Lipids and CAD: February essentials

  • Pavankumar Kamat
  • Global Monthly Essentials
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The top new studies we've selected from scanning more than 661 clinical articles on Lipids and CAD in the past month.

The presence of juvenile idiopathic arthritis (JIA) is associated with alterations in HDL particle distribution, cholesterol efflux and non-lipid transporting activities

Source: Cardiovasc Diagn Ther

Key results

  • JIA patients demonstrated lower levels of HDL cholesterol [47.0 (40.0, 56.0) vs. 56.0 (53.0, 61.0) mg/dL, P=0.04], total HDL [29.5 (27.9, 32.3) vs. 32.9 (31.6, 36.3) mg/dL, P=0.05] and large HDL [5.1 (3.7, 7.3) vs. 8.0 (6.7, 9.7) mg/dL, P=0.04] particles.
  • JIA patients demonstrated greater cholesterol efflux mediated via ATP binding cassette A1 (ABCA1) [17.3% (12.8, 19.7) vs. 10.0% (5.8, 16.0), P=0.05] and less efflux mediated via ATP binding cassette G-1 (ABCG1) [3.2% (2.0, 3.9) vs. 4.8% (3.5, 5.8), P=0.01] and SR-B1 [6.9% (6.0, 8.4) vs. 9.1% (8.6, 10.2), P=0.002] compared with controls.
  • Exposing macrophages to serum from JIA patients resulted in a smaller increase in mRNA expression of ABCA1 (2.0±0.95 vs. 7.1±5.7 fold increase, P=0.01) and greater increases in expression of ABCG1 [1.4 (0.9, 1.5) vs. 0.8 (0.7, 1.1) fold increase, P=0.04] and SR-B1 (1.3±0.47 vs. 0.7±0.3 fold increase, P=0.001) compared with controls.
  • No differences in cIMT were observed between JIA patients and controls.

Study design

  • Prospective cross-sectional matched characteristic study of 44 patients, comprising 29 adolescents and young adults with JIA and 15 controls.
  • The disease group were aged 10-35 years.

Why this matters

  • These abnormalities could translate to subclinical atherosclerosis and cardiovascular risk, and whether they identify an individual who requires more aggressive cardiovascular risk modification or if they respond to intensification of anti-inflammatory therapy should be examined in future and larger cohorts.
PubMed Abstract 

Nigella sativa (NS) supplementation had a significant impact on plasma lipid concentrations, but more research is needed to explore the NS benefits on cardiovascular outcomes

Source: Pharmacol Res                                                       

Key results

  • Meta-analysis suggested a significant association between NS supplementation and a reduction in total cholesterol (weighed-mean-difference [WMD]: -15.65mg/dL, 95% CI: -24.67, -6.63, p=0.001), LDL-C (WMD: -14.10mg/dL, 95% CI: -19.32, -8.88, p<0.001), and triglyceride levels (WMD: -20.64mg/dL, 95% CI: -30.29, -11.00, p<0.001).
  • No significant effect on HDL-C concentrations (WMD: 0.28mg/dL, 95% CI: -1.96, 2.53, p=0.804) was found.
  • A greater effect of NS seed oil versus seed powder was observed on serum total cholesterol and LDL-C levels, and an increase in HDL-C levels was found only after NS seed powder supplementation.

Study design

  • Meta analysi of 17 randomized controlled trials that examiined the effects of NS on plasma lipid concentrations.
Why this matters
  • Nigella sativa appears to be effective in regulating plasma lipid concentrations, and it is a relatively inexpensive and non-toxic supplement.
  • Further research is needed to examiine the effect on cardiovascular outcomes.
PubMed Abstract


Women appear to have a higher incidence of lipoprotein (a) (lp(a)) than the general population, and patients with elevated Lp(a) may have different manifestations of cardiovascular disease

Source: Clin Cardiol

Key results

  • Of 713 women, 290 (41%) had elevated Lp(a), but LDL-C and Lp(a) were weakly correlated (r = 0.08).
  • Significant discordance was observed between abnormal LDL-C and Lp(a) levels (McNemar P = 0.03).
  • Moderate correlation was noted between RRS-A and ASCVD risk (r = 0.71, P < 0.001), and Bland-Altman plot showed diminished correlation with increased risk.
  • More patients met treatment threshold by ASCVD risk estimation, but nearly 1 out of 20 patients met treatment threshold by RRS-A but not ASCVD score.

 Study design

  • Retrospective, cross-sectional study of consecutive female patients presenting to Heart Centers for Women was performed.
  • Discordance between low-density lipoprotein cholesterol (LDL-C) and Lp(a) was determined.
Why this matters
  • In this cohort, women had higher rates of Lp(a) and randomized controlled trials investigating Lp(a) treatment and interactions with other risk factors are needed to help guide therapy in further reducing cardiovascular risk in women.

PubMed Abstract