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Query: UMLS:C0162871 (abdominal aortic aneurysm)
 8,664 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Low density lipoproteins (LDL) comprise in humans two different main fractions: large, buoyant and small, dense particles. Small, dense LDL particles correlate negatively with plasma HDL levels and positively with plasma triglyceride concentrations and are associated with the metabolic syndrome and increased risk for cardiovascular disease. LDL size seems to be an important predictor of cardiovascular events and progression of coronary heart disease (CHD). In addition, several studies have suggested that therapeutic modulation of specific LDL subclasses may be of great benefit in reducing the atherosclerotic risk. Therefore, LDL size measurement may be of potential value in the clinical assessment and management of patients at high risk of CHD, a category that comprises individuals with non-coronary forms of atherosclerosis: peripheral arterial disease, carotid artery disease, abdominal aortic aneurysm. Potentially, screening for the presence of small, dense LDL in patients with those clinical forms of atherosclerosis may identify those with even higher vascular risk and may contribute in directing specific anti-atherosclerotic treatments in order to prevent new vascular events in the same or another district. However, to-date, not so many studies have investigated the LDL size in patients with non-coronary forms of atherosclerosis and we need to wait for further contributions with larger number of patients, even if available data seem to suggest an association between small, dense LDL and such diseases. The predominance of small dense LDL particles has been accepted as an emerging cardiovascular risk factor by the National Cholesterol Education Program Adult Treatment Panel III but screening for the presence of small, dense LDL particles in patients with non-coronary forms of atherosclerosis has not been so far recommended.
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PMID:The significance of low-density-lipoproteins size in vascular diseases. 1652 Jul 17

Low density lipoproteins (LDL) size seems to be an important predictor of cardiovascular events and progression of coronary artery disease and the predominance of small dense LDL have been accepted as an emerging cardiovascular risk factor by the National Cholesterol Education Program Adult Treatment Panel III. We recently showed increased LDL size or higher levels of small, dense LDL in different categories of patients at higher cardiovascular risk, such as those with coronary (including acute myocardial infarction) and non-coronary (including carotid disease, abdominal aortic aneurysm and peripheral arterial disease) forms of atherosclerosis or metabolic diseases (including type-II diabetes, polycystic ovary syndrome and growth hormone deficiency). Screening for the presence of small, dense LDL may potentially identify those with even higher risk and may contribute in directing specific treatments in order to prevent new cardiovascular events. This seems particularly true for statins and fibrates. Promising data are available for rosuvastatin, the latest statin molecule introduced in the market, and ezetimibe, a cholesterol absorption inhibitor. The most recent patents regarding these two hypolipidemic agents include the antiinflammatory, antithrombotic and antiplatelet activity (EP1626716B1 and CN1794987A for rosuvastatin) and the potential use for treatment of cholesterol-associated benign and malignant tumors and diabetes (US7098198 and US7071181 for ezetimibe).
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PMID:An update on the role of the quality of LDL in cardiovascular risk: the contribution of the universities of Palermo and Zurich. 1822 Nov 6

Decreased smoking has likely had the most significant impact on reducing the prevalence of AAAs. In a review of public data in England and Wales, Anjum and colleagues illustrated a reduction of AAA rupture from 1997 to2009 across all ages attributed to a concurrent decrease in prevalence of smoking. This trend has also been noted in a meta-analysis from Sweeting and colleagues and attributed to a reduction in the prevalence of smoking since the mid-1970s along with an enhanced awareness of cardiovascular risk factor reduction and selective aneurysm screening. Along with an effort to reduce AAA progression and rupture, tools to predict patient-specific risk of AAA rupture are evolving with refined models that incorporate both aneurysm wall stress and wall strength likely to provide the most promising approach. Although the role of statins, ACE inhibitors, beta-blockers, and aspirin in preventing or slowing aneurysmal rupture remains unresolved, their proven benefit in reducing long-term cardiovascular mortality suggests that these medications should be considered in any patient with a small AAA. Currently, randomized trials do not show any survival benefit for open or endovascular repair for small aneurysms in the range of 4.0 to 5.4 cm. AAA repair, whether through an endovascular or open approach, is not without potential complication. Even at centers of excellence, the 30-day mortality rate for conventional AAA surgery is 3% to 5%, with rates of major morbidityranging from 15% to 40%. The Society for Vascular Surgery guidelines recommends surveillance for patients with a fusiform AAA of 4.0 to 5.4 cm. The risk of AAA rupture appears to be decreasing through heightened public awareness, advanced technology for AAA detection, screening and surveillance, improved understanding of biomechanics and natural progression in AAA rupture, along with the availability of a wide range of medical therapies for risk factor reduction and minimally invasive options for AAA repair.
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PMID:Is the abdominal aortic aneurysm rupture rate decreasing? 2429 56