Highlighted Articles - Atherosclerosis August 2015 Issue
26 August 2015
25 August 2015
Volume 241 Issue 2 August 2015
By Elvira Mambetisaeva, Sarah Leigh and Steve Humphries (Editor–in-Chief)
In their study of 600 type 2 diabetic patients (aged 55–74 years) with no known coronary heart disease, Zafrir et al were able to demonstrate that cardiorespiratory fitness (CRF), measured by metabolic equivalents (METs) using maximal treadmill testing and quantified by percent predicted METs, was an independent predictor of cardiovascular risk. They therefore propose that low CRF could be used to identify asymptomatic type 2 diabetic patients who are at higher risk of all-cause mortality despite having low coronary artery calcification. Brawner & Ahmed commend this study in their invited commentary and suggest that although the data is limited it would be “prudent” for CRF to be used in risk assessment and to guide clinical recommendations, especially as low CRF is associated with high cardiovascular risk independent of age and other co-morbidities.
The role of gut microbiota in influencing cardiovascular risk is examined in the review article by Org et al. They present a detailed appraisal of the tools employed for the study of the microbiota, a literature review of evidence implicating microbes in atherosclerosis and its risk factors and approaches that may be used to reveal the complex interactions between gut microbiota composition, diet and genetics.
In their review article “Interaction between periodontal disease and atherosclerotic vascular disease – Fact or fiction?”, Aarabi et al examine the widely reported association between these two conditions. They conclude that in order to establish the validity of the “oral inflammatory hypothesis of atherosclerosis” and risk assessment, large longitudinal cohort studies will be needed. Furthermore, randomized controlled trials could reveal whether or not the anti-inflammatory treatments targeting oral inflammation and long-term improved oral hygiene, reduce vascular event rates. Finally, they point out that the role of other systemic inflammatory conditions should not be ignored.
Based on the Anitschkow Lecture given by John Kastelein at the EAS congress in 2014, Besseling et al present a review article on familial hypercholesterolemia (FH) screening and treatment. The authors highlight the benefits of cascade screening for FH, although they observe that FH is still widely under diagnosed. They report how statins and ezetimibe reduce coronary heart disease (CHD) risk in FH patients and welcome the development of novel therapies which have the potential to reduce CHD risk FH patients.
Economou et al discuss the emerging role of microRNAs (miRNAs) in etiology of atherosclerosis and coronary artery disease in their review article. They go onto discuss the potential for miRNAs to be used as diagnostic biomarkers and therapeutic agents for coronary artery disease and myocardial infarction. To complete their article Economou et al also highlight some of the limitations associated with this area of research.
Papers in this issue include: