| For medical practitioners and the general public - Cholesterol Journal Article Catalog. |
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| Carcinoembryonic antigen-related cell adhesion molecule 1 is the 85-kilodalton pronase-resistant biliary glycoprotein in the cholesterol crystallization promoting low density protein-lipid complex Jirsa, M., L. Muchova, et al. (2001), Hepatology 34(6): 1075-82. Abstract: A pronase resistant 85-kd glycoprotein in the Concanavalin A-binding fraction (CABF) of biliary glycoproteins has been reported to act as a promotor of cholesterol crystallization. De Bruijn et al. (Gastroenterology 1996;110:1936-1944) found this protein in a low-density protein-lipid complex (LDP) with potent cholesterol crystallization promoting activity. This study identifies and characterizes this protein. An LDP was prepared from CABF by discontinuous gradient ultracentrifugation. Proteins were analyzed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE), blotting and immunochemical staining with anti-carcinoembryonic antigen, CEA-related adhesion molecule 1 (CEACAM1) cross-reacting antibodies. Biliary concentrations of CEA cross-reacting proteins were determined in patients with and without gallstones. Two isoforms of CEACAM1 (85- and 115-kd bands), CEA and 2 CEA cross-reacting protein bands of 40 and 50 kd were found in human bile. All bands were also present in CABF, but only a subfraction of the 85-kd band found in the LDP was resistant to digestion with pronase. CEACAM1-85 exhibited potent cholesterol crystallization promoting activity in vitro and accounted for most of the activity in CABF. Total CEA cross-reacting protein concentrations were the same in gallbladder biles from patients with cholesterol and pigment gallstones but only half of those in biles from nongallstone subjects. In conclusion, we have identified the protein component of the cholesterol crystallization promoting LDP to be CEACAM1-85. |
| Cardanol as a replacement for cholesterol into the lipid bilayer of POPC liposomes De Maria, P., P. Filippone, et al. (2005), Colloids Surf B Biointerfaces 40(1): 11-8. Abstract: Large unilamellar liposomes were prepared by hydration of 1-palmitoyl-2-oleylphosphatydilcholine (POPC) films and subsequent extrusion of the obtained liposomal suspension. Inclusion of cholesterol and cardanol brings about a stabilization of the membranes of the liposomes, as determined by their rates of release of entrapped 5(6)-carboxyfluorescein. The liposome breakdown was promoted by a non-ionic surfactant (Triton X-100) and the kinetic measurements were carried out by fluorimetry in water at 25 degrees C. Morphological analyses of giant POPC liposomes in the presence and in the absence of both guests were also performed. The results obtained suggest the use of cardanol (an easy available natural product) as a replacement for cholesterol as a new possibility for stabilizing liposomes in drug targetting. |
| Cardiac Care. Cholesterol--(is it another word for paranoia) Corday, E. (1990), Can Crit Care Nurs J 7(4): 15. |
| Cardiac systolic and diastolic dysfunction after a cholesterol-rich diet Huang, Y., K. E. Walker, et al. (2004), Circulation 109(1): 97-102. Abstract: BACKGROUND: Although hypercholesterolemia is a well-established risk factor for coronary artery disease, little is known regarding its direct effects on cardiac function. METHODS AND RESULTS: We examined the effects of cholesterol feeding (0.5%) on cardiac function in rabbits. After 10 weeks, both systolic shortening and diastolic relaxation rates were impaired without any change in aortic pressure or ventricular hypertrophy. However, sarcoplasmic/endoplasmic reticulum Ca2+-ATPase (SERCA)-2 mRNA levels were reduced within 4 days after initiation of cholesterol feeding. After this effect, SERCA-2 protein and SERCA-mediated Ca uptake into sarcoplasmic reticulum vesicles were impaired, and the ratio of MHC-beta to MHC-alpha mRNA increased 5-fold. Suppression of the SERCA-2 message correlated temporally with enrichment of the cardiac sarcolemma with cholesterol. CONCLUSIONS: These data demonstrate that dietary hypercholesterolemia induces a "cholesterol cardiomyopathy" characterized by systolic and diastolic dysfunction. These alterations were independent of vascular disease and demonstrate a dietary link to cardiac dysfunction. |
| Cardiology patient page. Measurement of cholesterol: a patient perspective Birtcher, K. K. and C. M. Ballantyne (2004), Circulation 110(11): e296-7. |
| Cardiovascular basis for cholesterol therapy Rackley, C. E. (2000), Cardiol Rev 8(2): 124-31. Abstract: The success of cholesterol treatment in reducing cardiovascular events has suggested addition of a cholesterol paradigm to previous clinical models of stenosis and occlusion in coronary artery disease. Risk factors for coronary artery disease now serve as guidelines for treatment goals for low-density lipoprotein cholesterol reduction. Oxidation of low-density lipoprotein cholesterol within the vessel wall initiates a variety of deleterious mechanisms contributing to atherosclerosis. Hepatic hydroxymethylglutaryl-coenzyme A reductase inhibitors or statin drugs exert a primary action on hepatic cholesterol metabolism, as well as influences on vascular reactivity, thrombus formation, inflammation, ischemia, and plaque stabilization. Trials with statin drugs have reported reduction of cardiovascular events in men and women without clinical evidence of coronary artery disease. Several trials have demonstrated angiographic stabilization with cholesterol lowering and a greater reduction in cardiovascular events, revascularization procedures, and strokes. Recent studies suggest benefits in lowering triglycerides and raising high-density lipoprotein cholesterol with drugs. A clinical approach with available cholesterol-lowering drugs is presented based on National Cholesterol Education Program guidelines and follow-up time tables. Thus, cholesterol therapy offers the opportunity to treat atherosclerotic vascular disease before, during, and after ischemic events. |
| Cardiovascular biology: a cholesterol tether Staels, B. (2002), Nature 417(6890): 699-701. |
| Cardiovascular events and their reduction with pravastatin in diabetic and glucose-intolerant myocardial infarction survivors with average cholesterol levels: subgroup analyses in the cholesterol and recurrent events (CARE) trial. The Care Investigators Goldberg, R. B., M. J. Mellies, et al. (1998), Circulation 98(23): 2513-9. Abstract: BACKGROUND: Although diabetes is a major risk factor for coronary heart disease (CHD), little information is available on the effects of lipid lowering in diabetic patients. We determined whether lipid-lowering treatment with pravastatin prevents recurrent cardiovascular events in diabetic patients with CHD and average cholesterol levels. METHODS AND RESULTS: The Cholesterol And Recurrent Events (CARE) trial, a 5-year trial that compared the effect of pravastatin and placebo, included 586 patients (14.1%) with clinical diagnoses of diabetes. The participants with diabetes were older, more obese, and more hypertensive. The mean baseline lipid concentrations in the group with diabetes--136 mg/dL LDL cholesterol, 38 mg/dL HDL cholesterol, and 164 mg/dL triglycerides--were similar to those in the nondiabetic group. LDL cholesterol reduction by pravastatin was similar (27% and 28%) in the diabetic and nondiabetic groups, respectively. In the placebo group, the diabetic patients suffered more recurrent coronary events (CHD death, nonfatal myocardial infarction MI, CABG, and PTCA) than did the nondiabetic patients (37% versus 25%). Pravastatin treatment reduced the absolute risk of coronary events for the diabetic and nondiabetic patients by 8.1% and 5.2% and the relative risk by 25% (P=0.05) and 23% (P<0.001), respectively. Pravastatin reduced the relative risk for revascularization procedures by 32% (P=0.04) in the diabetic patients. In the 3553 patients who were not diagnosed as diabetic, 342 had impaired fasting glucose at entry defined by the American Diabetes Association as 110 to 125 mg/dL. These nondiabetic patients with impaired fasting glucose had a higher rate of recurrent coronary events than those with normal fasting glucose (eg, 13% versus 10% for nonfatal MI). Recurrence rates tended to be lower in the pravastatin compared with placebo group (eg, -50%, P=0.05 for nonfatal MI). CONCLUSIONS: Diabetic patients and nondiabetic patients with impaired fasting glucose are at high risk of recurrent coronary events that can be substantially reduced by pravastatin treatment. |
| Cardiovascular risk beyond LDL-C levels. Other lipids are performers in cholesterol story Nash, D. T. (2004), Postgrad Med 116(3): 11-5. Abstract: High levels of low-density lipoprotein cholesterol (LDL-C) are an obvious culprit in coronary artery disease (CAD). However, the search for lipid factors that influence cardiovascular health does not end there. In this article, Dr Nash presents the various lipid factors involved, for better or worse, in CAD. He emphasizes that although studies have expanded the understanding of this disease, the knowledge needs to be put to use more consistently in clinical practice in order to provide optimal patient care. |
| Cardiovascular risk determination: discrepancy between total cholesterol evaluation and two compound laboratory indices in Norway Berg, J. E. and A. T. Hostmark (1994), J Epidemiol Community Health 48(4): 338-43. Abstract: OBJECTIVE--To compare group classification of cardiovascular risk by two compound laboratory indices with classification according to the serum total cholesterol concentration alone. DESIGN--Healthy employees were defined as low and high cardiovascular risk subjects according to their total cholesterol concentration or two compound indices of blood lipid components-the total cholesterol: high density lipoprotein (HDL) cholesterol ratio and an atherogenic index defined as (total cholesterol-HDL cholesterol*apolipoprotein B)/(HDL cholesterol*apolipoprotein A-I). Cut off values to distinguish between low and high risk subjects were as follows: total cholesterol 6.5 mmol/l, HDL cholesterol 0.9 mmol/l, apolipoprotein A = 1.8 g/l, and apolipoprotein B = 1.3 g/l. These gave total: HDL cholesterol ratio and atherogenic index cut off values of 7.2 and 4.5 respectively. SETTING--An occupational health service in a non-manufacturing company in Norway. PARTICIPANTS--A total of 112 male and 117 female employees. The mean body mass index values were 25.6 and 23.6 kg/m2 and the mean ages 39.8 and 40.1 years in men and women respectively. Those with cardiovascular, diabetic, or renal diseases were excluded. MEAN OUTCOME MEASURES--Serum total cholesterol, HDL cholesterol, apolipoproteins A-I and B, lipid peroxidation, blood pressure, smoking, physical activity, and fruit, vegetables, and salt in the diet were determined. RESULTS--The cut off values allocated 19%, 7%, and 40% as high risk subjects according to total cholesterol, total: HDL cholesterol, and the atherogenic index respectively. The mean age was two to four years higher in the high risk groups. Cardiovascular risk in siblings and no reported physical activity were more prevalent in those high risk groups defined by the compound indices than by total cholesterol alone, as was a high body mass index and a measure of lipid peroxidation. Grouping according to total cholesterol failed to allocate heavy smokers mainly to the high risk group. Diet variables did not demarcate clearly between indices. CONCLUSIONS--There is considerable variability in classification into high and low risk subjects when using the total cholesterol concentration alone compared with compound risk indices. Smoking was more prevalent in the high risk groups defined by the compound indices than by total cholesterol. These findings call for caution when total cholesterol is used to estimate cardiovascular risk in epidemiological studies, and even more so at individual counselling in occupational or primary health care settings. |
| Cardiovascular risk factor clustering and ratio of total cholesterol to high-density lipoprotein cholesterol in angiographically documented coronary artery disease Luria, M. H., J. Erel, et al. (1991), Am J Cardiol 67(1): 31-6. Abstract: High levels of cardiac risk factors tend to cluster together and act synergistically. To develop a suitable and practical marker for clustering, we evaluated 380 consecutive patients at the time of coronary angiography. Analyses of lipid, rheologic, clinical and arteriographic profiles indicated a variety of interwoven relations. Because the ratio of total cholesterol to high-density lipoprotein (HDL) cholesterol (total/HDL cholesterol) was closely related to both the presence and extent of greater than or equal to 50% diameter reduction of greater than or equal to 1 coronary arteries, it was used to divide patients into quartiles. Clustering of high- and low-level risk factors was demonstrated in the highest and lowest quartiles of total/HDL cholesterol, respectively (p less than 0.001). The highest quartile may be characterized by an only moderately elevated total cholesterol level but patients in this quartile may have a very low HDL cholesterol level, high triglycerides, a tendency toward high hemoglobin and fibrinogen levels, a history of smoking, previous myocardial infarction and multivessel disease. These results suggest that total/HDL cholesterol serves as a marker not only for obstructive coronary disease but also for a cluster of potentially modifiable risk factors. |
| Cardiovascular risk factor reduction. Cholesterol absorption inhibitors: a new action principle Schunack, W. (2003), Pharm Unserer Zeit 32(6): 498-502. |
| Cardiovascular risk factors and lipoprotein profile in French Canadians with premature CAD: impact of the National Cholesterol Education Program II McNicoll, S., Y. Latour, et al. (1995), Can J Cardiol 11(2): 109-16. Abstract: BACKGROUND: Coronary artery disease (CAD) is the major cause of death in Canadian adults. Regional differences in the prevalence of CAD in Canada are due, in part, to differences in cardiovascular risk factor distribution. Two hundred and forty-nine patients of predominantly French Canadian descent (greater than 90%), aged less than 60 years (202 men and 47 women) with angiographically documented CAD were examined in a cardiology secondary prevention clinic and their cardiovascular risk factors and lipoprotein cholesterol levels were determined. OBJECTIVES: To determine the prevalence of cardiovascular risk factors in a group of French Canadian subjects compared with subjects screened for the Quebec Heart Health Survey and to determine the impact of the National Cholesterol Education Program II (NCEP II) on screening and treatment of these patients. METHODS: Observation study of free-living subjects with CAD, compared with a reference group. RESULTS: Mean ages were 48.6 +/- 6.8 and 50.6 +/- 6.4 years for men and women, respectively. On average, the patients were on a diet containing approximately 31% of calories as fat, with 9.7% as saturated fats at the time of blood sampling. The mean number of risk factors was the same in men and women (3.5 +/- 1.2 for men versus 3.2 +/- 1.3 for women; P not significant) but their prevalence differed between sexes. Family history of CAD was seen in 78.5% of men versus 77.3% of women (P not significant), smoking (defined as more than 10 cigarettes per day in the year preceding the clinical evaluation) in 45.7% of men versus 41.9% of women (P not significant), a history of smoking in 75.5% of men versus 69.8% of women (P not significant) and diabetes in 14.7% of men and 25% of women (P not significant). There was less hypertension in men (31.4% versus 52.3%, P = 0.015) and fewer men had a low density lipoprotein cholesterol of 3.4 mmol/L or greater (66.8% in men versus 83% in women, P < 0.05). Men, however, had a higher prevalence of reduced high density lipoprotein cholesterol (less than 0.9 mmol/L, 57.4% in men versus 31.9% in women, P < 0.01). Only approximately 5% of premature CAD patients had familial hypercholesterolemia. Compared with a reference group from the Quebec Heart Health Survey, men and women with CAD had a higher prevalence of cardiovascular risk factors. With a cut-off point for total cholesterol of 5.2 mmol/L, 26.2% of men and 17% of women had 'normal' cholesterol levels; of these, 67.9% of men and 25% of women had high density lipoprotein less than 0.9 mmol/L. CONCLUSIONS: French Canadian men and women with CAD have a high prevalence of all cardiovascular risk factors. The patients are representative of the Montreal urban area and findings of the present study may not apply to the Quebec population with respect to the prevalence of risk factors. Under the treatment recommendations of NCEP II, 66.8% of men and 83% of women are candidates for drug therapy of dyslipoproteinemia aimed at reducing low density lipoprotein cholesterol levels. According to these data, cardiovascular risk stratification must be based on a complete lipoprotein profile or misclassification, especially in men, may occur. |
| Cardiovascular risk factors in former and new Germany. City comparison of Leipzig/Nurnberg on the incidence of increased cholesterol values and other cardiovascular risk factors Richter, W. O., V. Richter, et al. (1993), Fortschr Med 111(13): 214-8. Abstract: FUNDAMENTALS: Cardiovascular risk factors depend decisively on living conditions and nutrition. The aim of the present study was to establish whether the different living conditions in the eastern and western parts of Germany were associated with differences in the frequency and severity of these risk factors. METHOD: In Leipzig, 15,291 people (9,600 women and 5,691 men), in Nuremberg 8,387 (4,559 women and 3,828 men) were examined either after responding to a public appeal, or in the factory, etc. RESULTS: Clearly elevated cholesterol levels (> 250 mg/dl) were found in 33.8% of the men, and 35.9% of the women in Leipzig, and in 39.1% of the men and 50.7% of the women in Nuremberg. This larger incidence of treatment-requiring hypercholesterolemia in Nuremberg was distributed throughout all age groups up to the age of 60. Hypertension was significantly more common among the 30 to 80-year-old women, and the 20 to 40-year-old and 50 to 80-year-old men in Leipzig. the frequency of cigarette smoking, diabetes mellitus and overweight did not differ significantly between the two cities. In cases with known dyslipoproteinemia, drug treatment was rarely applied, and the therapeutic aim of a cholesterol level < 200 mg/dl, was achieved in only 2-6% of those treated. The most significant difference with respect to cardiovascular risk factors was serum cholesterol. It is possible that a higher ingestion of monounsaturated fatty acids and more physical activity may be responsible for the lower cholesterol levels in Leipzig. |
| Cardiovascular risk in rheumatoid arthritis versus osteoarthritis: acute phase response related decreased insulin sensitivity and high-density lipoprotein cholesterol as well as clustering of metabolic syndrome features in rheumatoid arthritis Dessein, P. H., A. E. Stanwix, et al. (2002), Arthritis Res 4(5): R5. Abstract: Rheumatoid arthritis (RA) patients experience a markedly increased frequency of cardiovascular disease. We evaluated cardiovascular risk profiles in 79 RA patients and in 39 age-matched and sex-matched osteoarthritis (OA) patients. Laboratory tests comprised ultrasensitive C-reactive protein (CRP) and fasting lipids. Insulin sensitivity (IS) was determined by the Quantitative Insulin Sensitivity Check Index (QUICKI) in all OA patients and in 39 of the RA patients. Ten RA patients were on glucocorticoids. RA patients exercised more frequently than OA patients (chi2 = 3.9, P < 0.05). Nine RA patients and one OA patient had diabetes (chi2 = 4.5, P < 0.05). The median CRP, the mean QUICKI and the mean high-density lipoprotein (HDL) cholesterol were 9 mg/l (range, 0.5-395 mg/l), 0.344 (95% confidence interval CI, 0.332-0.355) and 1.40 mmol/l (95% CI, 1.30-1.49 mmol/l) in RA patients, respectively, as compared with 2.7 mg/l (range, 0.3-15.9 mg/l), 0.369 (95% CI, 0.356-0.383) and 1.68 mmol/l (95% CI, 1.50-1.85 mmol/l) in OA patients. Each of these differences was significant (P < 0.05). After controlling for the CRP, the QUICKI was similar in RA and OA patients (P = 0.07), while the differences in HDL cholesterol were attenuated but still significant (P = 0.03). The CRP correlated with IS, while IS was associated with high HDL cholesterol and low triglycerides in RA patients and not in OA patients. A high CRP (>/= 8 mg/l) was associated with hypertension (chi2 = 7.4, P < 0.05) in RA patients. RA glucocorticoid and nonglucocorticoid users did not differ in IS and lipids (P > 0.05). Excess cardiovascular risk in RA patients as compared with OA patients includes the presence of decreased IS and HDL cholesterol in RA patients. The latter is only partially attributable to the acute phase response. The CRP, IS, HDL cholesterol, triglycerides and hypertension are inter-related in RA patients, whereas none of these relationships were found in OA patients. |
| Cardiovascular screening and HDL cholesterol Piwinski, S. E. (1994), Aviat Space Environ Med 65(9): 878. |
| Care Study. Secondary prevention after myocardial infarct in moderately elevated total cholesterol Bonner, G. (1997), Fortschr Med 115(17): 57-8. |
| CARECholesterol and Recurrent Events Trial Oida, K. (2001), Nippon Rinsho 59 Suppl 3: 427-32. |
| Carob pulp preparation rich in insoluble fibre lowers total and LDL cholesterol in hypercholesterolemic patients Zunft, H. J., W. Luder, et al. (2003), Eur J Nutr 42(5): 235-42. Abstract: BACKGROUND: Recently, insoluble fibre from carob pulp has been found to affect blood lipids in animals in a similar manner as soluble dietary fibre. AIM OF THE STUDY: To investigate whether a carob pulp preparation containing high amounts of insoluble fibre has a beneficial effect on serum cholesterol in humans. METHODS: Volunteers (n = 58) with hypercholesterolemia were recruited to participate in a randomised, double- blind, placebo-controlled and parallel arm clinical study with a 6 week intervention phase. All participants consumed daily both, bread (two servings) and a fruitbar (one serving) either with (n = 29) or without (n = 29) a total amount of 15 g/d of a carob pulp preparation (carob fibre). Serum concentrations of total, LDL and HDL cholesterol and triglycerides were assessed at baseline and after week 4 and 6. RESULTS: The consumption of carob fibre reduced LDL cholesterol by 10.5 +/- 2.2% (p = 0.010). The LDL:HDL cholesterol ratio was marginally decreased by 7.9 +/- 2.2 % in the carob fibre group compared to the placebo group (p = 0.058). Carob fibre consumption also lowered triglycerides in females by 11.3 +/- 4.5% (p = 0.030). Lipid lowering effects were more pronounced in females than in males. CONCLUSION: Daily consumption of food products enriched with carob fibre shows beneficial effects on human blood lipid profile and may be effective in prevention and treatment of hypercholesterolemia. |
| Carotid artery atherosclerosis in cholesterol-fed female cynomolgus monkeys. Effects of oral contraceptive treatment, social factors, and regional adiposity Shively, C. A., J. R. Kaplan, et al. (1990), Arteriosclerosis 10(3): 358-66. Abstract: Female cynomolgus monkeys, a previously established model of carotid and coronary artery atherosclerosis, were used to study the relationships between potential risk factors and carotid artery atherosclerosis. Over a 24-month treatment period, one-third of the monkeys (n = 25) were given the oral contraceptive Ovral, one-third of the monkeys (n = 26) were given the oral contraceptive Demulen, and the remaining monkeys constituted a control group (n = 26). At necropsy, the atherosclerosis extent was measured in the left and right common carotid arteries and the left and right carotid bifurcations. Plasma lipid concentrations, regional adiposity, and social status were related to carotid artery atherosclerosis extent. The relationships between regional adiposity and social status and carotid artery atherosclerosis were accounted for, at least in part, by plasma lipid concentrations. Oral contraceptives had an adverse effect on plasma cholesterol concentrations and a protective effect against carotid artery atherosclerosis after adjusting for their effect on plasma lipids. The net result of these effects was little or no change in atherosclerosis extent in the carotid arteries due to oral contraceptive treatment. |