The heterogeneity of lipoproteins and their role in the development of cardiovascular diseases

The residual risk in patients with atherosclerosis, despite the its controversial aspects, remains an urgent problem of modern cardiology. The article presents a review of publications on the prevalence and significance for determining the prognosis of residual risk, which is currently interpreted as the risk of macroand microvascular complications in patients with atherosclerotic cardiovascular disease (ACVD) taking standard therapy, with the achievement of optimal levels of low-density lipoprotein cholesterol, blood pressure and glucose. Based on available publications, we highlighted current views on the factors associated with residual inflammatory and lipid risks in ACVD patients, including those associated with heart failure and diabetes, and the prognostic significance of residual risk in such patients. An attempt was made to rationale the significance of determining the residual risk for secondary prevention of cardiovascular events.

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Residual risk in patients with atherosclerotic cardiovascular disease

Khazova

Bulashova

2023

Cardiovasc Ther Prev

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Current trends in solving the problem of residual cardiovascular risk

Obedkova,

Guslyakova,

Mal

et al. 2024

Medicinskij sovet

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Cardiovascular mortality is an urgent health problem not only in the Russian Federation, but also throughout the world. Patients of high cardiovascular risk, which suffering from ischemic heart disease and attending dyslipidemia, remain with high residual risk of cardiovascular complications such as unstable angina, myocardial infarction, stroke even in the case of achieved target level of atherogenic lipoproteins, no matter effective multicomponent hypolipidemic therapy. This article reviews the relevant scientific literature, meta-analyses of studies, randomized clinical trials of lipid-lowering drugs, examines the main reasons for the persistence of residual cardiovascular risk, evaluates the role of each clinical diagnostic marker in its progression, among which are the level of lipoprotein (a), triglycerides and other atherogenic lipoproteins, persistent aseptic inflammation of the vascular wall, the markers of which are highly sensitive C-reactive protein, interleukin-6, interleukin-1β. Possible therapeutic strategies for reducing residual risk depending on the etiological factor are discussed including the effectiveness in reducing residual cardiovascular risk with omega-3 polyunsaturated fatty acids, fibrates, options for RNA interference with small interfering RNA and antisense oligonucleotides usage, lipoprotein apheresis, as well as anti-inflammatory therapy using colchicine, low doses of methotrexate and monoclonal antibodies that inhibit the production of proinflammatory interleukins. Assessing a patient’s residual risk in clinical practice allows us to determine the insufficiency or ineffectiveness of secondary prevention measures and choose a different, more modern or comprehensive tactic for cardiovascular risk reducing.

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The risk of developing cardiovascular complications in employees who operate and maintain communication facilities based on wired and wireless technologies

Кузьмина

Kolyaskina

Bezrukavnikova

et al. 2021

Med. tr. prom. èkol.

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Introduction. Heart disease has remained the leading cause of death in the world for the past 20 years. The development and progression of cardiovascular diseases, along with genetic, somatic, behavioral, socioeconomic, environmental, and other risk factors, are significantly affected by unfavorable industrial and professional aspects: physical-vibration, noise, temperature disturbance; ergonomic - inactivity, and monotonous work, physical overstrain, chemical, biological, stress, etc. The primary pathogenetic mechanism leading to the development of CHD and fatal complications - myocardial infarction, strokes, thrombosis, and other diseases of the cardiovascular system is atherosclerosis. The study aimed to assess the risk of developing cardiovascular complications in employees who operate and maintain communication facilities based on wired and wireless technologies Materials and methods. An in-depth examination of the health status of 50 employees of the service for the operation of radio equipment and communications was conducted. Blood serum levels of glucose, cholesterol, triglycerides, HDL, and LDL were determined, and the atherogenicity index was calculated. The probability of total risk of cardiovascular complications and five-year cardiovascular risk was calculated for all the examined patients according to the European SCORE scale and the ASCORE rating scale. The "Vascular age" was also calculated. Results. Based on the analysis of lipid metabolism indicators, a high cardiovascular risk was identified in 40% of the examined patients. Increased values of the atherogenicity index were already observed in middle-aged people (45-60 years). Analysis of the data obtained using the SCORE and ASCORE assessment scales revealed a high risk of developing cardiovascular complications in middle-aged (45-60 years) and elderly (61-74 years) individuals. The excess of the vascular age in comparison with the real (passport) age was established in middle-aged (45-60 years) and elderly (61-74 years) individuals, on average, 7 (p<0.001) and 5 (p=0.026) years, respectively. Conclusion. The most pronounced changes in lipid metabolism and the risk of cardiovascular risk were in people of the most working age (45-60). In this regard, it is necessary to develop preventive measures aimed at cardioscreening to detect early signs of health disorders, prevent the development of cardiovascular complications, and the formation of groups at increased risk of diseases.

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The heterogeneity of lipoproteins and their role in the development of cardiovascular diseases

Cited by 3 publications

References 39 publications

Residual risk in patients with atherosclerotic cardiovascular disease

Residual risk in patients with atherosclerotic cardiovascular disease

Current trends in solving the problem of residual cardiovascular risk

The risk of developing cardiovascular complications in employees who operate and maintain communication facilities based on wired and wireless technologies

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