Recent studies emphasize the importance of low-density lipoprotein cholesterol (LDL-C) in altering the hematopoietic cell compartment of bone marrow and of high-density lipoprotein cholesterol (HDL-C) in inhibiting metabolic endotoxemia-induced inflammation. The data suggest that these lipoproteins may exert their inflammatory or anti-inflammatory roles by modulating innate immune memory. Targeting specific LDL-C and HDL-C subfractions could therefore potentially reduce the residual risk in hepatic and cardiometabolic disease.

• Klíčová slova
• atherosclerosis, cholesterol, endotoxemia, inflammation, innate immune memory, liver,
• MeSH
• HDL-cholesterol * MeSH
• imunologická paměť * MeSH
• LDL-cholesterol * MeSH
• lidé MeSH
• přirozená imunita * MeSH
• zánět MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• HDL-cholesterol * MeSH
• LDL-cholesterol * MeSH

Purpose: We examined clinical characteristics and low-density lipoprotein cholesterol (LDL-C) lowering in patients initiating evolocumab in real-world practice in a Central and Eastern European (CEE) cohort from the pan-European HEYMANS study. Methods: Patients from Bulgaria, Czech Republic, and Slovakia were enrolled at initiation of evolocumab (baseline) as per local reimbursement criteria. Demographic/clinical characteristics, lipid-lowering therapy (LLT) and lipid values were collected from medical records for ≤6 months before baseline and ≤30 months after evolocumab initiation. Results: Overall, 333 patients were followed over a mean (SD) duration of 25.1 (7.5) months. At initiation of evolocumab, LDL-C levels were markedly elevated in all three countries, with a median (Q1, Q3) LDL-C of 5.2 (4.0, 6.6) mmol/L in Bulgaria, 4.5 (3.8, 5.8) mmol/L in the Czech Republic, and 4.7 (4.0, 5.6) mmol/L in Slovakia. Within the first three months of evolocumab treatment, LDL-C levels were reduced by a median of 61% in Bulgaria, 64% in the Czech Republic, and 53% in Slovakia. LDL-C levels remained low throughout the remaining period of observation. The 2019 ESC/EAS guideline-recommended risk-based LDL-C goals were attained by 46% of patients in Bulgaria, 59% in the Czech Republic, and 43% of patients in Slovakia. LDL-C goal attainment was higher in patients receiving a statin ± ezetimibe-based background therapy (Bulgaria: 55%, Czech Republic: 71%, Slovakia: 51%) compared to those receiving evolocumab alone (Bulgaria: 19%, Czech Republic: 49%, Slovakia: 34%). Conclusion: In the HEYMANS CEE cohort, patients initiated on evolocumab had baseline LDL-C levels approximately three-fold higher than guideline-recommended thresholds for PCSK9i initiation. Risk-based LDL-C goal attainment was highest in patients receiving high-intensity combination therapy. Lowering the LDL-C reimbursement threshold for PCSK9i initiation would allow more patients to receive combination therapy, thus improving LDL-C goal attainment. Trial registration: ClinicalTrials.gov (NCT02770131; registration date: 27 April 2016).

• Klíčová slova
• LDL-C, PCSK9i, cardiovascular risk, evolocumab, guidelines,
• MeSH
• anticholesteremika * škodlivé účinky   MeSH
• LDL-cholesterol MeSH
• lidé MeSH
• statiny * terapeutické užití   MeSH
• výsledek terapie MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• pozorovací studie MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• východní Evropa epidemiologie   MeSH
• Názvy látek
• anticholesteremika * MeSH
• evolocumab MeSH Prohlížeč
• LDL-cholesterol MeSH
• statiny * MeSH

PURPOSE: Low-density lipoprotein cholesterol (LDL-C) recommendations differ between the 2018 American College of Cardiology/American Heart Association (ACC/AHA) and 2019 European Society of Cardiology/European Atherosclerosis Society (ESC/EAS) guidelines for patients with atherosclerotic cardiovascular disease (ASCVD) (< 70 vs. < 55 mg/dl, respectively). In the DA VINCI study, residual cardiovascular risk was predicted in ASCVD patients. The extent to which relative and absolute risk might be lowered by achieving ACC/AHA versus ESC/EAS LDL-C recommended approaches was simulated. METHODS: DA VINCI was a cross-sectional observational study of patients prescribed lipid-lowering therapy (LLT) across 18 European countries. Ten-year cardiovascular risk (CVR) was predicted among ASCVD patients receiving stabilized LLT. For patients with LDL-C ≥ 70 mg/dl, the absolute LDL-C reduction required to achieve an LDL-C of < 70 or < 55 mg/dl (LDL-C of 69 or 54 mg/dl, respectively) was calculated. Relative and absolute risk reductions (RRRs and ARRs) were simulated. RESULTS: Of the 2039 patients, 61% did not achieve LDL-C < 70 mg/dl. For patients with LDL-C ≥ 70 mg/dl, median (interquartile range) baseline LDL-C and 10-year CVR were 93 (81-115) mg/dl and 32% (25-43%), respectively. Median LDL-C reductions of 24 (12-46) and 39 (27-91) mg/dl were needed to achieve an LDL-C of 69 and 54 mg/dl, respectively. Attaining ACC/AHA or ESC/EAS goals resulted in simulated RRRs of 14% (7-25%) and 22% (15-32%), respectively, and ARRs of 4% (2-7%) and 6% (4-9%), respectively. CONCLUSION: In ASCVD patients, achieving ESC/EAS LDL-C goals could result in a 2% additional ARR over 10 years versus the ACC/AHA approach.

• Klíčová slova
• Atherosclerotic cardiovascular disease, Cardiovascular disease prevention, Cardiovascular risk, LDL-C, Lipid-lowering, Statins,
• MeSH
• ateroskleróza * diagnóza   farmakoterapie   epidemiologie   MeSH
• chování snižující riziko MeSH
• kardiovaskulární nemoci * diagnóza   epidemiologie   prevence a kontrola   MeSH
• LDL-cholesterol MeSH
• lidé MeSH
• průřezové studie MeSH
• rizikové faktory MeSH
• statiny * terapeutické užití   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• pozorovací studie MeSH
• Geografické názvy
• Spojené státy americké epidemiologie   MeSH
• Názvy látek
• LDL-cholesterol MeSH
• statiny * MeSH

BACKGROUND AND AIMS: Despite the high prevalence of familial hypercholesterolemia (FH) and available effective lipid-lowering therapy, most of the individuals with this disorder remain undiagnosed and undertreated. The aim of the PLANET registry was to assess the real-life attainment of low-density lipoprotein cholesterol (LDL-C) therapeutic target level in patients with heterozygous FH, to characterize prescribed lipid-lowering therapy with assessment of its efficiency according to the attainment of the target LDL-C level, and to characterize cardiovascular events observed in this patient population again in relation to LDL-C target level attainment. METHODS: PLANET registry was designed as a non-interventional, retrospective, cross-sectional, multicentre disease registry for adult patients with heterozygous FH in the Czech Republic and Slovakia. RESULTS: Overall, 1755 patients were enrolled at 32 sites specialized in FH treatment. 15.4% of patients attained the target LDL-C value. The proportion of patients with LDL-C goal achievement increased to 17.3% in the subgroup of patients receiving high-intensity statin therapy (54.6% of study population). Out of 55 patients receiving inhibitors of proprotein convertase subtilisin/kexin type 9 (PCSK9), 61.8% reached the LDL-C treatment goal. Of all cardiovascular events reported, 14.0% occurred in patients attaining the LDL-C goal, while it was 86.0% in the not-at-target group. It was documented (p=0.004) that the longer is the patient in care at the specialized FH centre, the higher is the probability that he/she will attain the target LDL-C level. CONCLUSIONS: Although target LDL-C level attainment remains relatively low, the likelihood of LDL-C goal attainment increases with duration of specialized care.

• Klíčová slova
• Ezetimibe, Familial hypercholesterolemia, LDL-C goal attainment, LDL-Cholesterol, Statins, Treatment pattern,
• MeSH
• anticholesteremika škodlivé účinky   terapeutické užití   MeSH
• biologické markery krev   MeSH
• časové faktory MeSH
• down regulace MeSH
• ezetimib terapeutické užití   MeSH
• fenotyp MeSH
• genetická predispozice k nemoci MeSH
• genetické markery MeSH
• heterozygot MeSH
• hodnocení rizik MeSH
• hyperlipoproteinemie typ II krev   farmakoterapie   epidemiologie   genetika   MeSH
• inhibitory serinových proteinas terapeutické užití   MeSH
• kardiovaskulární nemoci epidemiologie   prevence a kontrola   MeSH
• kombinovaná farmakoterapie MeSH
• LDL-cholesterol krev   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mutace MeSH
• PCSK9 inhibitory MeSH
• proproteinkonvertasa subtilisin/kexin typu 9 metabolismus   MeSH
• průřezové studie MeSH
• registrace MeSH
• retrospektivní studie MeSH
• statiny terapeutické užití   MeSH
• výsledek terapie MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Česká republika epidemiologie   MeSH
• Slovenská republika epidemiologie   MeSH
• Názvy látek
• anticholesteremika MeSH
• biologické markery MeSH
• ezetimib MeSH
• genetické markery MeSH
• inhibitory serinových proteinas MeSH
• LDL-cholesterol MeSH
• PCSK9 inhibitory MeSH
• PCSK9 protein, human MeSH Prohlížeč
• proproteinkonvertasa subtilisin/kexin typu 9 MeSH
• statiny MeSH

Dyslipidemias are defined as a wide range of abnormalities of the lipid profile. Treatment guidelines recommend aiming at lowering LDL-C. We investigated the adherence of Czech cardiologists to the dyslipidaemia treatment guidelines, especially in the management of patients with high and very high cardiovascular risk. In this retrospective cross-sectional multicentric study data from medical records of 450 adults with ASCVD, enrolled between June 2021 and January 2022, were analysed. Demographics, clinical outcomes, medical history, LLT treatment and other medications were collected. The physicians were to include patients at a very high risk of ASCVD and to complete a general questionnaire on their personal therapeutic preferences. Objectively assessed, only 80% of total patients (N = 450) enrolled in the study were at very high risk of ASCVD, and 12.7% of patients were at high risk of ASCVD, respectively. In total, 55 (13.1%) patients were diagnosed with familial hypercholesterolemia, and 39.1% of them had a positive family history of ASCVD. Generally, only 20.5% of patients reached the 2019 LDL-C goals- 19.4% of very high risk patients and 28.1% of high risk patients, respectively. 61% of the physicians preferred a slow and careful up-titration of the dose, which is contradictory to the guidelines. Only 17% of the physicians increased the statin dose or added/combined/changed the treatment to achieve the LDL-C goals as soon as possible. Surprisingly, in up to 61.5% of patients at very high risk who did not meet the LDL-C goals, their physicians stated subjective satisfaction with the treatment and considered no change needed. Among very high and high risk patients receiving lipid-lowering therapy, with high treatment adherence, the LDL-C goal attainment is very low and LLT utilization is rather sub-optimal. Improving observance of the guidelines by physicians bears a substantial potential for LDL-C goal attainment and thus improving overall benefit for patients for no additional costs.

• MeSH
• cíle MeSH
• dospělí MeSH
• dyslipidemie * farmakoterapie   diagnóza   MeSH
• hypolipoproteinemie * MeSH
• kardiovaskulární nemoci * prevence a kontrola   farmakoterapie   MeSH
• LDL-cholesterol MeSH
• lidé MeSH
• průřezové studie MeSH
• retrospektivní studie MeSH
• rizikové faktory kardiovaskulárních chorob MeSH
• rizikové faktory MeSH
• statiny * terapeutické užití   MeSH
• výsledek terapie MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• LDL-cholesterol MeSH
• statiny * MeSH

OBJECTIVE: LDL-cholesterol (LDL-C) is determined by methods whose accuracy is significantly affected in various clinical or analytical situations. Two computational methods have recently been described, the Martin equation and the Sampson equation, validity of which we compare with the Friedewald equation. METHODS: LDL-C comparisons determined by the 3 equations were performed on 4 real sets of lipid data, generated in various previous studies, ranging from n = 140 to n = 7 393. We have created an artificial set of data on the extent of 900 members with equally distributed values of TC, HDL-C and TG troughout the commonly found range. Such a data set is independent of the phrase "we performed the calculations on our file". Comparisons were also made on this artificial file. RESULTS: The difference between the LDL-C values determined by the different equations gradually increases with decreasing LDL-C levels, both in the subgroup of low TG values and in the subgroups of medium and higher TG values. This applies to all 4 real files as well as to the artificial file. These differences are more visible the larger the file size. For the artificial set, the overall agreement between the LDL-C categories was lowest when comparing the Friedewald and Martin equations (83.1%), higher between the Sampson and Martin equations (88.9%) and highest when comparing the Friedewald and Sampson equations (90.9%). In all 4 real sets, the trends of overestimation and underestimation between the equations were exactly the same as in the artificial set. CONCLUSION: The results of clinical and epidemiological studies are significantly influenced by the method used to determine LDL-C. When comparing the calculation methods for determining LDL-C, it is possible to preferably use the described artificial set.

• Klíčová slova
• Friedewald equation, LDL cholesterol, Martin/Hopkins equation, Sampson equation, hypertension, method comparison,
• MeSH
• LDL-cholesterol * MeSH
• lidé MeSH
• triglyceridy MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• LDL-cholesterol * MeSH
• triglyceridy MeSH

PURPOSE OF REVIEW: To evaluate evidence from human epidemiology, mechanistic studies, animal studies, human genetics, and human intervention trials to address whether elevated C-reactive protein (CRP) causes human atherothrombotic cardiovascular disease. RECENT FINDINGS: Human epidemiology demonstrates that elevated CRP levels are associated with increased risk of atherothrombosis. Mechanistic and animal studies provide evidence both for and against a causal relationship of CRP with atherothrombosis. Human genetics demonstrate that genetic variation in the CRP gene is associated with lifelong increased CRP levels, but not with increased risk of atherothrombosis. A human intervention trial in healthy people with low LDL cholesterol and elevated CRP demonstrated that aggressive statin treatment caused reductions of 50% in LDL cholesterol, 37% in CRP, 50% in atherothrombotic cardiovascular events, 20% in total mortality, and 45% in venothrombotic events. Importantly, the maximal atherothrombotic treatment benefits were obtained in those who achieved the lowest levels of both LDL cholesterol and CRP. SUMMARY: Given the data available in mid-2009, elevated CRP per se does not seem to cause atherothrombotic cardiovascular disease, which questions whether CRP-reducing agents will prevent these diseases. However, inflammation per se possibly contributes to atherothrombotic and venothrombotic disease, and CRP measurement may be used in risk assessment and treatment monitoring in atherothrombotic cardiovascular disease.

• MeSH
• arterie patologie   MeSH
• C-reaktivní protein metabolismus   MeSH
• estrogeny metabolismus   MeSH
• HDL-cholesterol metabolismus   MeSH
• klinické zkoušky jako téma * MeSH
• LDL-cholesterol metabolismus   MeSH
• lidé MeSH
• trombóza farmakoterapie   etiologie   genetika   metabolismus   MeSH
• zvířata MeSH
• Check Tag
• lidé MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• přehledy MeSH
• Názvy látek
• C-reaktivní protein MeSH
• estrogeny MeSH
• HDL-cholesterol MeSH
• LDL-cholesterol MeSH

OBJECTIVES: To evaluate the association between plasma lipids and insulin and variation in the genes for apolipoproteins (APO) E (CfoI), B (insertion/deletion), C1 (HpaI), and C3 (C-482T, C3238G) in a population-based Czech Slavonic study. DESIGN AND METHODS: In 131 men and 154 women, polymorphisms were investigated using PCR. In the same subjects plasma lipid levels and insulin were measured. RESULTS: In the women, carriers of the e4 allele had higher apoB (p = 0.03) and triglyceride (p = 0.03) compared to e3 homozygotes, whereas in the men, the effect of the e4 allele was seen on total cholesterol (p = 0.02), LDL cholesterol (p = 0.003) and apoB (p = 0.001). Compared with SP27 (insertion) homozygotes of the APOB polymorphism, women SP24 (deletion) homozygotes had higher levels of total (p = 0.003) and LDL cholesterol (p = 0.007) and apoB (p = 0.05). No significant effect was seen in the men. Women homozygous for the APOC3 -482T allele had higher insulin levels than -482C homozygotes (p = 0.03). Men homozygous for APOC3 -482T allele have the highest plasma triglyceride level (p = 0.02). The APOC1 polymorphism exhibited no significant effect on any of the parameters studied. CONCLUSIONS: In this sample, variation at the APOE, APOB and APOC3 genes play a role in determining plasma levels of insulin and lipids, and emphasize the importance of gender-associated effects in the genetic determinations.

• MeSH
• alely MeSH
• apolipoprotein C-I MeSH
• apolipoprotein C-III MeSH
• apolipoproteiny B genetika   MeSH
• apolipoproteiny C genetika   MeSH
• apolipoproteiny E genetika   MeSH
• cholesterol krev   MeSH
• dospělí MeSH
• genetická variace MeSH
• genotyp MeSH
• HDL-cholesterol krev   MeSH
• homozygot MeSH
• inzulin krev   MeSH
• LDL-cholesterol krev   MeSH
• lidé středního věku MeSH
• lidé MeSH
• lipidy krev   MeSH
• mutace MeSH
• polymerázová řetězová reakce MeSH
• polymorfismus genetický MeSH
• sexuální faktory MeSH
• triglyceridy krev   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Česká republika MeSH
• Názvy látek
• apolipoprotein C-I MeSH
• apolipoprotein C-III MeSH
• apolipoproteiny B MeSH
• apolipoproteiny C MeSH
• apolipoproteiny E MeSH
• cholesterol MeSH
• HDL-cholesterol MeSH
• inzulin MeSH
• LDL-cholesterol MeSH
• lipidy MeSH
• triglyceridy MeSH

OBJECTIVE: Obesity is linked with a state of increased oxidative stress, which plays an important role in the etiology of atherosclerosis and type 2 diabetes mellitus. The aim of our study was to evaluate the effect of rapid weight loss on oxidative stress markers in obese individuals with metabolic syndrome (MetS). DESIGN AND METHODS: We measured oxidative stress markers in 40 obese subjects with metabolic syndrome (MetS+), 40 obese subjects without metabolic syndrome (MetS-), and 20 lean controls (LC) at baseline and after three months of very low caloric diet. RESULTS: Oxidized low density lipoprotein (ox-LDL) levels decreased by 12% in MetS+ subjects, associated with a reduction in total cholesterol (TC), even after adjustment for age and sex. Lipoprotein associated phospholipase A₂ (Lp-PLA₂) activity decreased by 4.7% in MetS+ subjects, associated with a drop in LDL-cholesterol (LDL-C), TC, and insulin levels. Multivariate logistic regression analysis showed that a model including ox-LDL, LpPLA₂ activity, and myeloperoxidase (MPO) improved prediction of MetS status among obese individuals compared to each oxidative stress marker alone. CONCLUSIONS: Oxidative stress markers were predictive of MetS in obese subjects, suggesting a higher oxidative stress. Rapid weight loss resulted in a decline in oxidative stress markers, especially in MetS+ patients.

• MeSH
• biologické markery krev   MeSH
• C-reaktivní protein metabolismus   MeSH
• hmotnostní úbytek * MeSH
• inzulin krev   MeSH
• kalorická restrikce MeSH
• LDL-cholesterol krev   MeSH
• lidé středního věku MeSH
• lidé MeSH
• lipoproteiny LDL krev   MeSH
• metabolický syndrom krev   etiologie   patofyziologie   prevence a kontrola   MeSH
• obezita krev   komplikace   patofyziologie   MeSH
• oxidační stres MeSH
• triglyceridy krev   MeSH
• zánět krev   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Research Support, N.I.H., Extramural MeSH
• srovnávací studie MeSH
• Názvy látek
• biologické markery MeSH
• C-reaktivní protein MeSH
• inzulin MeSH
• LDL-cholesterol MeSH
• lipoproteiny LDL MeSH
• oxidized low density lipoprotein MeSH Prohlížeč
• triglyceridy MeSH

BACKGROUND: Lipoprotein-associated phospholipase A2 (Lp-PLA2) probably plays an important role in the development of acute coronary syndrome (ACS); elevated levels of Lp-PLA2 are associated with a poorer prognosis in patients with ischemic heart disease. Alterations of Lp-PLA2 levels during ACS and its relationship to standard biomarkers are, however, unclear. FINDINGS: Fifty-one consecutive ACS patients were enrolled in the study. All were managed with early invasive strategy and according to the current guidelines for pharmacotherapy; intensive statin therapy was started in all patients at admission. Serum levels of Lp-PLA2, LDL-cholesterol (LDL), troponin l (Tnl), and C-reactive protein (CRP) were assessed at admission (D0), on the first morning (D1), and on the second morning of hospitalization (D2). Mean serum levels of Lp-PLA2 (ng/mL) decreased from 264.6±19.1 at D0, to 193.2±14.4 at D1 (P < 0.001 vs. D0) and 189.8±22.6 at D2 (P = 0.002 vs. D0; P = not significant vs. D1). Alterations in Lp-PLA2 levels significantly correlated with changes in LDL (r = 0.43; P = 0.008). On the other hand, no relationship between Lp-PLA2 and Tnl or CRP was found. CONCLUSIONS: Initially, serum levels of Lp-PLA2 were significantly elevated in ACS patients, but decreased within the first 24 hours after admission and subsequently remained stable. Lp-PLA2 levels correlated with LDL levels but not with Tnl or CRP levels. Our results demonstrated dynamic alterations in Lp-PLA2 levels during the early stages of ACS and, therefore, indirectly support the hypothesis of an active role for Lp-PLA2 in the pathogenesis of ACS.

• MeSH
• 1-alkyl-2-acetylglycerofosfocholinesterasa * krev   genetika   MeSH
• akutní koronární syndrom * krev   genetika   patofyziologie   MeSH
• aminokyseliny * aplikace a dávkování   škodlivé účinky   MeSH
• biologické markery krev   MeSH
• C-reaktivní protein analýza   MeSH
• LDL-cholesterol krev   MeSH
• lidé středního věku MeSH
• lidé MeSH
• prognóza MeSH
• rizikové faktory MeSH
• senioři MeSH
• troponin krev   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• 1-alkyl-2-acetylglycerofosfocholinesterasa * MeSH
• aminokyseliny * MeSH
• biologické markery MeSH
• C-reaktivní protein MeSH
• LDL-cholesterol MeSH
• statine MeSH Prohlížeč
• troponin MeSH