Displaying publications 1 - 20 of 101 in total

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  1. Vântu A, Ghertescu D, Fiscă C, Mărginean A, Hutanu A, Gheban D, et al.
    Malays J Pathol, 2019 Apr;41(1):25-32.
    PMID: 31025634
    INTRODUCTION: Experimental models are essential for clarifying the pathogenesis of atherosclerosis in the context of diabetes mellitus (DM). We aimed to evaluate the presence and the magnitude of several factors known to promote atherogenesis, and to assess the potential of a pro-atherogenic environment to stimulate the development of atherosclerotic lesions in a rat model of long-term type 1 DM.

    MATERIALS AND METHODS: Six control and five DM Wistar rats were evaluated. DM was induced at 11 weeks of age using streptozotocin (STZ; 60 mg/kg, intraperitoneal). Animals were monitored up to 38 weeks of age, when plasma glucose, lipid profile, and markers specific for systemic inflammation, endothelial dysfunction, and oxidative stress were measured. The amount of fat within the aortic wall was assessed semiquantitatively using Oil Red O staining.

    RESULTS: Diabetic rats presented significantly higher plasma glucose (p < 0.001), total cholesterol and triglycerides (both p = 0.02), high-sensitivity C-reactive protein (p = 0.01), and vascular endothelial growth factor (p = 0.04) levels, and significantly lower interleukin-10 (p = 0.04), superoxide dismutase (p < 0.01), and glutathione peroxidase (p = 0.01) levels than the control rats. Mild (grade 1) atherosclerotic lesions were observed in the aortic wall of 80% of the diabetic rats and in none of the control rats.

    CONCLUSIONS: This study presents a STZ-induced type 1 DM rat model with one of the longest follow-ups in the literature. In this model, long-term DM created a highly pro-atherogenic environment characterised by hyperglycemia, dyslipidemia, systemic inflammation, endothelial dysfunction, and oxidative stress that resulted in the development of early aortic atherosclerotic lesions.

    Matched MeSH terms: Atherosclerosis
  2. Kay, Sin Tan, Navarro, Jose C, Ka, Sing Wong, Yi, Ning Huang, Hou, Chang Chiu, Poungvarin, Niphon, et al.
    Neurology Asia, 2014;19(2):117-127.
    MyJurnal
    Background and Objective: There is a lack of international collaborative studies on young adults with ischaemic stroke in Asia. The aim of this study was to investigate risk factors, aetiology and outcome at hospital discharge of these patients across 8 participating countries in Asia. Methods: This was a prospective, observational, multicentre, hospital based cohort study. Consecutive young stroke patients with confirmed cerebral infarction between the ages of 18-49 were recruited from December 2011 to May 2012. Data was collected for patient demography, risk factors, investigations, clinical profile and TOAST classification. Outcome measures were death and independence (modified Rankin score≤ 2) at hospital discharge. Results: Two hundred and eighteen patients with the mean age was 40.8±6.7 years were recruited. There was a larger proportion of male patients with a ratio of 1.9:1. Traditional risk factors observed were hypertension (n=103; 47.3%), dyslipidaemia (n=93; 42.4%), smoking (n=85; 38.8%), diabetes (n=53; 24.3%), alcohol use (n=33; 15.0%), a previous history of stroke and transient ischaemic attacks (6.4%), family history (n=12; 5.5%), migraine (n=6;2.8%), pregnancy related (n=5; 2.3%) and numerous cardiac risk factors (0.9-5.5%). The majority suffered arterial infarction; n=216 (99.4%) while n=2 (0.6%) had venous strokes. The predominant stroke subtypes were large artery atherosclerosis (LAA); 29.8% and small vessel occlusion (SVO); 20.2%. LAA and SVO accounted for 37.5% of all stroke subtypes in the ≤36 year age-group. Cardioembolism (15.1%) and stroke of determined aetiology (14.7%) contributed to the other categories of identified stroke subtypes. Mortality on hospital discharge was 3.1% while 65.1% of patients were independent on discharge. Conclusion: This study demonstrated the substantial presence of premature atherosclerosis and conventional risk factors in young ischaemic stroke patients from 8 Asian cities. Venous infarction from cerebral venous thrombosis was rare in this study. Outcome on hospital discharge was poorer compared to Western studies. Detection of vascular risk factors and primary prevention measures should be initiated during late adolescence or early adulthood in urban Asia.
    Matched MeSH terms: Atherosclerosis
  3. Tan CX, Chong GH, Hamzah H, Ghazali HM
    Phytother Res, 2018 Nov;32(11):2264-2274.
    PMID: 30051518 DOI: 10.1002/ptr.6164
    Hypercholesterolemia is a major risk factor for the initiation and development of nonalcoholic fatty liver disease and atherosclerosis. The present study evaluated the hypocholesterolemic effect of virgin avocado oil (VAO) using urinary metabolomic method. Male Sprague-Dawley rats were fed high-cholesterol diet for four weeks to induce hypercholesterolemia. After confirming the establishment of hypercholesterolemia model, the VAO (450 and 900 mg·kg-1 ·day-1 ) and simvastatin (10 mg·kg-1 ·day-1 ) were given orally while maintaining the high-cholesterol diet for another four weeks. Assessment of urinary metabolomics using NMR revealed that VAO treatment could partially recover the metabolism dysfunction induced by hypercholesterolemia mainly via lipid, energy, amino acid, and gut microbiota metabolism.
    Matched MeSH terms: Atherosclerosis
  4. Tang WJ, Mat Saad AZ
    J Vasc Access, 2018 Mar;19(2):191-194.
    PMID: 29148006 DOI: 10.5301/jva.5000801
    INTRODUCTION: Arteriovenous fistula is a lifeline for end-stage kidney disease patients on dialysis. The quality of the vein and artery to be used plays a crucial role in attaining a functioning, reliable and long-lasting arteriovenous fistula. The aim of the study is to present an alternative for haemodialysis access to preserve the upper arm vasculature for future use - the forearm loop arteriovenous fistula.

    METHODS: From October 2015 to September 2016, 202 patients with chronic kidney disease (CKD), stages 4 and 5, underwent arteriovenous fistula creation at the Universiti Sains Malaysia Hospital, Malaysia. Nine patients, with severe atherosclerosis of the distal artery, but with satisfactory veins, underwent forearm loop arteriovenous fistula creation. Maturation of the fistula was based on the classification by the National Kidney Foundation Kidney Disease Outcomes Quality Initiative (NKF KDOQI).

    RESULTS: All nine patients who underwent forearm loop arteriovenous fistula have had diabetes mellitus for more than 10 years. Only one fistula failed to mature within 6 weeks. Two arteriovenous fistulas thrombosed at 3 and 5 months, respectively, after the commencement of haemodialysis. However, the other six matured fistulas are still functioning well after a year of regular usage.

    CONCLUSIONS: Distal forearm arteries in diabetics may be severely atherosclerotic. Forearm loop arteriovenous fistula can be considered as the primary access for cases decided as inconvenient for fistula creation due to severe occlusive atherosclerotic disease of the forearm arteries; in order to preserve upper arm veins for future access procedures.

    Matched MeSH terms: Atherosclerosis/complications*
  5. Chua SK, Kilung A, Ong TK, Fong AY, Yew KL, Khiew NZ, et al.
    Med J Malaysia, 2014 Aug;69(4):166-74.
    PMID: 25500844 MyJurnal
    INTRODUCTION: Carotid intima media thickness (CIMT) being a cost effective and easily performed technique is useful in the detection of subclinical atherosclerosis and has been shown to be a prognosticator of cardiovascular events. The primary objective of this study was to obtain the distribution of CIMT measurements, highly sensitive C reactive protein (hs-CRP) and assessing health awareness and attitudes of the Malaysian population at cardiovascular disease (CVD) risk and not receiving lipid lowering agents. Secondarily the study sought to assess the significance of the relationship between these measurements against various patient characteristics.

    METHODS: Measurements of CIMT are obtained by ultrasonography of 12 sites within the common carotid artery was recorded for 123 subjects from a single centre tertiary hospital of Malaysia who had two or more CVD risk factors but were not receiving lipid lowering therapy. CVD risk factors and lipid and glucose profiles were analyzed with respect to distribution of CIMT and high-sensitivity Creactive protein (hs-CRP) values.

    RESULTS: The mean-max CIMT was 0.916±0.129mm (minimum 0.630mm, maximum 1.28mm) and the mean-mean CIMT was 0.743±0.110mm (minimum 0.482mm, maximum 1.050mm) and mean hs-CRP was 0.191mg/dL (minimum 0.030mg/dL, maximum 5.440mg/dL). Multivariate analyses confirmed a significant association between increasing CIMT and increasing age, total and low density lipoprotein cholesterol while log-transformed hs-CRP levels showed significant association with increasing body mass index, waist circumference, high blood glucose and triglyceride levels. Our patients had good health awareness on CVD.

    CONCLUSION: Newly defined CIMT measurements and hs-CRP levels may be useful adjunctive tools to screen for atherosclerosis in the Malaysian population. It may help in refining risk stratification on top of traditional clinical assessment.
    Matched MeSH terms: Atherosclerosis
  6. Lee YY, Bhaskar S
    Case Rep Med, 2011;2011:271560.
    PMID: 22229036 DOI: 10.1155/2011/271560
    We report a 33-year-old Malay woman presented with acute left dense hemiparesis and an NIHSS score of 11/15. Computed tomography (CT) scan brain showed a massive right middle cerebral artery (MCA) territory infarct. The right internal carotid artery (ICA) and right proximal MCA were shown occluded from digital substraction angiography (DSA). Carotid dissection, carotid canal anomaly, and intercavernous communication were systematically ruled out. She had no risk factors for atherosclerosis. The connective tissue screening and thrombophilic markers were negative. However, she was anaemic on admission and subsequent investigations revealed that she had alpha-thalassemia and iron deficiency anaemia. The right ICA remained occluded from a repeat CT cerebral angiogram after one year, but otherwise she was neurologically stable. This case illustrates an unusual association between intracranial vessel occlusion with iron deficiency anaemia and alpha-thalassemia trait.
    Matched MeSH terms: Atherosclerosis
  7. Sundram K, Pathmanathan R, Wong KT, Baskaran G
    Asia Pac J Clin Nutr, 1997 Mar;6(1):31-5.
    PMID: 24394650
    Thirty six-male New Zealand White rabbits subdivided into four dietary groups (9 animals per group) were fed high fat (36% en), cholesterol-free diets for nine months. The dietary oil blends were formulated to contain high levels of the target fatty acids namely trans-rich (partially hydrogenated soybean oil; TRANS), cis monounsaturated-rich (rapeseed, sunflower seed oil and palm olein; MONO), palmitic-rich (palm olein; POL) and lauric-myristic rich (coconut, palm kernel and corn oils; LM). Ad libitum feeding of the rabbits resulted in normal growth throughout the nine months and no differences in the final body weights of the animals were evident at autopsy. Plasma total cholesterol was significantly elevated only by the LM enriched diet compared with all other treatments; values were comparable between the other three treatment groups. Changes in the total cholesterol were not reflected in the VLDL and LDL lipoproteins. However, HDL-cholesterol was significantly lowered by the TRANS diet compared with all other dietary groups. HDL-cholesterol was also significantly increased by the LM diet in comparison to the POL-diet. Both adipose and liver triglyceride fatty acid compositions tended to reflect the type of fatty acids fed the animals. Trans fatty acids were evident only in animals fed the trans diet and it was apparent that the trans fatty acids competed with linoleic acid for incorporation into these tissues. Increased concentrations of lauric and myristic fatty acids in the LM-fed animals were also evident. In the POL and high MONO fed rabbits, palmitic and oleic fatty acids (respectively) were concentrated in the adipose and liver. The diets, however, failed to induce severe atherosclerosis in this study. This can be explained, in part, by the lack of dietary cholesterol and the use of plant (rather than animal) proteins in our dietary formulations. The effect of these important atherosclerosis modulators in association with these fatty acids requires further evaluation.
    Matched MeSH terms: Atherosclerosis
  8. Ismail SM, Sundar UM, Hui CK, Aminuddin A, Ugusman A
    J Taibah Univ Med Sci, 2018 Jun;13(3):225-231.
    PMID: 31435328 DOI: 10.1016/j.jtumed.2018.01.003
    Objectives: Inflammation plays a key role in the pathogenesis of atherosclerosis. Piper sarmentosum is an herb with antioxidant and anti-atherosclerotic activities. The aim of this study was to evaluate the anti-inflammatory properties of an aqueous extract of P. sarmentosum (AEPS) in human umbilical vein endothelial cells (HUVECs).

    Methods: HUVECs were divided into six groups: control, treatment with 10 ng/ml TNF-α, and co-treatment of 10 ng/ml TNF-α with four different concentrations of AEPS (100, 150, 250, and 300 μg/ml) for 24 h. Subsequently, vascular cell adhesion molecule-1 (VCAM-1) and intercellular adhesion molecule-1 (ICAM-1) protein expression, U937 monocyte cells adhesion, and nuclear factor-kappaB (NF-κB) p65 expression in HUVECs were measured.

    Results: Treatment of TNF-α-stimulated HUVECs with AEPS at different concentrations resulted in decreased VCAM-1 and ICAM-1 protein expression in a dose-dependent manner. Furthermore, AEPS also inhibited TNF-α-stimulated U937 monocyte cells adhesion to HUVECs. In addition, AEPS reduced TNF-α-induced NF-κB p65 expression in a dose-dependent manner.

    Conclusions: The results indicated that AEPS suppressed TNF-α-induced VCAM-1 and ICAM-1 expression NF-κB signaling.

    Matched MeSH terms: Atherosclerosis
  9. Thuhairah Rahman, Radzi Ahmad, Suhaila Muid, Tengku Saifudin Tengku Ismail, Buravkova, Ludmila B., Hapizah Nawawi
    MyJurnal
    Inflammation and endothelial dysfunction are key components in atherogenesis. Should the status of these pro-atherogenesis factors be enhanced during prolonged confined space travel, specific countermeasures need to be instituted to prevent these processes to ensure safe outcome for astronauts during space expeditions. Six crew members were exposed to prolonged, confined isolation for 520 days. Standard exercise and diet regime were instituted throughout isolation phase. Age and gender-matched healthy, free living controls were recruited in parallel. Serial serum and whole blood were analysed for biomarkers of inflammation (hsCRP and IL-6) and endothelial activation (sICAM-1, sVCAM-1 and E-selectin). Flow-mediated dilatation (FMD) of the artery was performed following the standard protocols set by the International Brachial Artery Reactivity Task Force by trained personnel. There was decreased sVCAM-1 concentration in crew members compared to baseline. However, there was significant decrease in percentage dilatation from baseline in FMD of the brachial artery in the crew members. Percent change increment was observed in hsCRP while percent change reduction was seen in sVCAM-1. The enhanced inflammation and reduced endothelial function could possibly be attributed to the rigorous exercise instituted throughout the confinement period. Furthermore, possible haemoconcentration as a result of psychosocial stress and/ or exercise-induced physiological response could further explain elevations in hsCRP, and unlikely pathological. Furthermore, endothelial activation was attenuated during isolation, suggesting that the diet and exercise program instated throughout the period improved endothelial function.
    Matched MeSH terms: Atherosclerosis
  10. Hamad Alfarisi, Hamad Abdulsalam, Nuraniza Azahari, Muhammad Ibrahim, Mohamed, Zenab Hamad, Asmah Hanim Hamdan, Che Anuar Che Mohamad
    MyJurnal
    Introduction: Hypercholesterolemia has been proven as a main pathogenic trigger for pathogenesis of atherosclerosis. Atherosclerosis characterised by chronic inflammatory process and increased expression of inflammatory markers. In this study; Trihoney (a combination of three types of natural honey namely: Trigona, mellifera, and Dorsata)
    was investigated for its anti-inflammatory effect in hypercholesterolemic atherosclerotic rabbits. Methods: Thirty
    male New Zealand white rabbits (NZW) were grouped into: normal diet (C), normal diet with 0.6g/kg/day of Trihoney (C+H), 1% cholesterol diet (HCD), 1% cholesterol diet with 0.6g/kg/day of Trihoney (HCD+H), and 1%
    cholesterol diet with 2mg/kg/day of atorvastatin (HCD+At.). After 12 weeks of starting the experiment, animals were
    sacrificed and serum analysed for homocysteine and pro-atherogenic inflammatory markers such as: interleukin-1β
    (IL-1β), interleukin-6 (IL-6), and tumour necrosis factor-α (TNF-α). Fasting serum glucose was analysed to assess glycaemic status. Results: Trihoney treated group showed significantly lower (p
    Matched MeSH terms: Atherosclerosis
  11. Zaribaf F, Mohammadifard N, Sarrafzadegan N, Karimi G, Gholampour A, Azadbakht L
    J Cardiovasc Thorac Res, 2019;11(1):19-27.
    PMID: 31024668 DOI: 10.15171/jcvtr.2019.04
    Introduction:
    Lipid metabolism is one of the main concerns of cardiovascular disease and atherosclerosis. Little is known about the association between dietary patterns and dyslipidemia. Therefore, the present study aimed to determine such association among Iranian adults.
    Methods:
    This cross-sectional study was conducted on 1433 Iranian adults in Isfahan Healthy Heart Program (IHHP). Usual dietary intakes were assessed with the use of a 48 items food frequency questionnaire (FFQ). Factor analysis was used to identify dietary patterns. Three major dietary patterns were identified: western, semi healthy and healthy fat patterns.
    Results:
    After adjustment, subjects in the upper quartiles of western dietary pattern were more likely to have high total cholesterol concentrations than those in the first quartile (odds ratio [OR]: 2.07; 95% CI: 1.25-3.42). Individuals with greater adherence to western dietary pattern had greater odds of having high low-density lipoprotein-cholesterol (LDL-C) levels compared with those in the lowest quartiles (2.53; 1.45-4.40).
    Conclusion:
    Semi healthy dietary pattern was not associated with cardiovascular disease (CVD) risk factors. Same trend was observed for healthy fat dietary pattern. Significant association was found between western dietary pattern and dyslipidemia among Iranian adults.
    Matched MeSH terms: Atherosclerosis
  12. Mohd Kasim NA, Al-Khateeb A, Chua YA, Sanusi AR, Mohd Nawawi H
    Malays J Pathol, 2021 Apr;43(1):87-93.
    PMID: 33903311
    Homozygous familial hypercholesterolaemia (HoFH) is a rare genetic disorder of lipoprotein metabolism mainly due to mutation of the low-density lipoprotein (LDL)-receptor gene (LDLR). It is a life-threatening disease that causes accelerated, multi-vessel atherosclerosis presented in early childhood. Pregnancy in HoFH may pose early coronary morbidity and mortality to both the foetus and mother. The combination of HoFH and pregnancy can be a fatal condition. While statins are very effective in lowering low-density lipoprotein cholesterol (LDL-C) levels, they are generally contraindicated during pregnancy, thus their use during pregnancy is uncommon. On the other hand, lipid apheresis (LA) has turned into an effective treatment to control cholesterol level amid pregnancy. However, the procedure is not widely available in our region. To date, there are scarcely documented case reports of HoFH in pregnancy in which the majority of them underwent LA to keep LDL-C at a low level. We report a rare case of successful pregnancy outcome of HoFH patient treated with lipid-lowering drugs including statin without LA therapy. Apart from that, we also discussed the genetic findings of the proband and all screened family members in which to the best of our knowledge, the first study using the whole-exome sequencing technique to identify the causative gene mutations for familial hypercholesterolaemia among the Malaysian population.
    Matched MeSH terms: Atherosclerosis
  13. Alfarisi, H. A. H., Ibrahim, M.,, Mohamed, Z. B. H., Hamdan, A. H., Che Mohamad, C. A.
    MyJurnal
    Oxidative stress and reactive oxygen species (ROS) constitute a major pathogenic mechanism
    for the development of atherosclerosis. In the present work, the antioxidant potential of
    Trihoney was investigated in hypercholesterolaemic rabbits. Thirty-six male New Zealand
    white (NZW) rabbits were grouped into: normal diet (C), normal diet with 0.6 g/kg/day of
    Trihoney (C+H), 1% cholesterol diet (HCD), 1% cholesterol diet with 0.3 g/kg/day of
    Trihoney (HCD+H1
    ), 1% cholesterol diet with 0.6 g/kg/day of Trihoney (HCD+H2
    ), and 1%
    cholesterol diet with 2 mg/kg/day of atorvastatin (HCD+At.). Animals were sacrificed following 12 weeks of treatment, and their serum was analysed for oxidised-low density lipoprotein
    (Ox-LDL). Serum and aortic tissue homogenate were assayed for superoxide dismutase
    (SOD), glutathione peroxidase (GPx), and malondialdehyde (MDA). Hypercholesterolemia
    caused a significant (p < 0.05) elevation in serum Ox-LDL and a significant (p < 0.05) reduction of antioxidant enzyme activities in serum of the HCD group. Trihoney induced a significant (p < 0.05) increase in antioxidant enzyme activities in serum as compared to the HCD
    group. The high cholesterol diet suppressed both antioxidant enzymes in aortic homogenate.
    Trihoney significantly (p < 0.05) enhanced both antioxidant enzymes in aortic homogenate.
    Hypercholesterolemia induced a significant (p < 0.05) elevation of serum lipid peroxidation in
    the HCD group. Trihoney caused a significant (p < 0.05) reduction of lipid peroxidation in
    aortic homogenate. These results demonstrated that Trihoney has the potential to ameliorate
    oxidative stress systemically, as well as locally in the atherosclerotic aorta.
    Matched MeSH terms: Atherosclerosis
  14. Chow YL, Teh LK, Chyi LH, Lim LF, Yee CC, Wei LK
    Curr Pharm Des, 2020;26(34):4261-4271.
    PMID: 32534558 DOI: 10.2174/1381612826666200614180958
    Stroke is the second leading cause of death and a major cause of disability worldwide. Both modifiable and non-modifiable risk factors can affect the occurrence of ischemic stroke at varying degrees. Among them, atherosclerosis has been well-recognized as one of the main culprits for the rising incidence of stroke-related mortality. Hence, the current review aimed to summarize the prominent role of lipid metabolism genes such as PCSK9, ApoB, ApoA5, ApoC3, ApoE, and ABCA1 in mediating ischemic stroke occurrence.
    Matched MeSH terms: Atherosclerosis
  15. Azlina A. Razak, Effat Omar, Suhaila Muid, Hapizah Nawawi
    MyJurnal
    Tocotrienols have been reported to possess potent cholesterol lowering, anti-hypertensive, antiinflammatory and anti-oxidative properties which are superior to tocopherols. Emerging evidence suggests pure tocotrienols have anti-atherogenic properties. However, optimal doses of oftocotrienolrich fraction (TRF) in progressive atherogenesis remain unclear. This animal model experiment was designed to investigate the effects of a range concentration of TRF supplementation on the extent of atherosclerosis and soluble lipids, inflammatory and oxidative stress biomarkers in high-cholesterol diet (HCD) induced hypercholesterolaemic (HC) rabbits with atherosclerosis. A total of 28 New Zealand white rabbits were given 1% high-cholesterol diet (HCD) for two months and then randomised into five groups: Placebo (n=7), TRF 15 mg/kg (n=5), TRF 30 mg/kg (n=6), TRF 60 mg/kg (n=5) and TRF 90 mg/kg (n=5) daily. The treatment was given for three months and the animals were fed HCD throughout the duration. Aortic vessels were obtained to assess the extent of atherosclerotic lesions at the end of the study. Fasting serum lipids (FSL), C-reactive protein (CRP), malondialdehyde (MDA) and 8-isoprostane levels were measured at baseline, one and two months post-HCD, one, two, and three months postintervention. There were no differences in the extent of the atherosclerotic lesions, percentage changes of FSL, MDA, 8-isoprostane and CRP levels between the placebo and TRF groups. In conclusion, TRF across all doses studied have neutral effects on atherosclerotic lesions, soluble lipids, biomarkers of oxidative stress, coronary risk and inflammation in severely atherosclerotic rabbits with progressive and continuous insult by high cholesterol feeding.
    Matched MeSH terms: Atherosclerosis
  16. Alshamiri M, Ghanaim MMA, Barter P, Chang KC, Li JJ, Matawaran BJ, et al.
    Int J Gen Med, 2018;11:313-322.
    PMID: 30050317 DOI: 10.2147/IJGM.S160555
    Cardiovascular disease (CVD) is a growing burden across the world. In Asia and the Middle East, in particular, CVD is among the most prevalent and debilitating diseases. Dyslipidemia is an important factor in the development of atherosclerosis and associated cardiovascular events, and so effective management strategies are critical to reducing overall cardiovascular risk. Multiple dyslipidemia guidelines have been developed by international bodies such as the European Society of Cardiology/European Atherosclerosis Society and the American College of Cardiology/American Heart Association, which all have similarities in practice recommendations for the optimal management of dyslipidemia. However, they differ in certain aspects including pharmacological treatment, lifestyle modification and the target levels used for low-density lipoprotein cholesterol. The evidence behind these guidelines is generally based on data from Western populations, and their applicability to people in Asia and the Middle East is largely untested. As a result, practitioners within Asia and the Middle East continue to rely on international evidence despite population differences in lipid phenotypes and CVD risk factors. An expert panel was convened to review the international guidelines commonly used in Asia and the Middle East and determine their applicability to clinical practice in the region, with specific recommendations, or considerations, provided where current guideline recommendations differ from local practice. Herein, we describe the heterogeneous approaches and application of current guidelines used to manage dyslipidemia in Asia and the Middle East. We provide consensus management recommendations to cover different patient scenarios, including primary prevention, elderly, chronic kidney disease, type 2 diabetes, documented CVD, acute coronary syndromes and family history of ischemic heart disease. Moreover, we advocate for countries within the Asian and Middle East regions to continue to develop guidelines that are appropriate for the local population.
    Matched MeSH terms: Atherosclerosis
  17. Sundar UM, Ugusman A, Chua HK, Latip J, Aminuddin A
    Front Pharmacol, 2019;10:1033.
    PMID: 31607906 DOI: 10.3389/fphar.2019.01033
    Asymmetric dimethylarginine (ADMA) is an endogenous inhibitor of endothelial nitric oxide synthase (eNOS). ADMA is degraded by dimethylarginine dimethylaminohydrolase (DDAH). Elevated levels of ADMA lead to reduction in nitric oxide (NO) production, which is linked to endothelial dysfunction and atherosclerosis. Piper sarmentosum is an herb that has shown stimulation on endothelial NO production by increasing both expression and activity of eNOS. Thus, this study determined whether the positive effect of P. sarmentosum on NO production is related to its modulation on the DDAH-ADMA pathway in cultured human umbilical vein endothelial cells (HUVEC) exposed to tumor necrosis factor-α (TNF-α). HUVEC were divided into four groups: control, treatment with 250 µg/ml of aqueous extract of P. sarmentosum leaves (AEPS), treatment with 30 ng/ml of TNF-α, and concomitant treatment with AEPS and TNF-α for 24 h. After treatments, HUVEC were collected to measure DDAH1 messenger RNA (mRNA) expression using quantitative real-time polymerase chain reaction. DDAH1 protein level was measured using enzyme-linked immunosorbent assay (ELISA), and DDAH enzyme activity was measured using colorimetric assay. ADMA concentration was measured using ELISA, and NO level was measured using Griess assay. Compared to control, TNF-α-treated HUVEC showed reduction in DDAH1 mRNA expression (P < 0.05), DDAH1 protein level (P < 0.01), and DDAH activity (P < 0.05). Treatment with AEPS successfully increased DDAH1 mRNA expression (P < 0.05), DDAH1 protein level (P < 0.01), and DDAH activity (P < 0.05) in TNF-α-treated HUVEC. Treatment with TNF-α caused an increase in ADMA level (P < 0.01) and a decrease in endothelial NO production (P < 0.001). Whereas treatment with AEPS was able to reduce ADMA level (P < 0.01) and restore NO (P < 0.001) in TNF-α-treated HUVEC. The results suggested that AEPS promotes endothelial NO production by stimulating DDAH activity and thus reducing ADMA level in TNF-α-treated HUVEC.
    Matched MeSH terms: Atherosclerosis
  18. Fakhria Al-Joufi, Anil K. Saxena, Imad M. Al-Ani, Norlelawati A. Talib, Rafidah H. Mokhtar, Norsidah Ku -Zaifah
    MyJurnal
    Atherosclerosis in cardiovascular disease (CVD) is a growing health problem, especially in developing countries. Hyperlipidemia is known as a dominant risk factor for the development of atherosclerosis. This study was designed to investigate the effects of Eurycoma Longifolia (EL) also known as Malaysian Ginseng/ Tongkat Ali on the testosterone level, biochemical changes of lipid profile and intima media thickness (IMT) in rats fed on high-fat diet. Twenty young, adult male Sprague-Dawley (SD) rats were housed for 12 weeks. After one week of acclimatization, they were randomly divided into four groups of 5 animals each and treated for 12 weeks as follow: Group ND was given only normal diet, group NDEL was given normal diet and EL extracts (15mg/kg) dissolved in distilled water, group HFD was given only high fat diet and group HFDEL was given high fat diet and EL extracts (15mg/kg). Rats which were treated with EL (NDEL and HFDEL) showed a significant increase (p
    Matched MeSH terms: Atherosclerosis
  19. Amran AA, Zakaria Z, Othman F, Das S, Al-Mekhlafi HM, Raj S, et al.
    EXCLI J, 2012;11:274-83.
    PMID: 27366140
    Previous research has shown the beneficial effects of aqueous extract of Piper sarmentosum (P.s) on atherosclerosis. The first stage in atherosclerosis is the formation of foam cell. The aim of this study was to investigate the effect of the methanol extract of P.s on fatty streaks by calculating neointimal foam cell infiltration in rabbits fed with high cholesterol diet. Thirty six male New Zealand white rabbits were divided equally into six groups: (i) C: control group fed normal rabbit chow; (ii) CH: cholesterol diet (1 % cholesterol); (iii) PM1: 1 % cholesterol with methanol extract of P.s (62.5 mg/kg); (iv) PM2: 1 % cholesterol with methanol extract of P.s (125 mg/kg); (v) PM3: 1 % cholesterol with methanol extract of P.s (250 mg/kg); (vi) SMV group fed 1 % cholesterol supplemented with Simvistatin drug (1.2 mg/kg). All animals were treated for 10 weeks. At the end of the treatment, the rabbits were fasted and sacrificed and the aortic tissues were collected for histological studies to measure the area of the neointimal foam cell infiltration using software. The thickening of intima ratio of atherosclerosis and morphological changes by scanning electron microscope were measured. The results showed that the atherosclerotic group had significantly bigger area of fatty streak compared to the control group. The area of fatty streak in the abdominal aorta was significantly reduced in the treatment groups which were similar with the SMV group. Similarly, there was a reduction in the number of foam cell in the treatment groups compared to the atherosclerotic group as seen under scanning microscope. In conclusion, histological study demonstrated that the methanol extract of the P.s could reduce the neointimal foam cell infiltration in the lumen of the aorta and the atherosclerotic lesion.
    Matched MeSH terms: Atherosclerosis
  20. Baker EJ, Yusof MH, Yaqoob P, Miles EA, Calder PC
    Mol Aspects Med, 2018 12;64:169-181.
    PMID: 30102930 DOI: 10.1016/j.mam.2018.08.002
    Endothelial cells (ECs) play a role in the optimal function of blood vessels. When endothelial function becomes dysregulated, the risk of developing atherosclerosis increases. Specifically, upregulation of adhesion molecule expression on ECs promotes the movement of leukocytes, particularly monocytes, into the vessel wall. Here, monocytes differentiate into macrophages and may become foam cells, contributing to the initiation and progression of an atherosclerotic plaque. The ability of omega-3 (n-3) polyunsaturated fatty acids (PUFAs) to influence the expression of adhesion molecules by ECs and to modulate leukocyte-endothelial adhesion has been studied in cell culture using various types of ECs, in animal feeding studies and in human trials; the latter have tended to evaluate soluble forms of adhesion molecules that circulate in the bloodstream. These studies indicate that n-3 PUFAs (both eicosapentaenoic acid and docosahexaenoic acid) can decrease the expression of key adhesion molecules, such as vascular cell adhesion molecule 1, by ECs and that this results in decreased adhesive interactions between leukocytes and ECs. These findings suggest that n-3 PUFAs may lower leukocyte infiltration into the vascular wall, which could contribute to reduced atherosclerosis and lowered risk of cardiovascular disease.
    Matched MeSH terms: Atherosclerosis
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