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Management of Dyslipidaemias: Enhancing Lipid Modification to Reduce Cardiovascular Risk
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Management of Dyslipidaemias: Enhancing Lipid Modification to Reduce Cardiovascular Risk

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

Deadline for manuscript submissions: 20 December 2024 | Viewed by 7863

Special Issue Editors

Dr. Daniel Gaudet

E-Mail Website
Guest Editor
Clinical Lipidology and Rare Lipid Disorders Unit, Department of Medicine, Université de Montréal Community Gene Medicine Center, Lipid Clinic Chicoutimi Hospital and ECOGENE-21 Clinical and Translational Research Center, Chicoutimi, QC G7H 7K9, Canada
Interests: management of dyslipidemia and associated risks
Dr. Etienne Khoury

E-Mail Website
Guest Editor
Community Gene Medicine Center, Department of Medicine, Université de Montréal, Chicoutimi, QC G7H 7K9, Canada
Interests: management of dyslipidemia and associated risks

Special Issue Information

Dear Colleagues,

Cardiovascular disease (CVD) is a leading cause of death in several developed countries, with low-density lipoproteins (LDL), among other atherogenic lipoproteins such as lipoprotein remnants (e.g., very low-density lipoproteins (VLDL) and chylomicron remnants), being considered as the key causal factors or contributors to the development of atherosclerosis. 

Continued research and new observational studies as well as interventional trials have revealed that beyond LDL-Cholesterol (LDL-C) levels, the identification of markers (biological, environmental, and genetic) associated with remnant metabolism could enhance CV risk prediction and optimize treatment strategies. However, many conditions of rare and severe causes of atherogenic lipid disorders, such as homozygous familial hypercholesterolemia (HoFH), refractory hypercholesterolemia and severe hypertriglyceridemia, pose significant challenges for lipid management. Patients with these conditions cannot attain the desired thresholds of lipid parameters and continue to experience CV events, despite being treated with maximally tolerated lipid-lowering therapies (LLT). 

LLTs are evolving rapidly, and several agents have now included new inhibitors such as PCSK9, ANGPLT3 and APOC3 as targets. Future directions might also involve additional therapies derived from new mechanisms of action or signaling pathways that will potentially allow for the development of new classes of drugs targeting lipoprotein metabolism for CVD prevention. The impact of other fat-related disorders, such as non-alcoholic steatohepatitis (NASH), which is shown to be associated with increased risk of CV events, is also worth mentioning; however, the underlying mechanisms between NASH and CVD in respect to their targeted interventions still remain unknown.

We take this opportunity to extend an invitation to researchers and clinical practitioners to contribute to a Special Issue of the Journal of Clinical Medicine titled, ‘Management of Dyslipidemia: Enhancing Lipid Modification to Reduce Cardiovascular Risk.’ We will accept submissions of original research, comprehensive review articles, and innovative protocols that highlight the recent research progress, including, but not limited to, novel mechanistic pathways and/or the identification of emerging avenues for therapies aimed at refining CV risk management.

Dr. Daniel Gaudet
Dr. Etienne Khoury
Guest Editors

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

  • cardiovascular disease
  • dyslipidemia
  • lipoprotein remnant
  • emerging lipid-lowering therapies
  • rare and severe causes of atherogenic lipid disorders
  • cardiovascular risk-related biomarkers
  • drug safety and efficacy

Published Papers (5 papers)

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Research

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13 pages, 1291 KiB  
Article
The Dynamics of Cardiovascular Risk—An Analysis of the Prospective Urban Rural Epidemiology (PURE) Poland Cohort Study
by Paweł Lubieniecki, Łukasz Lewandowski, Maria Wołyniec, Katarzyna Połtyn-Zaradna, Katarzyna Zatońska and Andrzej Szuba
J. Clin. Med. 2024, 13(13), 3728; https://doi.org/10.3390/jcm13133728 - 26 Jun 2024
Viewed by 814
Abstract
Background: The purpose of this study was to analyze the major cardiovascular risk (CVR) factors and their trends in the study population. Methods: The results of subjects in the Polish Prospective Urban and Rural Epidemiological Study (PURE) study group were interpreted. [...] Read more.
Background: The purpose of this study was to analyze the major cardiovascular risk (CVR) factors and their trends in the study population. Methods: The results of subjects in the Polish Prospective Urban and Rural Epidemiological Study (PURE) study group were interpreted. CVR was calculated for each participant according to the Systematic Coronary Risk Evaluation (SCORE2) scale or the Systematic Coronary Risk Evaluation–Older Persons (SCORE2–OP) scale. Data from the beginning of the analysis (2013) and nine years later (2022) were included. In addition, the use of lipid–lowering therapy (LLT) and meeting the low–density lipoprotein cholesterol (LDL–c) target criterion at the beginning and end of the study were analyzed. Results: Patients in the high and very high CVR groups who had abnormal LDL–c results accounted for 64% and 91% of their group in 2013 and 70% and 92% in 2022, respectively. Conclusions: Regardless of age, patients using LLT at the start of the analysis had a greater increase in future CVR, especially if they had lipid abnormalities at the start of the study. This may be due to reverse causality and multimorbidity in these patients, highlighting the importance of appropriate treatment of lipid abnormalities. Full article
(This article belongs to the Special Issue Management of Dyslipidaemias: Enhancing Lipid Modification to Reduce Cardiovascular Risk)
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10 pages, 632 KiB  
Article
Lipid-Lowering Therapy in PURE Poland Cohort Study
by Paweł Lubieniecki, Maria Wołyniec, Katarzyna Połtyn-Zaradna, Katarzyna Zatońska and Andrzej Szuba
J. Clin. Med. 2024, 13(1), 60; https://doi.org/10.3390/jcm13010060 - 22 Dec 2023
Cited by 1 | Viewed by 760
Abstract
The aim of this study is to present data on the use of lipid-lowering therapy (LLT) in relation to calculated cardiovascular risk (CVR) and an additionally defined target LDL-C concentration. The cohort consisted of 1287 participants in the Polish edition of the Prospective [...] Read more.
The aim of this study is to present data on the use of lipid-lowering therapy (LLT) in relation to calculated cardiovascular risk (CVR) and an additionally defined target LDL-C concentration. The cohort consisted of 1287 participants in the Polish edition of the Prospective Urban and Rural Epidemiological Study (PURE). CVR was calculated for each participant using the SCORE2 or SCORE2-OP scale, and for patients with diabetes mellitus (DM), chronic kidney disease (CKD) or atherosclerotic cardiovascular disease (ASCVD) according to the respective criteria. In the cohort analysed, 107 of 212 people (50.5%) in the low cardiovascular risk (CVR) group, 284 of 414 people (68.6%) in the moderate CVR group, 562 of 612 people (91.8%) in the high CVR group and 48 of 49 people (98%) in the very high CVR group did not meet the target LDL-c criterion. Of those in the low CVR group, 86% of participants were not receiving lipid-lowering therapy (LLT); in the moderate CVR group, the proportion was 77.8%; in the high CVR group, 68.1% and in the very high CVR group, 75%. In each cardiovascular risk group, participants who did not meet the target LDL-c concentration criterion and did not take LLT made up the larger group. Full article
(This article belongs to the Special Issue Management of Dyslipidaemias: Enhancing Lipid Modification to Reduce Cardiovascular Risk)
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14 pages, 1256 KiB  
Article
Efficacy and Safety of Statin Treatment in Children with Familial Hypercholesterolemia: Outcomes of 20 Years of Experience
by Radosław Motkowski, Paweł Abramowicz, Jolanta Kubalska, Bożena Mikołuć and Jerzy Konstantynowicz
J. Clin. Med. 2023, 12(23), 7197; https://doi.org/10.3390/jcm12237197 - 21 Nov 2023
Viewed by 1287
Abstract
Background: The objective of this retrospective cohort study was to present the experience of 20-year-long comprehensive care of pediatric patients with familial hypercholesterolemia (FH) in a single academic center. Methods and Results: The study included 84 children aged 1–18 years with FH. For [...] Read more.
Background: The objective of this retrospective cohort study was to present the experience of 20-year-long comprehensive care of pediatric patients with familial hypercholesterolemia (FH) in a single academic center. Methods and Results: The study included 84 children aged 1–18 years with FH. For the whole study group, 535 medical visits were recorded. The mean follow-up period was 33.6 months. Molecular testing performed in 55 children (65%) provided genetic confirmation of the diagnosis in 36 children (43%). Twenty-seven children (32%) were treated pharmacologically with statins. Follow-up during the treatment averaged 29 months. Treatment with statins was associated with a mean reduction in total cholesterol and LDL-cholesterol levels of 24 and 33% from the baseline. Symptoms of statin intolerance occurred incidentally and did not require amendment in the treatment protocol. Significantly higher values of body weight, height, and BMI were found only among girls older than 10 years who were treated with statins. Conclusions: These data confirm a high efficacy and a good safety profile of statin treatment in children with FH, demonstrating no harm to physical development. However, there is a need for further cause-and-effect research regarding associations between long-term treatment with low-cholesterol, low-fat diets, statin therapy, and excessive weight gain. Full article
(This article belongs to the Special Issue Management of Dyslipidaemias: Enhancing Lipid Modification to Reduce Cardiovascular Risk)
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Review

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21 pages, 359 KiB  
Review
The Hurdle of Access to Emerging Therapies and Potential Solutions in the Management of Dyslipidemias
by Brett S. Mansfield, Farzahna Mohamed, Miriam Larouche and Frederick J. Raal
J. Clin. Med. 2024, 13(14), 4160; https://doi.org/10.3390/jcm13144160 - 16 Jul 2024
Viewed by 428
Abstract
This review explores the many barriers to accessing lipid-lowering therapies (LLTs) for the prevention and management of atherosclerotic cardiovascular disease (ASCVD). Geographical, knowledge, and regulatory barriers significantly impede access to LLTs, exacerbating disparities in healthcare infrastructure and affordability. We highlight the importance of [...] Read more.
This review explores the many barriers to accessing lipid-lowering therapies (LLTs) for the prevention and management of atherosclerotic cardiovascular disease (ASCVD). Geographical, knowledge, and regulatory barriers significantly impede access to LLTs, exacerbating disparities in healthcare infrastructure and affordability. We highlight the importance of policy reforms, including pricing regulations and reimbursement policies, for enhancing affordability and streamlining regulatory processes. Innovative funding models, such as value-based pricing and outcome-based payment arrangements, have been recommended to make novel LLTs more accessible. Public health interventions, including community-based programs and telemedicine, can be utilized to reach underserved populations and improve medication adherence. Education and advocacy initiatives led by patient advocacy groups and healthcare providers play a crucial role in raising awareness and empowering patients. Despite the barriers to access, novel LLTs present a big opportunity to reduce the burden of ASCVD, emphasizing the need for collaborative efforts among policymakers, healthcare providers, industry stakeholders, and patient advocacy groups to address these barriers to improve access to LLTs globally. Full article
(This article belongs to the Special Issue Management of Dyslipidaemias: Enhancing Lipid Modification to Reduce Cardiovascular Risk)
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0 pages, 319 KiB  
Review
Lifestyle and Lipoprotein(a) Levels: Does a Specific Counseling Make Sense?
by Federica Fogacci, Valentina Di Micoli, Pierre Sabouret, Marina Giovannini and Arrigo F. G. Cicero
J. Clin. Med. 2024, 13(3), 751; https://doi.org/10.3390/jcm13030751 - 28 Jan 2024
Cited by 3 | Viewed by 4192
Abstract
Lipoprotein(Lp)(a) is a variant of low-density lipoprotein (LDL), bound to apolipoprotein B100, whose levels are associated with a significant increase in the risk of atherosclerosis-related cardiovascular events, but also to aortic stenosis and atrial fibrillation. Since plasma levels of Lp(a) are commonly considered [...] Read more.
Lipoprotein(Lp)(a) is a variant of low-density lipoprotein (LDL), bound to apolipoprotein B100, whose levels are associated with a significant increase in the risk of atherosclerosis-related cardiovascular events, but also to aortic stenosis and atrial fibrillation. Since plasma levels of Lp(a) are commonly considered resistant to lifestyle changes, we critically reviewed the available evidence on the effect of weight loss, dietary supplements, and physical activity on this risk factor. In our review, we observed that relevant body weight loss, a relatively high intake of saturated fatty acids, the consumption of red wine, and intense physical exercise seems to be associated with significantly lower plasma Lp(a) levels. On the contrary, foods rich in trans-unsaturated fatty acids are associated with increased Lp(a) levels. With regard to dietary supplements, coenzyme Q10, L-Carnitine, and flaxseed exert a mild but significant lowering effect on plasma Lp(a). Full article
(This article belongs to the Special Issue Management of Dyslipidaemias: Enhancing Lipid Modification to Reduce Cardiovascular Risk)
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