Atherosclerosis 2

Question 0

Metabolic syndrome is considered a significant risk factor for CHD. How is metabolic syndrome defined?

Answer 0

At least of the 3 of the following 5 conditions:
Central obesity (by waist circumference).
High TGs. (>150mg/dL)
Low HDL. (85 dias).
High fasting glucose (>110mg/dL).

(note that some of these don’t meet the cutoffs for HTN or T2DM)

Question 1

How bad is diabetes for CHD risk? (what’s a useful comparison)

Answer 1

Diabetes increases risk for CHD by 20%. This is equivalent to that caused by having had a prior MI.
So it’s bad.

Question 2

Are increased levels of inflammatory molecules associated with increased risk of CVD?

Answer 2

Yep.

Question 3

Would lowering CRP directly (say… with an anti-CRP antibody, or something) affect CVD risk?

Answer 3

Probably not. Genetic studies suggest that CRP is a marker of increased CVD risk, but does not itself drive CVD.

Question 4

What does Lp-PLA2 do, and what does it have to do with atherosclerosis?

Answer 4

Lipoprotein phospholipase A2 breaks down lipids stored in LDL into pro-inflammatory / atherogenic peptides.
Drugs targeting it are in Phase III trials.

Question 5

4 methods for non-invasive (i.e. not cardioangiogram) screening for subclinical atherosclerosis? (What does each technique assess?)

Answer 5

B-mode ultrasonography (intimal thickening/proliferation)
Electron beam tomography or CT (to assess calcification)
MRI (plaque size and morphology)
Molecular imaging (not sure what this is getting at… assessment of expression of molecules like ICAM / VCAM??)

Question 6

What protease was identified in GWASs / other large studies as being a significant risk factor for CHD?

Answer 6

ADAMTS7 - overexpression may lead to fibrous cap thinning and increased risk for plaque rupture. A good potential drug target.

Question 7

Interesting things are being identified in these large genetic studies.

Answer 7

Cool.