Recommendation for the management of dyslipidemia in Poland — Third Declaration of Sopot. Interdisciplinary Expert Position Statement endorsed by the Polish Cardiac Society Working Group on Cardiovascular Pharmacotherapy

Szymański, Filip M.; Barylski, Marcin; Cybulska, Barbara; Wożakowska−Kapłon, Beata; Krasiński, Zbigniew; Mamcarz, Artur; Widecka, Krystyna; Płatek, Anna E.; Dudek, Dariusz; Mickiewicz, Agnieszka; Kobayashi, Adam; Dzida, Grzegorz; Grajek, Stefan; Wełnicki, Marcin; Zubilewicz, Tomasz; Ufnal, Marcin; Hering, Dagmara; Mizia-Stec, Katarzyna; Kasprzak, Jarosław D.; Koziński, Marek; Imiela, Jacek; Gorczyca, Iwona; Postuła, Marek; Jaguszewski, Miłosz; Filipiak‬, Krzysztof J.

doi:10.5603/cj.2018.0141

Cited by 22 publications

(28 citation statements)

References 26 publications

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“…The study was conducted on highly educated individuals on the academic staff of a university, many of whom therefore may have considered that they did not need medical check-ups and ignored doctors' instructions. Another reason may be that most academic work involves considerable sedentary time, which is an important risk factor of insulin resistance [14].…”

Section: Discussionmentioning

confidence: 99%

Dyslipidaemia, carbohydrate metabolism disorders and arterial hypertension detected in academic employees during examinations in occupational medicine

Marcinkiewicz¹,

Śliż²,

Olejniczak³

et al. 2021

Ann Agric Environ Med.

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Section: Discussionmentioning

confidence: 99%

Dyslipidaemia, carbohydrate metabolism disorders and arterial hypertension detected in academic employees during examinations in occupational medicine

Marcinkiewicz¹,

Śliż²,

Olejniczak³

et al. 2021

Ann Agric Environ Med.

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“…Data on polygenic hypercholesterolemia are still lacking, as the genotyping for the polygenic score in mutation-negative FH patients is not routinely performed. Therefore, the studies focusing on a treatment response and the achievement of LDL-C goals in polygenic vs. monogenic hypercholesterolemia are valuable in light of new treatment targets and novel drugs [25][26][27][28][29].…”

Section: Discussionmentioning

confidence: 99%

“…Undoubtedly, severe hypercholesterolemia must be treated, irrespective of the underlying genetic cause due to the causal role of elevated LDL-C in the development of atherosclerosis. All of the patients with hypercholesterolemia should reach recommended LDL-C treatment targets to improve their clinical outcome [25,35,36]. However, different approaches can be proposed for monogenic and mutation negative FH cases and in consequence for those with polygenic cause of FH due to higher CV risk in HeFH [37].…”

Section: Discussionmentioning

confidence: 99%

Higher responsiveness to rosuvastatin in polygenic versus monogenic hypercholesterolaemia: a propensity score analysis

Mickiewicz

Futema

Ćwiklińska

et al. 2020

European Heart Journal

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Background The underlying monogenic defect in familial hypercholesterolemia (FH) can be detected in ∼40% of cases. The majority of mutation-negative patients have a polygenic cause of high LDL-cholesterol (LDL-C) due to having inherited a greater than average number of common LDL-C raising single nucleotide polymorphisms (SNPs). Purpose We sought to investigate, whether the monogenic or polygenic defect in FH is associated with the response to rosuvastatin. Methods Individuals with a clinical diagnosis of FH were tested for mutations in LDLR and APOB genes. A previously established LDL-C-specific polygenic risk score (PRS) was used to examine the possibility of polygenic hypercholesterolemia in mutation negative patients. The propensity score analysis was performed to evaluate the variables associated with the response to rosuvastatin. The type of hypercholesterolemia (polygenic or monogenic) and following variables: age, gender, LDL-baseline, statin intolerance, ezetimibe use, rosuvastatin dose, diabetes and cardiovascular disease (CVD), were examined to minimize the bias of this observational study. Results LDLR/APOB mutation was found in 47 (42%) patients, whereas polygenic hypercholesterolemia was diagnosed in 65 (58%) of patients. Mean age was comparable in both groups (54±13 vs 51±13, p=0.134). CVD was diagnosed in ≈26% of individuals in both cohorts (p=0.343). There was no difference in the distribution of CV risk factors, such as arterial hypertension, smoking, diabetes, body mass index and in rate of statin intolerance. Monogenic subjects had higher baseline LDL-C compared to polygenic (Table 1). Adjusted model showed a lower percentage of change in LDL-C after rosuvastatin treatment in monogenic vs. polygenic subjects (46% vs 55%, p<0.001) (Figure 1). The probability of achieving LDL-C targets in monogenic FH was lower than in polygenic subjects (0.075 vs. 0.245, p=0.004). Polygenic patients were more likely to achieve LDL-C goals, compared to mutation-positive patients (OR 3.28; 95% CI:1.23–8.72). Conclusion Our findings indicate an essentially higher responsiveness to rosuvastatin in patients with a polygenic cause, as compared to those carrying monogenic mutations. Figure 1 Funding Acknowledgement Type of funding source: Public grant(s) – EU funding. Main funding source(s): 1. Polish Ministry of Science and Higher Education European Regional Development Fund under the Programme Innovative Economy 2007–2013 (POIG.01.01.02-22-079/09). 2. British Heart Foundation (PG 08/008). 3. The National Institute for Health Research, University College London Hospitals, Biomedical Research Centre. 4. The Foundation Leducq Transatlantic Networks of Excellence Program grant (no. 14 CVD03)

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“…FH was diagnosed based on the Dutch Lipid Clinic Network Score, validated in the Polish population [20]. Before the initiation of LA, all subjects were treated with maximally tolerated lipid-lowering therapy to achieve recommended LDL-C treatment goals [5,21]. The study was performed in accordance with the ethical guidelines of the 1975 Declaration of Helsinki and was approved by the Medical Ethics Committee of the Medical University of Gdańsk (Project code: 428/2018-2019).…”

Section: Methodsmentioning

confidence: 99%

“…Lipid-lowering medications, diet, and lifestyle modification do not always achieve the intended and restrictive therapeutic goals and proper reduction of cardiovascular event rate [5]. Individuals with severe familial hypercholesterolemia (FH) and those with high levels of lp(a) may require extracorporeal treatment with lipoprotein apheresis (LA).…”

Section: Introductionmentioning

confidence: 99%

The Impact of Lipoprotein Apheresis on Oxidative Stress Biomarkers and High-Density Lipoprotein Subfractions

Mickiewicz

Kreft

Kuchta

et al. 2020

Oxidative Medicine and Cellular Longevity

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Lipoprotein apheresis (LA) treatment results in a substantial reduction of low-density lipoprotein- (LDL-) cholesterol and lipoprotein(a) concentrations, which consequently decreases the rate of cardiovascular events. The additional benefit of LA may be associated with its impact on the composition and quality of high-density lipoprotein (HDL) particles, inflammation, and oxidative stress condition. To verify the effects of LA procedure, the current study is aimed at analyzing the effect of a single apheresis procedure with direct hemadsorption (DALI) and cascade filtration (MONET) on oxidative stress markers and HDL-related parameters. The study included eleven patients with familial hypercholesterolemia and hyperlipoproteinemia(a) treated with regular LA (DALI or MONET). We investigated the pre- and postapheresis concentration of the lipid-related oxidative stress markers 8-isoPGF2, oxLDL, TBARS, and PON-1. We also tracked potential changes in the main HDL apolipoproteins (ApoA-I, ApoA-II) and cholesterol contained in HDL subfractions. A single session of LA with DALI or MONET techniques resulted in a similar reduction of lipid-related oxidative stress markers. Concentrations of 8-isoPGF2 and TBARS were reduced by ~60% and ~30%, respectively. LA resulted in a 67% decrease in oxLDL levels along with a ~19% reduction in the oxLDL/ApoB ratio. Concentrations of HDL cholesterol, ApoA-I, ApoA-II, and PON-1 activity were also reduced by LA sessions, with more noticeable effects seen in the MONET technique. The quantitative proportions between HDL2 and HDL3 cholesterol did not change significantly by both methods. In conclusion, LA treatment with MONET or DALI system has a small nonselective effect on lowering HDL particles without any changes in the protein composition of these particles. Significant reduction in the level of oxidative stress parameters and less oxidation of LDL particles may provide an additional benefit of LA therapy.

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Recommendation for the management of dyslipidemia in Poland — Third Declaration of Sopot. Interdisciplinary Expert Position Statement endorsed by the Polish Cardiac Society Working Group on Cardiovascular Pharmacotherapy

Abstract: This article has been co-published in the Choroby Serca i Naczyń 2018; 15(4): 199-210.

Cited by 22 publications

References 26 publications

Dyslipidaemia, carbohydrate metabolism disorders and arterial hypertension detected in academic employees during examinations in occupational medicine

Dyslipidaemia, carbohydrate metabolism disorders and arterial hypertension detected in academic employees during examinations in occupational medicine

Higher responsiveness to rosuvastatin in polygenic versus monogenic hypercholesterolaemia: a propensity score analysis

The Impact of Lipoprotein Apheresis on Oxidative Stress Biomarkers and High-Density Lipoprotein Subfractions

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