Editorial
Atherogenic indices: usefulness as predictors of cardiovascular disease
Índices aterogénicos: utilidad como predictores en enfermedad cardiovascular
Juan José Tamarit García
Servicio de Medicina Interna, Unidad de Lípidos y Riesgo Vascular, Consorcio Hospital General Universitario de Valencia, Spain
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TC: total cholesterol, TG: triglycerides, HDL<span class="elsevierStyleInf">c</span>: high density lipoprotein cholesterol, LDL<span class="elsevierStyleInf">c</span>: low density lipoprotein cholesterol.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Maroua Slouma, Khaoula Ben Ali, Lobna Kharrat, Chadia Zouaoui, Haroun Ouertani, Imen Gharsallah" "autores" => array:6 [ 0 => array:2 [ "nombre" => "Maroua" "apellidos" => "Slouma" ] 1 => array:2 [ "nombre" => "Khaoula" "apellidos" => "Ben Ali" ] 2 => array:2 [ "nombre" => "Lobna" "apellidos" => "Kharrat" ] 3 => array:2 [ "nombre" => "Chadia" "apellidos" => "Zouaoui" ] 4 => array:2 [ "nombre" => "Haroun" "apellidos" => "Ouertani" ] 5 => array:2 [ "nombre" => "Imen" "apellidos" => "Gharsallah" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2529912322000602?idApp=UINPBA00004N" "url" => "/25299123/0000003400000005/v1_202209250551/S2529912322000602/v1_202209250551/en/main.assets" ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Editorial</span>" "titulo" => "Atherogenic indices: usefulness as predictors of cardiovascular disease" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "269" "paginaFinal" => "270" ] ] "autores" => array:1 [ 0 => array:3 [ "autoresLista" => "Juan José Tamarit García" "autores" => array:1 [ 0 => array:3 [ "nombre" => "Juan José" "apellidos" => "Tamarit García" "email" => array:1 [ 0 => "juanjotamarit@gmail.com" ] ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Servicio de Medicina Interna, Unidad de Lípidos y Riesgo Vascular, Consorcio Hospital General Universitario de Valencia, Spain" "identificador" => "aff0005" ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Índices aterogénicos: utilidad como predictores en enfermedad cardiovascular" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Cardiovascular diseases (CVD) continue to be, even in the years of the COVID-19 pandemic, the leading cause of death, according to data from the World Health Organisation (WHO)<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> in 2021, with figures of around 18 million lives lost each year. In Spain, they are also the leading cause of death, with 119,853 people dying in 2020, accounting for 24.3% of total deaths.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Under this CVD heading we find a series of clinical manifestations (ischaemic heart disease, cerebrovascular disease or peripheral arterial disease) whose underlying cause is arteriosclerosis, defined as a chronic inflammatory process that affects the arteries of different vascular beds and is characterised by the presence of atheroma plaque (lipids, fibrous tissue and inflammatory cells), in the intima and media layers that eventually produce a progressive loss of elasticity, which can be complicated by the appearance of fissures, erosion or rupture in the plaque and the formation of a thrombus, which will condition the appearance distal to the lesion, of ischaemia or tissue necrosis.</p><p id="par0015" class="elsevierStylePara elsevierViewall">When clinicians are faced with a patient with various cardiovascular risk factors (CVRF), one of our first tasks is to estimate cardiovascular risk, which is nothing more than calculating the probability of a given vascular event occurring in a predefined period of time, according to their CVRF and the population group to which they belong. In other words, we try to know what the future will hold for that patient if we do not change his or her evolution. After determining this level of risk, we must make decisions that, guided by the therapeutic objectives we set, will often lead to the initiation or modification of treatment.</p><p id="par0020" class="elsevierStylePara elsevierViewall">This desire to calculate cardiovascular risk in advance has generated many tables for estimating it, the most widely used being those of the National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATP III) based on the Framingham equation modified by Wilson, and the SCORE<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> (Systematic COronary Risk Evaluation), and its subsequent update SCORE 2 and SCORE OP.<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">4,5</span></a> These tables, despite having been a great advance in the calculation of CVR, continue to have many limitations and we therefore continue to seek other indicators and/or indices that act as early evolutionary predictors.</p><p id="par0025" class="elsevierStylePara elsevierViewall">At this point, it is important to remember that, although atherosclerosis has a multifactorial aetiology, lipid abnormalities are the main attributable risk factor for the development of CVD<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> and account for about 50% of the risk. But we cannot assess cardiovascular risk in an optimal way<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> merely with the determination of the "classical" serum lipid profile, meaning total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) and non-HDL cholesterol. And it is precisely to try to provide greater predictive value that several lipoprotein indices or ratios have been defined, in an attempt to provide information on other clinical and/or metabolic aspects, such as the greater atherogenicity of some lipoproteins, their inflammatory, antioxidant, antiaggregant, vasodilator activity, or their relationship with the metabolic syndrome.</p><p id="par0030" class="elsevierStylePara elsevierViewall">The article by M. Slouma<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a> published in this issue of the journal <span class="elsevierStyleItalic">Clínica e Investigación en Arteriosclerosis</span> attempts to shed light on the usefulness of atherogenic indices as predictors of metabolic syndrome (MS) in patients with axial spondyloarthritis and whether these are modified after treatment with tumour necrosis factor inhibitor drugs. Their results show a higher frequency of (MS) in the population with axial spondyloarthritis than in the general population, which is consistent with that obtained in other chronic inflammatory diseases such as psoriasis, rheumatoid arthritis or systemic lupus erythematosus. The fact that atherogenic indices were significantly higher in patients with MS and that some of them were associated with high disease activity, as shown in their conclusions, is consistent with the already known relationship between lipid alterations, plaque progression, inflammatory processes and atherosclerosis. Undoubtedly, further work should continue to explore the usefulness of these markers in the identification of subgroups of patients at high cardiovascular risk.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:8 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "WHO Mortality Database" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "Organización Mundial de la Salud [Internet]" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "WWW" => array:2 [ "link" => "https://www.who.int/es/health-topics/cardiovascular-diseases#tab=tab_1" "fecha" => "2022" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "INEbase" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "Instituto Nacional de Estadística [Internet]" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "WWW" => array:2 [ "link" => "https://www.ine.es/dyngs/INEbase/es/operacion.htm?c=Estadistica_C&cid=1254736176780&menu=ultiDatos&idp=1254735573175" "fecha" => "2022" ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Estimation of ten-year risk of fatal cardiovascular disease in Europe: the SCORE project" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "R.M. 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Goodman" 2 => "M Roth" 3 => "D Newstein" 4 => "AD Guerci" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jacc.2005.02.088" "Revista" => array:6 [ "tituloSerie" => "J Am Coll Cardiol" "fecha" => "2005" "volumen" => "46" "paginaInicial" => "158" "paginaFinal" => "165" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15992651" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0040" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Athrogenic indexes: Useful markers for predicting metabolic syndrome in axial spondyloarthritis" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "S. Maroua" 1 => "BA Khaoula" 2 => "K. Lobna" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.arteri.2022.03.005" "Revista" => array:2 [ "tituloSerie" => "Clin Investig Arterioscler" "fecha" => "2022" ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/25299123/0000003400000005/v1_202209250551/S2529912322000651/v1_202209250551/en/main.assets" "Apartado" => array:4 [ "identificador" => "63723" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Editorial" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/25299123/0000003400000005/v1_202209250551/S2529912322000651/v1_202209250551/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2529912322000651?idApp=UINPBA00004N" ]
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