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BackgroundProprotein subtilisin kexin type 9 (PCSK9) and lipoprotein (a) [Lp(a)] levels are causative risk factors for coronary heart disease.ObjectivesThe objective of the study was to determine the impact of lipid-lowering treatments on circulating PCSK9 and Lp(a).MethodsWe measured PCSK9 and Lp(a) levels in plasma samples from Investigation of Lipid Level Management to Understand its Impact in Atherosclerotic Events trial patients with coronary heart disease and/or type II diabetes (T2D) mellitus. Patients received atorvastatin, which was titrated (10, 20, 40, or 80 mg/d) to achieve low-density lipoprotein cholesterol levels

UnlabelledSeveral plasma non-lipid biomarkers have been shown to predict major cardiovascular events (MCVEs) in population studies. Our objective was to investigate the relationship between lipid and non-lipid biomarkers levels achieved during statin therapy and the incidence of MCVEs in patients with stable coronary heart disease (CHD). We conducted a substudy of the TNT (Treating to New Targets) study, which was a randomized trial that compared the efficacy of high (80 mg) versus low (10 mg) dose atorvastatin for the secondary prevention of CHD. Fasting plasma levels of standard lipids and of 18 non-lipid biomarkers were obtained after an 8-week run-in period on atorvastatin 10 mg in 157 patients who experienced MCVEs during the 4.9 years of study follow-up and in 1349 controls. MCVE was defined as CHD death, nonfatal, non-procedure-related myocardial infarction, resuscitated cardiac arrest, and fatal or nonfatal stroke. After adjusting for age, sex and treatment arm, plasma levels of high-density lipoprotein (HDL) cholesterol, triglycerides, high-sensitivity C-reactive protein (hsCRP), insulin, neopterin, N-terminal pro-brain natriuretic peptide (BNP), lipoprotein(a) [Lp(a)], and the soluble receptor for advanced glycation end products (sRAGE) were predictive of recurrent MCVEs (P ≤ 0.02 for each doubling of plasma concentration). However, no significant association was observed between the risk of recurrent MCVEs and plasma levels of low-density lipoprotein cholesterol, adiponectin, cystatin C, lipoprotein-associated phospholipase A2, monocyte chemotactic protein-1, matrix metalloproteinase-9, myeloperoxidase, osteopontin, soluble CD40 ligand, soluble intercellular adhesion molecule-1, or soluble vascular cell adhesion molecule-1. After further adjustment for diabetes, hypertension, smoking, and BMI, the relationship between hsCRP, insulin and MCVE were no longer significant, while the relationship between Lp(a), neopterin, NT-proBNP and sRAGE and MCVE remained statistically significant. In conclusion, in patients with CHD treated with atorvastatin, plasma levels of Lp(a), neopterin, NT-proBNP, and sRAGE are associated with the risk of recurrent MCVEs.Trial registrationClinicalTrials.gov NCT00327691.

Children and young adults with one or more risk factors for cardiovascular disease are more likely to have fatty streaks and plaques in their blood vessels that could lead to atherosclerosis. Researchers examined autopsy samples from the aorta and coronary arteries of 93 young people aged 2 to 39 years who died from different causes. Cardiovascular risk factors included obesity, smoking, high blood pressure, and elevated blood levels of cholesterol, triglycerides and other fats. The more risk factors the individual had, the greater the amount of fatty streaks and plaques in the aorta and coronary arteries.

Children whose parents have coronary artery disease (CAD) may be at greater risk of developing cardiac risk factors as they grow older. In an 19-year study of 1,524 young people in Bogalusa, LA, those with a parent with CAD were more likely to be overweight and to develop early unhealthy changes in blood lipids and glucose. Overweight was apparent at 10-11 years of age. Parental CAD was associated with unhealthy cholesterol levels in white males and increased insulin levels in black males. Early screening for cardiovascular risk factors may be important in young people with a parental history of CAD., Context.--Although the association between parental coronary artery disease (CAD) and its risk factors in the offspring is known, the timing and the course of development of risk factors from childhood to adulthood in the offspring is not known. Objective.--To examine the association between parental CAD and longitudinal changes in risk factor profile from childhood to young adulthood in offspring. Design.--Cohort study. Setting.--Bogalusa, La, a semirural, biracial community. Participants.--Individuals with clinically verified parental history of CAD (n=271) vs those without such a history (n = 1253) Mean age at first CAD event was 50 years for fathers and 52 years for mothers. Main Outcome Measures.--Body mass index, subscapular skinfolds, blood pressure, and triglyceride, cholesterol (total, very low-density lipoprotein [VLDL-C], low-density lipoprotein [LDL-C], and high-density lipoprotein [HDL-C] cholesterols), glucose, and insulin levels. Results.--The offspring of parents with CAD were consistently overweight beginning in childhood. Their levels of total serum cholesterol, LDL-C, plasma glucose, and insulin became significantly higher at older ages, because of a higher rate of increase in these risk factors over time. In adulthood, the offspring with a positive parental history had a higher prevalence of obesity (body mass index [is greater than] 85th percentile in the National Health and Nutrition Examination Survey I, 35% vs 26%, P=.01), elevated total cholesterol ([is greater than] 6.2 mmol/L [240 mg/dL], 8.4% vs 4.8%, P=.05) and LDL-C levels ([is greater than] 4.1 mmol/L [160 mg/dL], 12.4% vs 4.7%, P=.05), and hyperglycemia (glucose, [is greater than] 6.6 mmol/L, 2.7% vs 0.4%, P [is less than] .001), as well as a higher coexistence of these conditions (P=.01). Further, the prevalence of dyslipidemia, either involving only LDL-C or LDL-C in combination with HDL-C or triglycerides or both was significantly higher in the adult offspring with parental CAD. Conclusions.--Offspring of parents with early CAD were overweight beginning in childhood and developed an adverse cardiovascular risk factor profile at an increased rate. These observations have important implications for prevention and intervention. JAMA. 1997;278:1749-1754

The composition of children's diets has come under increased scrutiny in recent years. More emphasis has been placed on defining dietary adequacy in terms of the distribution of energy components [...]