PCSK9 is a protein with proven deleterious effects on lipid metabolism. PCSK9 facilitates the degradation of the LDL receptors on the surface of hepatocytes. As a result, LDL concentrations in the serum increase. Statin therapy stimulates a positive feedback circle which causes PCSK9 levels to increase, attenuating statin’s efficiency. PCSK9 inhibitors have proven themselves in several clinical trials as safe drugs that cause significant improvements in lipid profiles. The purpose of this review is to fully delineate the link between PCSK9 and atherosclerosis, as well as the future of PCSK9 inhibition.
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Dimitrios Mouselimis
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Spontaneous coronary artery dissection (SCAD) is considered a non-traumatic, non-iatrogenic rupture of the coronary artery wall with a consequential formation of a false lumen and an intramural hematoma (IMH), capable under certain circumstances of compressing the true lumen causing acute coronary syndrome. We report our recent experience in the field, by presenting 9 different cases of SCAD, first admitted with an initial diagnosis of non-ST segment elevation myocardial infarction (NSTEMI). We additionally provide a brief review of the literature.
Erectile dysfunction (ED) is a highly prevalent disease that affects the quality of life of mainly older men. Among the complex etiology of ED, atherosclerosis is the predominant of the arteriogenic causes. It has been reported that ED and cardiovascular disease share common risk factors and common pathophysiological mechanisms (endothelial dysfunction, inflammation, and low testosterone levels). Moreover, increasing evidence suggests that clinical manifestations of ED precede cardiovascular events by about three years and thus, its diagnosis offers a window for early cardiologic assessment and intervention. In patients with suspected arteriogenic ED, data ha sshown that percutaneous revascularization of penile arteries may be considered an effective treatmentstrategy in patients with macroangiopathic disease who have not responded to oral conservative therapy. All in all, a complex and yet-to-be understood interplay between ED and cardiovascular disease has been revealed in recent years.
Keywords: erectile dysfunction, penis pumps,sildenafil
Type 2 diabetes mellitus (T2DM) is a growing pandemic, constituting the 7th cause of death worldwide. Morbidity and mortality rates among patients with T2DM are increasing, while the incidence of cardiovascular disease in this population is estimated to be 14%greater compared to the general population. Aortic stiffness represents now a valuable biomarker of cardiovascular disease and a promising treatment target in various populations, including patients with T2DM; however, most of available studies are crosssectional, and thus, causality cannot be proven. Non-invasive measurement, easy learning and low cost constitute evaluation of aortic stiffness a routine diagnostic test with significant prognostic value. Recently, a new class of antidiabetics, namely sodium-glucose co-transporter-2 (SGLT-2) inhibitors have attracted scientific interest, due to their beneficial cardiovascular effects. There is limited relevant literature concerning the impact of the SGLT-2 inhibitors on the aortic stiffness, while the results are rather considered as ambiguous. The aim of the present review article is to present past and contemporary knowledge regarding the diagnostic and prognostic value of aortic stiffness in the field of T2DM and related cardiovascular disease, and to discuss the promising role of SGLT-2 inhibitors in aortic stiffness reduction.
Keywords: Aortic stiffness, type 2 diabetes mellitus, cardiovascular disease, SGLT-2 inhibitors.
Diabetic cardiomyopathy is a cardiac dysfunction with a prevalence of 12% in diabetic patients. The precise pathophysiological mechanism leading to the development of thisspecific type of cardiomyopathy is complex and not completely yet known. Since 1972, when the definition of diabetic cardiomyopathy wasintroduced, until today significant progress has been made in its diagnosis and treatment. The earlier the diagnosis is made by using mainly echocardiography, the higher the chances of reversing the progression of the disease to overt failure. Thisreview aimsto summarize the various diagnostic methods, current prevention approaches, and innovative treatment strategies.
Keywords: Cardiac dysfunction, diabetes mellitus, diabetic cardiomyopathy