemia and, in part, elevated triglycerides
(TGs). In this review, the authors focus on the mechanism of elevated TGs
and provide a discussion of the challenges of measuring TGs as a biomarker,
its role in the pathogenesis of atherosclerotic heart disease, and results of
several recent studies that have elucidated the relationship between TGs
and cardiovascular morbidity and mortality.
Atherosclerosis in Chronic Kidney Disease: Lessons Learned from Glycation
in Diabetes 57
Dilbahar S. Mohar, Ailin Barseghian, Nezam Haider, Michael Domanski,
and Jagat Narula
In diabetes, glycation is a nonenzymatic posttranslational modification
resulting from the bonding of a sugar molecule with a protein or lipid fol-
lowed by oxidation, resulting in the development of advanced glycation
end products (AGE). Like glycation, carbamylation is a posttranslational
protein modification that is associated with AGE formation. Glycation of
extracellular matrix proteins and low-density lipoprotein with subsequent
deposition in the vessel wall could contribute to inflammatory response
and atheroma formation. It is logical to extrapolate that carbamylation
may result in modification of vessel wall proteins similar to glycation,
and predispose to atherosclerosis.
My Parents Died of Myocardial Infarction: Is that My Destiny? 67
Nupoor Narula, Claudio Rapezzi, Luigi Tavazzi, and Eloisa Arbustini
This article presents an overview of clinical and molecular genetics of myo-
cardial infarction (Ml). Discussion includes the partial overlapping of risk
factors for myocardial infarction and atherosclerosis, the impact of a pos-
itive family history on the risk of Ml, the familial nongenetic, environmen-
tal factors, the inherited risk associated with the low-dose input of many
genes, and a simple approach to stratify the individual risk in genetic
counseling.
Age As a Risk Factor 87
Ravi Dhingra and Ramachandran S. Vasan
The risk of developing cardiovascular disease (CVD) is generally dependent
on the presence or absence of traditional risk factors. Age is a well-known
traditional risk factor, generally considered nonmodifiable. This review dis-
cusses the common use of individual age in prediction of CVD incidence
using different risk scores, whether or not age as a risk factor can be mod-
ified, the methods used to evaluate long-term and short-term CVD risk,
appropriate communication of individual risk based on age group and
CVD risk, and the influence of age on cardiac and vascular risk factors.
Coronary Artery Disease in Aging Women: A Menopause of Endothelial
Progenitor Cells? 93
Randolph Hutter, Juan Jose Badimon, Valentin Fuster, and Jagat Narula
The cardiovascular protection provided to women during the reproductive
age and the unique angiogenic properties of the female reproductive
Contents
system provide insights into the complex regulatory network of female sex
hormones, angiogenic growth factors, and stem cell regulatory molecules.
The intricate and interwoven endometrial physiology of the female
menstrual cycle shows that in order to harness the physiologic cardiopro-
tection provided by nature to women of reproductive age, for better car-
diovascular therapies in postmenopausal women and the population in
general, a coherent and systematic approach is needed.
Imaging for Prevention 103
Leslee J. Shaw
Cardiovascular disease deaths have declined considerably, with more
than 35% reductions during the past two decades, yet a sizable detection
gap remains. Cardiovascular disease remains the leading cause of mor-
bidity and mortality in the United States and across the world, including
in developing and developed nations. Recent statistics reveal that approx-
imately 840,000 deaths were attributed to cardiovascular disease, approx-
imately 300,000 more deaths than reported for cancer; three-quarters
were reported in previously asymptomatic individuals, raising the question
as to whether screening for cardiovascular disease is warranted in detect-
ing potentially high-risk patients.
Genomics: Is It Ready for Primetime? 113
Sonny Dandona, Alexandre F.R. Stewart, and Robert Roberts
The next decade will focus on identifying the missing heritability of coronary
artery disease (CAD). This process will involve a more comprehensive inter-
rogation of common single nucleotide polymorphisms (SNPs) that impart
modest biologic effect and an interrogation of rare SNPs that impart pro-
found biologic effect. In parallel, an investigation of the underlying biology
of the described association will likely yield novel pathways that provide
therapeutic targets. Once we obtain a more complete inventory of sequence
variation that predisposes to CAD, a more realistic assessment of the role of
genetic risk scoring allied with standard risk algorithms will be possible.
Statins Personalized 123
H. Robert Superko, Kathryn M. Momary, and Yonghong Li
3-Hydroxy-3-methylglutaryl coenzyme A reductase inhibitor medications,
commonly referred to as statins, are among the most widely prescribed
medications. Variation in individual response to statins concerning low-
density lipoprotein cholesterol reduction, clinical event benefit, and side
effects has been observed. Some of this variability is attributed to demo-
graphic and environmental issues, chief of which is compliance. A large
portion of the individual response to statin therapy is attributed to single
nucleotide polymorphisms that have recently been elucidated, several of
which seem to have clinical utility.
Childhood Cholesterol Disorders: The Iceberg Base or Nondisease? 141
Sarah D. de Ferranti
Pediatric cholesterol disorders are common, affecting 1 in 5 adolescents,
although most are mild or moderate abnormalities. Because cholesterol
Contents
values during childhood are moderately predictive of adult cholesterol
levels, and are associated with atherosclerosis by pathology and by vas-
cular testing, and because familial hyperlipidemias are associated with
early cardiovascular events, cholesterol screening is recommended during
childhood. Identified lipid abnormalities are an indication for lifestyle
improvement and, in rare cases, pharmacotherapy. However, many
gaps in the pediatric knowledge base remain about the benefits and
risk, the optimal method for lipid screening, and about appropriate indica-
tions for pharmacotherapy.
Index 155
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| spelling | Fuster, Valentin 1943- Verfasser (DE-588)136865054 aut Coronary risk factors update guest ed. Valentin Fuster ; Jagat Narula Philadelphia, Pa. Saunders 2012 XIV, 164 S. Ill., graph. Darst. 24 cm txt rdacontent n rdamedia nc rdacarrier Medical clinics of North America 96,1 Includes bibliographical references and index Preface: Risk factor update: old wine in a new bottle? -- Are novel serum biomarkers informative? -- LDL cholesterol: the lower the better -- HDL-cholesterol: perfection is the enemy of good? -- Trigylcerides: how much credit do they deserve? -- Atherosclerosis in chronic kidney disease: lessons learned from glycation in diabetes -- "My parents died of myocardial infarction: is that my destiny?" -- Age as a risk factor -- Coronary artery disease in aging women: a menopause of endothelial progenitor cells? -- Imaging for prevention -- Genomics: is it ready for primetime? -- Statins personalized -- Childhood cholesterol disorders: the iceberg base or nondisease? Coronary heart disease / Risk factors Narula, Jagat Sonstige (DE-588)135851440 oth Medical clinics of North America 96,1 (DE-604)BV000003310 96,1 HBZ Datenaustausch application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=024975701&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis |
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| title | Coronary risk factors update |
| title_auth | Coronary risk factors update |
| title_exact_search | Coronary risk factors update |
| title_full | Coronary risk factors update guest ed. Valentin Fuster ; Jagat Narula |
| title_fullStr | Coronary risk factors update guest ed. Valentin Fuster ; Jagat Narula |
| title_full_unstemmed | Coronary risk factors update guest ed. Valentin Fuster ; Jagat Narula |
| title_short | Coronary risk factors update |
| title_sort | coronary risk factors update |
| topic | Coronary heart disease / Risk factors |
| topic_facet | Coronary heart disease / Risk factors |
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