New Risk Factors for Atherosclerosis and Patient Risk Assessment

Abstract

Abstract-Advances in our understanding of the ways in which the traditional cardiovascular risk factors, including standard lipid (eg, total cholesterol, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol) and nonlipid (eg, hypertension) risk factors, interact to initiate atherosclerosis and promote the development of cardiovascular disease have enhanced our ability to assess risk in the individual patient. In addition, the ongoing identification and understanding of so-called novel risk factors may further improve our ability to predict future risk when these are included along with the classic risk factors in assessing the global risk profile. This review briefly summarizes the evidence that some newer risk factors, including impaired fasting glucose, triglycerides and triglyceride-rich lipoprotein remnants, lipoprotein(a), homocysteine, and high-sensitivity C-reactive protein, contribute to an increased risk of coronary and cardiovascular diseases.

High glucose and homocysteine synergistically affect the metalloproteinases–tissue inhibitors of metalloproteinases pattern, but not TGFB expression, in human fibroblasts

“…Hyperhomocysteinaemia (Hcy) is generally considered to be a risk factor for coronary, cerebral, and peripheral vascular disease [14,15]. Elevated plasma homocysteine levels may cause endothelial damage [16,17], vascular thrombosis, oxidative stress [18], and cytokine secretion [19].…”

Risk prediction—Homocysteine in Coronary Heart Disease

“…These newer risk factors are called 'novel risk factors' which includes Lp(a), homocysteine, fibrinogen, and hsCRP. Elevated plasma homocysteine may be an important cause for atherosclerosis formation (5). The adverse effects of homocysteine, involve oxidative damage to vascular endothelial cells, increased proliferation of smooth muscle cells, and oxidative modification of low density lipoprotein, all leading to atherosclerosis (6).…”

Mechanisms of Periodontitis - Induced Atherosclerosis

“…In many epidemiological studies, periodontitis was proven to play important roles in initiation and progression of CVD, [69,70] by chronic infection on the blood vessels [20][21][22][23][24][25][26][27][28][29] or by the elevation of body�s CRP level. [29][30][31][32][33][34][35][36][37][38][39] The prevalence of chronic periodontitis was very high among populations, especially in chronic form.…”

“…CRP, interleukin, and chemokines were suggested to be the causes and markers in atherosclerosis lesions. [19,20] Atherosclerosis had been proven to be induced by periodontopathogen from periodontitis. [21][22][23][24][25][26][27][28] Inflammation in mouth may cause systemic inflammation, which is indicated by the elevation of CRP in the body, [29,30] which is functioned as markers, [31,32] predictors of CVD, [33,34] and may induce atherosclerosis lesions.…”