Biomedical subjects

Sander I van Leuven

Publications and source records attributed to Sander I van Leuven.

5 recordsLinked to original sources

PubMed2006

Serum levels of mannose-binding lectin and the risk of future coronary artery disease in apparently healthy men and women.

OBJECTIVE: To determine the association between serum levels of mannose-binding lectin (MBL) and the risk of future coronary artery disease (CAD) in apparently healthy men and women. METHODS AND RESULTS: We performed a prospective case-control study among apparently healthy men and women nested in the EPIC-Norfolk cohort. Baseline concentrations of MBL were measured in serum samples of 946 patients who experienced a myocardial infarction or died of CAD during follow-up, and 1799 matched controls who remained free of CAD. Among men, median MBL levels were 1.63 ng/mL (interquartile range [IQR]: 0.59 to 3.80) in cases and 1.20 ng/mL (IQR: 0.48 to 3.37) in controls. Among women, median MBL levels were 1.02 ng/mL (IQR: 0.43 to 2.95) in cases and 1.01 ng/mL (IQR: 0.43 to 2.94) in controls. After adjustment, the odds ratio in men for future CAD was 1.59 (95% confidence interval [CI]: 1.09 to 2.32; P for linearity=0.01) for those in the highest quartile compared with those in the lowest quartile. In women no such relation was observed. CONCLUSIONS: Elevated levels of MBL are associated with an increased risk of future CAD in apparently healthy men but not in women. The sex difference merits further exploration.

Aged↗

PubMed2006

The dyslipidemia of chronic renal disease: effects of statin therapy.

PURPOSE OF REVIEW: Dyslipidemia is a prevalent condition in patients with chronic renal disease, but is often left untreated. Statin treatment constitutes an effective way to improve lipid abnormalities. This review summarizes present studies on dyslipidemia and its treatment in patients with chronic renal disease. RECENT FINDINGS: The specific dyslipidemia in renal disease is associated with the presence of proteinuria and decreased creatinine clearance, and may even adversely affect the progression of chronic renal disease. Statin therapy may have renoprotective effects due to a combination of lipid lowering and pleiotropic effects. Statins exert several anti-inflammatory properties and lead to a decrease of proteinuria. Post-hoc analyses of large-scale lipid lowering trials have shown that the reduction of cardiovascular risk was equivalent to the reduction achieved in patients without chronic renal failure. We feel, however, that if intervention with statins is postponed until patients reach end-stage renal disease, statins have limited benefit. SUMMARY: Present studies suggest that patients with renal disease should be screened early for dyslipidemia and that statins have to be considered as the lipid lowering therapy of choice. These drugs reduce cardiovascular risk. Further studies are needed to firmly establish whether statins preserve renal function.

Cardiovascular Diseases↗

PubMed2005

Mycophenolate mofetil (MMF): firing at the atherosclerotic plaque from different angles?

Atherosclerosis is characterized by a persistent, low-grade inflammatory state in which immune cell activation is inseparably linked to plaque formation and destabilization. The T-lymphocyte in particular has emerged as a pivotal player throughout the course of atherogenesis. As a consequence, the concept that immune modulation is a suitable target for cardiovascular prevention is currently an important focus of research. Mycophenolate mofetil (MMF) has emerged as a non-competitive inhibitor of inosine monophosphate dehydrogenase (IMPDH) that exerts cytostatic effects, particularly on proliferating T-lymphocytes. In addition, MMF has other immune-modulating effects, such as downregulation of the expression of adhesion molecules and attenuation of monocyte and macrophage responses. Given the added benefit that MMF is well tolerated, this immunosuppressive agent constitutes an attractive candidate for the modulation of inflammatory activation in atherogenesis. The present review provides an overview of the potential anti-atherogenic properties of MMF.

Animals↗

PubMed2005

Cardiovascular disease in systemic lupus erythematosus: has the time for action come?

PURPOSE OF REVIEW: The recognition that inflammation is a hallmark of atherosclerotic disease has led to a series of studies reporting accelerated atherogenesis in chronic inflammatory diseases. Indeed, systemic lupus erythematosus is associated with an increased incidence of cardiovascular disease and the etiology thereof deserves closer attention. RECENT FINDINGS: The association between systemic lupus erythematosus and accelerated atherosclerosis has recently been confirmed by surrogate-marker studies for cardiovascular disease in patients with systemic lupus erythematosus. Since the propensity towards cardiovascular disease cannot solely be explained by classical risk factors, disease-specific pathways have been put forward as additional risk factors. SUMMARY: In the present review, we will discuss several of these factors as well as their potential impact for future prevention strategies in systemic lupus erythematosus.

Atherosclerosis↗

PubMed2005

Atorvastatin.

The introduction of statins has drastically changed the treatment and prevention of atherosclerotic vascular disease. By lowering lipid levels and reducing the risk of coronary heart disease, these drugs are among the most effective at reducing morbidity and mortality available to clinical practice. In fact, these compounds have demonstrated the reversible nature of the process of atherosclerosis and can be considered the most useful drugs we currently have in our armamentarium in the prevention of atherosclerosis and its clinical sequelae. Atorvastatin provides pronounced lipid lowering in a broad range of individuals with hypercholesterolaemia and, as such, is an appropriate first-line therapy for patients at low to high risk of coronary heart disease. Reductions in total and low-density lipoprotein cholesterol achieved with atorvastatin have been shown to translate into reductions in risk of cardiovascular morbidity and mortality in both primary and secondary prevention settings. Significant clinical benefits have specifically been observed among patients with Type 2 diabetes and in those with acute coronary syndromes. In common with other members of the statin class, atorvastatin is well tolerated, and adverse events are generally mild and transient in nature. Despite the significant clinical benefits provided by atorvastatin, its full potential in the management of atherosclerotic disease has yet to be wholly explored; however, studies currently ongoing will answer many of the outstanding questions.

Anticholesteremic Agents↗