Atherosclerosis
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Myocardial Infarction with Non-Obstructed Coronary Arteries (MINOCA) is common, but the causes are to a large extent unknown. Thus, we aimed to study the prevalence of myocarditis and "true" myocardial infarction determined by cardiac magnetic resonance (CMR) imaging in MINOCA patients, and risk markers for these two conditions in this population. ⋯ The results of this meta-analysis of individual data showed that myocarditis and "true" myocardial infarction are common in MINOCA when determined by CMR imaging. This information emphasizes the importance of performing CMR imaging in MINOCA patients and can be used clinically to guide diagnostics and treatment of MINOCA patients.
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Ischaemic heart disease (IHD) is the leading cause of death in women as in men, although presentation in women is on average 7-10 years later. Recent temporal trends show declining IHD incidence and mortality among men but not among women. Other gender differences concern the prevalence of underlying mechanisms. ⋯ After adjustments, in-hospital mortality after acute myocardial infarction is reported to remain higher among younger women compared to male peers. Such female vulnerability, in apparent contrast with the delayed average onset and lesser extent of epicardial atherosclerosis, likely reflects gender differences in early presentation, as well as in mechanisms, prevention, diagnosis, comorbidities, management, and response to treatment. Recognition and quality of care of IHD are still not the same for women and men.
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Review Meta Analysis
Breast arterial calcifications: a systematic review and meta-analysis of their determinants and their association with cardiovascular events.
Breast arterial calcifications (BAC), regularly observed at mammography, are medial calcifications and as such an expression of arteriosclerosis. Our objective was to evaluate and summarize the available evidence on the associations of BAC with cardiovascular risk factors and cardiovascular risk. ⋯ BAC appear to be associated with an increased risk of cardiovascular disease events, while only being associated with some of the known cardiovascular risk factors, illustrating that medial arterial calcification might contribute to cardiovascular disease through a pathway distinct from the intimal atherosclerotic process.
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Review
Lysosomal acid lipase deficiency--an under-recognized cause of dyslipidaemia and liver dysfunction.
Lysosomal acid lipase deficiency (LAL-D) is a rare autosomal recessive lysosomal storage disease caused by deleterious mutations in the LIPA gene. The age at onset and rate of progression vary greatly and this may relate to the nature of the underlying mutations. Patients presenting in infancy have the most rapidly progressive disease, developing signs and symptoms in the first weeks of life and rarely surviving beyond 6 months of age. ⋯ This article provides practical guidance to lipidologists, endocrinologists, cardiologists and hepatologists on how to recognize individuals with this life-limiting disease. A diagnostic algorithm is proposed with a view to achieving definitive diagnosis using a recently developed blood test for lysosomal acid lipase. Finally, current management options are reviewed in light of the ongoing development of enzyme replacement therapy with sebelipase alfa (Synageva BioPharma Corp., Lexington, MA, USA), a recombinant human lysosomal acid lipase enzyme.
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Review Meta Analysis
Effect of continuous positive airway pressure on lipid profile in patients with obstructive sleep apnea syndrome: a meta-analysis of randomized controlled trials.
Obstructive sleep apnea syndrome (OSAS) is an independent risk factor for development of dyslipidemia. Continuous positive airway pressure (CPAP) is the first-line treatment for OSAS. However, it is unclear whether CPAP improves lipid metabolism. ⋯ We confirmed that CPAP decreases the TC level, especially in OSAS patients who are younger, more obese, and who use CPAP for a longer period. CPAP did not alter TG, LDL, or HDL levels, suggesting that CPAP may have no clinically important effect on lipid metabolism.