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New Therapeutic Strategies for Cholesterol Management
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New Therapeutic Strategies for Cholesterol Management

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Cardiology".

Deadline for manuscript submissions: closed (30 November 2021) | Viewed by 15169

Special Issue Editor

Dr. Michalina Kołodziejczak

E-Mail Website
Guest Editor
Department of Anesthesiology and Intensive Care, Collegium Medicum Bydgoszcz, Nicolaus Copernicus University Torun, Antoni Jurasz University Hospital No.1, Bydgoszcz, Poland
Interests: cardiovascular medicine; personalized medicine; artificial intelligence; multidisciplinary team care; heart failure
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Treatment of lipid metabolism disorders remains one of the foundations of preventive cardiology, affecting the populational life expectancy and quality. In recent years, owing to the hard work of multidisciplinary teams, we have acquired more resources in our therapeutic arsenal. Additionally, the entire spectrum of scientific research methodologies, including genetic studies, prospective epidemiologic cohort studies, Mendelian randomisation studies, and randomised trials of LDL-C lowering therapies, provided further insights to the impact of lipid profile on the burden of atherosclerotic disease and directly influenced the dynamic development of new therapeutic standards. With those advancements, as reflected in the current ESC 2019 guideline recommendations, patients at high and very high cardiovascular risk should now achieve more restrictive than ever before LDL-C treatment goals (≥50% reduction from baseline and <1.8 mmol/L [<70mg/dL]). On the other hand, many researchers also pursue the early introduction of dyslipidemia management in low-risk populations to reduce the LDL-C exposure and the concomitant atherosclerotic cardiovascular disease burden.

It is my great privilege to invite you to contribute to this Special Issue on cholesterol regulation. I welcome the submission of innovative original research, state-of-the-art reviews, and viewpoints dealing with the novel frontiers and individualized management of dyslipidemias

Dr. Michalina Kołodziejczak
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • dyslipidemia
  • hypercholesterolemia
  • cardiovascular disease risk factors
  • lipid-lowering therapy
  • lipid disorders
  • statins
  • PCSK9 inhibition

Published Papers (3 papers)

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Research

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11 pages, 425 KiB  
Article
Dyslipidemia Management in Patients with Coronary Artery Disease. Data from the POLASPIRE Survey
by Piotr Jankowski, Paweł Kozieł, Małgorzata Setny, Marlena Paniczko, Maciej Haberka, Maciej Banach, Dirk De Bacquer, Guy De Backer, Kornelia Kotseva, David Wood, Zbigniew Gąsior, Karol Kamiński, Dariusz A. Kosior and Andrzej Pająk
J. Clin. Med. 2021, 10(16), 3711; https://doi.org/10.3390/jcm10163711 - 20 Aug 2021
Cited by 11 | Viewed by 2651
Abstract
Lipid-lowering in patients with coronary artery disease (CAD) is related to a lower risk of cardiovascular events. We evaluated factors related to the management of hypercholesterolemia in patients with established CAD. Patients were interviewed 6–18 months after hospitalization for an acute coronary syndrome [...] Read more.
Lipid-lowering in patients with coronary artery disease (CAD) is related to a lower risk of cardiovascular events. We evaluated factors related to the management of hypercholesterolemia in patients with established CAD. Patients were interviewed 6–18 months after hospitalization for an acute coronary syndrome (ACS) or a myocardial revascularization procedure. Statins were prescribed at discharge to 94.4% of patients, while 68.1% of the patients hospitalized for an ACS were prescribed a high-dose statin. Hospitalization in a teaching hospital, percutaneous coronary intervention, cholesterol measurement during hospitalization and the male sex were related to prescription of statins at discharge. The intensity of lipid-lowering therapy in the post-discharge period increased in 17.3%, decreased in 11.7%, and did not change in 71.0% of the patients. The prescription of a lipid-lowering drug (LLD) at discharge (odds ratio 5.88 [95% confidence intervals 3.05–11.34]) and a consultation with a cardiologist (2.48 [1.51–4.08]) were related to the use of LLDs, while age (1.32 [1.10–1.59] per 10 years), loneliness (0.42 [0.19–0.94]), professional activity (1.56 [1.13–2.16]), and diabetes (1.66 [1.27–2.16]) were related to achieving an LDL cholesterol goal 6–18 months after discharge. In conclusion, health-system-related factors are associated with the LLD utilization, whereas mainly patient-related factors are related to the control of hypercholesterolemia following hospitalization for CAD. Full article
(This article belongs to the Special Issue New Therapeutic Strategies for Cholesterol Management)
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Review

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43 pages, 7273 KiB  
Review
Modification of High-Density Lipoprotein Functions by Diet and Other Lifestyle Changes: A Systematic Review of Randomized Controlled Trials
by Albert Sanllorente, Camille Lassale, Maria Trinidad Soria-Florido, Olga Castañer, Montserrat Fitó and Álvaro Hernáez
J. Clin. Med. 2021, 10(24), 5897; https://doi.org/10.3390/jcm10245897 - 15 Dec 2021
Cited by 6 | Viewed by 3507
Abstract
High-density lipoprotein (HDL) functional traits have emerged as relevant elements that may explain HDL antiatherogenic capacity better than HDL cholesterol levels. These properties have been improved in several lifestyle intervention trials. The aim of this systematic review is to summarize the results of [...] Read more.
High-density lipoprotein (HDL) functional traits have emerged as relevant elements that may explain HDL antiatherogenic capacity better than HDL cholesterol levels. These properties have been improved in several lifestyle intervention trials. The aim of this systematic review is to summarize the results of such trials of the most commonly used dietary modifications (fatty acids, cholesterol, antioxidants, alcohol, and calorie restriction) and physical activity. Articles were screened from the Medline database until March 2021, and 118 randomized controlled trials were selected. Results from HDL functions and associated functional components were extracted, including cholesterol efflux capacity, cholesteryl ester transfer protein, lecithin-cholesterol acyltransferase, HDL antioxidant capacity, HDL oxidation status, paraoxonase-1 activity, HDL anti-inflammatory and endothelial protection capacity, HDL-associated phospholipase A2, HDL-associated serum amyloid A, and HDL-alpha-1-antitrypsin. In mainly short-term clinical trials, the consumption of monounsaturated and polyunsaturated fatty acids (particularly omega-3 in fish), and dietary antioxidants showed benefits to HDL functionality, especially in subjects with cardiovascular risk factors. In this regard, antioxidant-rich dietary patterns were able to improve HDL function in both healthy individuals and subjects at high cardiovascular risk. In addition, in randomized trial assays performed mainly in healthy individuals, reverse cholesterol transport with ethanol in moderate quantities enhanced HDL function. Nevertheless, the evidence summarized was of unclear quality and short-term nature and presented heterogeneity in lifestyle modifications, trial designs, and biochemical techniques for the assessment of HDL functions. Such findings should therefore be interpreted with caution. Large-scale, long-term, randomized, controlled trials in different populations and individuals with diverse pathologies are warranted. Full article
(This article belongs to the Special Issue New Therapeutic Strategies for Cholesterol Management)
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17 pages, 18176 KiB  
Review
Inclisiran—Silencing the Cholesterol, Speaking up the Prognosis
by Sylwester Rogula, Ewelina Błażejowska, Aleksandra Gąsecka, Łukasz Szarpak, Milosz J. Jaguszewski, Tomasz Mazurek and Krzysztof J. Filipiak
J. Clin. Med. 2021, 10(11), 2467; https://doi.org/10.3390/jcm10112467 - 02 Jun 2021
Cited by 12 | Viewed by 7738
Abstract
The reduction of circulating low-density lipoprotein-cholesterol (LDL-C) is a primary target in cardiovascular risk reduction due to its well-established benefits in terms of decreased mortality. Despite the use of statin therapy, 10%–20% of high- and very-high-risk patients do not reach their LDL-C targets. [...] Read more.
The reduction of circulating low-density lipoprotein-cholesterol (LDL-C) is a primary target in cardiovascular risk reduction due to its well-established benefits in terms of decreased mortality. Despite the use of statin therapy, 10%–20% of high- and very-high-risk patients do not reach their LDL-C targets. There is an urgent need for improved strategies to manage dyslipidemia, especially among patients with homozygous familial hypercholesterolemia, but also in patients with established cardiovascular disease who fail to achieve LDL goals despite combined statin, ezetimibe, and PCSK9 inhibitor (PCSK9i) therapy. Inclisiran is a disruptive, first-in-class small interfering RNA (siRNA)-based therapeutic developed for the treatment of hypercholesterolemia that inhibits proprotein convertase subtilisin–kexin type 9 (PCSK9) synthesis, thereby upregulating the number of LDL receptors on the hepatocytes, thus lowering the plasma LDL-C concentration. Inclisiran decreases the LDL-C levels by over 50% with one dose every 6 months, making it a simple and well-tolerated treatment strategy. In this review, we summarize the general information regarding (i) the role of LDL-C in atherosclerotic cardiovascular disease, (ii) data regarding the role of PCSK9 in cholesterol metabolism, (iii) pleiotropic effects of PCSK9, and (iv) the effects of PCSK9 silencing. In addition, we focus on inclisiran, in terms of its (i) mechanism of action, (ii) biological efficacy and safety, (iii) results from the ORION trials, (iv) benefits of its combination with statins, and (v) its potential future role in atherosclerotic cardiovascular disease. Full article
(This article belongs to the Special Issue New Therapeutic Strategies for Cholesterol Management)
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