Biomedical subjects

Alberico L Catapano

Publications and source records attributed to Alberico L Catapano.

At least 19 recordsLinked to original sources

PubMed2026

Comparative safety of lipid-lowering drugs alone or in combination: insights from a systematic review and network meta-analysis.

BACKGROUND AND AIMS: Although the safety profile of lipid-lowering therapies (LLTs) is known, there are no comprehensive comparative assessments. We aimed to compare the risk of muscle-related events, diabetes, liver dysfunction, and cognitive disorders among LLTs through a network meta-analysis. METHODS AND RESULTS: Databases were searched from inception to May 2025. Eligible studies included adult patients, using statins, ezetimibe, PCSK9 monoclonal antibodies (PCSK9mAbs), inclisiran, bempedoic acid, or their combinations as intervention, reporting the information about any of the selected adverse events, a total sample size of ≥200 subjects, and had ≥1 month of intervention. Pooled estimates were assessed by fixed effects model within a frequentist setting. Pooled relative risks (RR) and their 95% confidence interval were estimated. A total of 303,397 subjects from 153 RCTs were included. Bempedoic acid ranked the lowest risk of myalgia (vs PCSK9mAbs, RR 0.80 [0.69, 0.93]). PCSK9mAbs were associated with lower incidence of creatine kinase (CK) elevation, diabetes, and liver dysfunction comparing to statins (statins vs PCSK9mAbs, RR 1.44 [1.14, 1.81], RR 1.13 [1.05, 1.22], and RR 1.38 [1.17, 1.62], respectively). In terms of muscle-related events and cognitive disorders, no significant risk differences were found among treatments and their combinations. CONCLUSIONS: PCSK9mAbs appear to have a more favourable safety profile regarding the risk of CK elevation, diabetes, and liver dysfunction. Bempedoic acid seem to be a better choice for subjects with high risk of myalgia. This information can be valuable when selecting therapy for specific patient subgroups at higher risk of certain adverse events.

Humans↗

PubMed2006

Effects of fractalkine receptor variants on common carotid artery intima-media thickness.

BACKGROUND AND PURPOSE: Fractalkine receptor (CX3CR1) plays a key role during atherogenesis. CX3CR1 has 2 common coding polymorphisms, namely V249I and T280M, that have been associated with interindividual differences in susceptibility to atherosclerosis. In the present study, we investigated the possible association between CX3CR1variants and intima-media thickness (IMT). METHODS: We genotyped 1256 samples from the Progression of Lesions in the Intima of the Carotid (PLIC) study (a prospective population-based study) for the presence of the V249 and the M280 variants of CX3CR1. RESULTS: Significantly reduced IMT was observed in subjects with the MM280 genotype (0.57+/-0.12 mm) compared with subjects with the TT (0.65+/-0.14 mm) or the TM (0.65+/-0.13 mm) genotype. No difference in IMT was observed within carrier of the II249, VI249, or VV249 genotype. Subjects with combined genotype VI249/MM280 and II249/MM280 showed a reduced IMT. CONCLUSIONS: The presence of the M280 polymorphism of the fractalkine receptor is associated with a decreased common carotid artery IMT, whereas the presence of the I249 polymorphism does not play a major role on the progression of carotid atherosclerosis.

Adult↗

PubMed2006

15-Lipoxygenase-mediated modification of high-density lipoproteins impairs SR-BI- and ABCA1-dependent cholesterol efflux from macrophages.

Elevated plasma levels of high-density lipoprotein cholesterol (HDL-C) are atheroprotective and HDL-dependent reverse cholesterol transport has been related to this effect. HDL particles may, however, undergo modifications that affect their biological activities. Lipoxygenases (LOs) belong to a family of lipid peroxidizing enzymes; among them, reticulocyte-type 15-lipoxygenase (15-LO-1) appears to play a pathophysiological role in atherosclerosis, as its expression is increased in atherosclerotic plaques and it has been shown to oxidize low-density lipoproteins to an atherogenic form. In this work we investigated the impact of in vitro 15-lipoxygenase-catalyzed modification of HDL3 on their ability to act as cholesterol acceptor and found that 15-LO-modified HDL3 were less effective in mediating cholesterol efflux from lipid-laden J774 cells. A reduced binding of 15-LO-modified HDL3 to scavenger receptor class B, type I (SR-BI), due to HDL apoproteins cross-linking, explained, at least in part, the observed reduction of cholesterol efflux. In addition, ATP-binding cassette transporter A1 (ABCA1)-mediated cholesterol efflux was also reduced, as a consequence of pre-beta-particles loss after HDL3 modification. These results suggest that 15-lipoxygenase might induce structural alterations of HDL3 particles that impair their capability of triggering reverse cholesterol transport.

ATP Binding Cassette Transporter 1↗

PubMed2006

Lipid-altering efficacy of the ezetimibe/simvastatin single tablet versus rosuvastatin in hypercholesterolemic patients.

OBJECTIVE: To assess the lipid-altering efficacy and safety of ezetimibe/simvastatin single tablet product compared with rosuvastatin at the approved usual starting, next highest, and maximum doses. RESEARCH DESIGN AND METHODS: Double-blind, multicenter, 6-week, parallel-group study in hypercholesterolemic patients (n = 2959). Patients were randomized based on stratification by low-density lipoprotein cholesterol (LDL-C) levels to ezetimibe/simvastatin or rosuvastatin, respectively, at the usual starting (10/20 or 10 mg/day), the next highest (10/40 or 20 mg/day), and maximum doses (10/80 or 40 mg/day). RESULTS: At all doses and across doses, ezetimibe/simvastatin reduced LDL-C levels significantly more (52-61%) than rosuvastatin (46-57%; p < or = 0.001). Significantly greater percentages of all patients (p < 0.001) and high risk patients (p < or = 0.005) attained LDL-C levels < 70 mg/dL (1.8 mmol/L) following ezetimibe/simvastatin treatment compared with rosuvastatin at the prespecified doses and across doses. Ezetimibe/simvastatin also produced significantly greater reductions in total cholesterol (p < 0.001), non-high-density lipoprotein cholesterol (p < 0.001), lipid ratios (p < or = 0.003), and apolipoprotein B (p < 0.05). Reductions in triglycerides were significantly greater with ezetimibe/simvastatin than rosuvastatin at the usual starting (p = 0.004) and next highest (p = 0.006) doses, and across all doses (p < 0.001). Increases in high-density lipoprotein cholesterol, and decreases in high sensitivity C reactive protein (hsCRP) were similar between treatment groups. Safety profiles were comparable for both treatments; however, the percent of patients with proteinuria was significantly higher following rosuvastatin treatment than ezetimibe/simvastatin, respectively at 10 mg versus 10/20 mg/day (p = 0.004) and 40 mg versus 10/80 mg/day (p < 0.001). CONCLUSION: Ezetimibe/simvastatin was more effective than rosuvastatin in LDL-C lowering, and provided greater or comparable improvements in other lipid measures and hsCRP at the approved usual starting, next highest, and maximum doses in hypercholesterolemic patients. Although the doses compared in this study were not equivalent on a milligram basis, the results provide clinically relevant information regarding the use of these drugs for initial therapy and for subsequent use at higher doses when appropriate. Both treatments were generally well-tolerated; however, this study was not powered nor of sufficient duration to assess the prevalence of rare clinical adverse effects. Overall, ezetimibe/simvastatin offers an effective and tolerable treatment option for lipid management. An assessment of its full clinical benefit awaits evaluation in longer-term clinical studies.

Anticholesteremic Agents↗

PubMed2006

Secondary prevention of myocardial infarction: a survey in primary care.

OBJECTIVE: To collect information on the major risk factors and secondary prevention among patients with myocardial infarction in Italy. METHODS: Data were obtained from the database of the Italian College of General Practitioners; 3588 patients (mean age 68.7 +/- 11.3 years; 2698 men, 888 women; two unrecorded gender), with an average time from event of 6 +/- 5.7 years, were identified. RESULTS: Among the major risk factors, data entry ranged from 50.3% for physical activity to 74.9% for blood pressure. Inadequate blood pressure control was present in 49.2% and elevated plasma cholesterol levels (> 5.2 mmol/l) in 57.3%; among the latter group, 65% were on lipid-lowering therapy. Only 47.2% of the treated patients achieved a total cholesterol level of < 5.2 mmol/l. Antiplatelet or anticoagulant drugs, beta-blockers, and angiotensin-converting enzyme inhibitors were prescribed to 43%, 10.3%, and 57.9% of patients, respectively. CONCLUSIONS: The preventive attitude of Italian general practitioners is similar to that reported in other European countries with two noticeable exceptions: under-prescription of beta-blockers and of antiplatelet drugs. Clearly, secondary prevention requires major improvement.

Adult↗

PubMed2006

Oxidized-HDL3 modulates the expression of Cox-2 in human endothelial cells.

Modified high density lipoprotein (HDL) has been suggested to modulate endothelial expression of proinflammatory genes. Since oxidised HDL (Ox-HDL) has been found in atheromatous plaques and receptors for modified HDL are present on endothelial cells, we investigated the effect of Ox-HDL3 on the expression of Cox-1 or Cox-2. Ox-HDL3, increased Cox-2 mRNA and protein expression in endothelial cells while no effect on Cox-1 expression was observed. The intracellular pathways involved in this effect were investigated. The incubation with specific inhibitors of intracellular kinases showed that PI3K is mainly involved in the Ox-HDL3-dependent Cox-2 induction. Transient transfection experiments suggested that the NF-IL6 response element in the proximal promoter (-327 to 59) is involved in Ox-HDL3-mediated Cox-2 expression. These data suggest that Ox-HDL induce Cox-2 expression in endothelial cells through a PI3K/NF-IL6-dependent pathway.

Butadienes↗

PubMed2005

High-density lipoproteins induce transforming growth factor-beta2 expression in endothelial cells.

BACKGROUND: HDL is endowed with cardiovascular protective activities. In addition to its role in reverse cholesterol transport, HDL influences different functions of endothelial cells. In the present study, we investigated in endothelial cells the genes involved in inflammation modulated by HDL. METHODS AND RESULTS: Through cDNA array analysis, transforming growth factor (TGF)-beta2 appeared to be a gene responsive to HDL treatment in endothelial cells. Quantitative real-time polymerase chain reaction confirmed that HDL subfraction 3 selectively induces TGF-beta2 mRNA expression and protein release, whereas TGF-beta1 and TGF-beta3 were not affected. This effect was mainly PI3K/Akt dependent. Lysosphingolipids present in HDL such as sphingosine 1 phosphate and sphingosylphosphorylcholine mimicked the effects of the whole HDL. These results were confirmed in vivo in transgenic mice overexpressing human apolipoprotein (apo) A-I. Compared with apoA-I-knockout mice, phospho-Akt, phospho-ERK1/2, and TGF-beta2 expression was increased in the aorta of transgenic mice overexpressing human apoA-I. In addition, the expression of phospho-Smad2/3, the transcription factor activated by TGF-beta, is increased in transgenic mice compared with knockout mice. CONCLUSIONS: Because TGF-beta possesses antiinflammatory properties and stabilizes the plaque, the results of the present work suggest a novel target for the antiatherosclerotic effect of HDL.

Animals↗

PubMed2005

Cholesterol control in stroke prevention in Italy: a cross-sectional study in family practice.

BACKGROUND: Stroke represents worldwide the second and seventh cause of death and invalidity, respectively. Patients with ischaemic stroke or transitory ischaemic attack (TIA) are at high risk of recurrence, therefore requiring intensive treatment. Hypercholesterolaemia is a modifiable risk factor for stroke. The general practitioners attitude towards detection and treatment of dyslipidaemia among patients with stroke or TIA in Italy is unknown; we therefore aimed to address this issue taking advantage of the database of The Italian College of General Practitioners. METHODS: Prevalence of the monitored factors (lipid levels, statin prescription, and lipid level control with hypolipidaemic agents prescription) were analysed on a patient population of 465 061. RESULTS: A total of 2555 (49% women and 51% men) patients with a diagnosis of stroke and 2755 patients (52% women and 48% men) with a diagnosis of TIA were included in the study. Total plasma cholesterol (TC) was reported in more than 60% of the patients and low-density lipoprotein cholesterol (LDLc) and high-density lipoprotein cholesterol (HDLc) in less than half. Total plasma cholesterol and LDLc were controlled in 70.3 and 72.8% of the patients, respectively. The percentage of controlled patients decreased to 64% when both LDLc and TC were considered. Statins and fibrates were prescribed in a small proportion of patients (16.9 and 3.5%, respectively). An acceptable control of blood lipids was achieved in a majority of those patients (60.2%). However a relatively large number of patients (646) with high plasma lipids remained untreated. CONCLUSIONS: Monitoring and intervention strategies on plasma lipid levels in patients with a diagnosis of stroke or TIA need to be improved.

Age Distribution↗

PubMed2005

The database of Italian general practitioners allows a reliable determination of the prevalence of myocardial infarction.

BACKGROUND: To plan preventive intervention after myocardial infarction (MI) the disease prevalence and the age and time from acute event of the index population should be known. METHODS: We identified all the living patients with MI coded diagnosis in the database of the Italian College of General Practitioners (Health Search Database-HSD). The years from the first acute MI were also determined. RESULTS: 3588 subjects with MI diagnosis were identified (2698 males and 888 females, for 2 gender not recorded). Based on the distribution of our population and on that reported by the Italian Institute of Statistics, stratified by gender and age (segments of 10 years), the estimated number of subjects with MI in Italy (age-standardized rates x 10000) was 309284 for men and 102343 for women. CONCLUSIONS: The prevalence of MI diagnosis in the HSD is very close to that obtained by other epidemiological methods. Querying the database can provide a simple and inexpensive way to estimate and monitor the prevalence of MI in Italy.

Adult↗

PubMed2004

High-density lipoprotein subfraction 3 decreases ADAMTS-1 expression induced by lipopolysaccharide and tumor necrosis factor-alpha in human endothelial cells.

Endothelial expression of matrix metalloproteinases has been implicated in angiogenesis and endothelial cell proliferation. Recently, it has been shown that high-density lipoproteins (HDLs) promote angiogenesis. In the present study, we investigated the effects of native HDLs on the expression of several proteases and their inhibitors in human umbilical vein endothelial cells. We show that ADAMTS-1 (a disintegrin and metalloproteinase with thrombospondin motif) was potently induced by incubation with lipopolysaccharide or tumor necrosis factor-alpha and that the expression was significantly reduced in the presence of HDL subfraction 3. Since ADAMTS-1 has recently been shown to inhibit endothelial cell proliferation, the result of the present work may represent a new mechanism by which HDL could have a positive effect on endothelial cell and vascular wall function.

ADAM Proteins↗

PubMed2004

Oxidised-HDL3 induces the expression of PAI-1 in human endothelial cells. Role of p38MAPK activation and mRNA stabilization.

Modified lipoproteins have been suggested to modulate endothelial expression of plasminogen activator inhibitor-1 (PAI-1). As oxidized high-density lipoprotein (Ox-HDL) has been found in atheromatous plaques and receptors for modified HDL are present on endothelial cells, we investigated the role of Ox-HDL3 on the expression of PAI-1. Ox-HDL3 but not native HDL3, increased PAI-1 mRNA expression in endothelial cells. Furthermore, PAI-1 antigen expression and activity increased in the supernatant of cells incubated with Ox-HDL3. The intracellular pathways involved in this effect were investigated. Ox-HDL3 activated both extracellular signal-regulated kinases (ERK) 1/2 and p38 mitogen-activated protein kinase (MAPK). Moreover, incubation with specific inhibitors of these kinases showed that p38MAPK was mainly involved in the Ox-HDL3-dependent PAI-1 induction. Transient transfection experiments suggested that none of the response elements in the proximal promoter (-804 to 17) were involved in Ox-HDL3-mediated PAI-1 expression. mRNA stability experiments showed that Ox-HDL3 increased the PAI-1 mRNA half-life. In summary, Ox-HDL3 induced PAI-1 mRNA expression and antigen release through a molecular mechanism involving MAPK activation and mRNA stabilization. Thus, oxidative modification converts HDL to a prothrombotic lipoprotein species.

Cells, Cultured↗

PubMed2004

[Intestinal cholesterol absorption: a pharmacological target for lowering of plasma cholesterol].

A number of clinical studies clearly demonstrate the efficacy of hypocholesterolemic treatment in reducing incident cardiovascular events. The benefit appears to be proportional to the reduction of LDL cholesterol. Recent guidelines suggest an even more stringent target of 70 mg/dl for LDL cholesterol in high-risk subjects. Statins represent a very effective treatment of hypercholesterolemia, and the co-administration of drugs with complementary mechanisms of action, may represent an additional pharmacological tool in clinical practice to achieve the suggested targets for LDL lowering. In this short review we address the most recent discoveries in the physiological pathways of cholesterol absorption and identify the concept of dual inhibition as a therapeutic paradigm that may help in reaching the LDL cholesterol targets in clinical practice.

Cardiovascular Diseases↗

PubMed2003

Apolipoprotein C-II deficiency presenting as a lipid encephalopathy in infancy.

An infant presented with massive hyperchylomicronemia and a severe encephalopathy. MRI showed marked lipid deposition throughout the brain. Despite the normalization of the biochemistry, there was little clinical improvement, and at 18 months of age she has severe developmental delay, a strikingly abnormal MRI. Apolipoprotein C-II, the lipoprotein on chylomicrons responsible for the activation of lipoprotein lipase, was not detectable in blood. Analysis of the APO C-II gene revealed a novel homozygous point mutation, 1118C-->A. Subsequently, another sibling has been born with the same homozygous mutation and similar biochemistry but, perhaps because of early treatment, a normal neurological outcome.

Apolipoprotein C-II↗

PubMed2003

Statins and oxidative stress during atherogenesis.

Oxidised low-density lipoprotein (LDL) is believed to be the most atherogenic form of LDL. However, while a number of experimental data support this concept, the protective role of antioxidants that may prevent LDL oxidation in atherosclerosis is only partially confirmed by studies in man. Observational and epidemiological data as well as randomised trials failed to provide clear-cut indications, because of mixed results on the protective role of antioxidants against cardiovascular diseases. In spite of the lack of a general consensus, recent data reinforce the concept that a regular intake of antioxidants present in food blocks the progression of atherosclerosis and that the reduced ability of LDL to oxidise may represent a good marker to follow the action of antioxidants. Among their properties statins also possess antioxidant activities and the aim of this paper is to review the scientific evidence for such an effect and its possible clinical relevance.

Antioxidants↗

PubMed2003

Effects of HDL3 on the expression of matrix-degrading proteases in human endothelial cells.

Modified lipoproteins have been suggested to modulate the expression of matrix-degrading proteases in the vascular wall. Since oxidized high density lipoprotein (HDL) has been found in atheromatous plaques and receptors for modified HDL are present on endothelial cells, we investigated the role of native and oxidized HDL3 on the expression of 35 proteases and their inhibitors in human endothelial cells using microarray analysis. Matrix metalloproteinase (MMP)-1, -2, -10, -13 and -14, tissue inhibitor of MMP (TIMP)-1, -2 and -3, cathepsin B and D, and cystatin C were expressed under basal conditions, of which MMP-10 and cystatin C expression have not been described before in endothelial cells. Native HDL3 increased MMP-1 and MMP-14 expression and decreased MMP-13 expression, whereas oxidized HDL3 increased PAI-1 and MMP-1 expression. The expression pattern was confirmed by quantitative real-time PCR. In summary, a large repertoire of matrix-degrading proteases is expressed in endothelial cells, an expression that can be modulated by native and oxidized HDL3.

Endopeptidases↗

PubMed2003

[Rosuvastatin: pharmacologic features].

The development of more active and safe new 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statins) will increase the armamentarium of therapeutic tools available to the physicians for antiatherosclerotic therapies. Rosuvastatin presents a promising pharmacological profile: high affinity for the enzyme, a relative high hydrophilicity, selective hepatic uptake and activity, minimal cytochrome P450-mediated metabolism. Clinically the drug displays the highest lipid-lowering efficacy in the class with a safety profile similar to the other statins. Drug interaction potential is reduced. Rosuvastatin effectively decreases triglycerides, triglyceride-rich lipoproteins, non-HDL cholesterol, and increases HDL cholesterol. All together these properties will favor the achievement of therapeutic goals in the treated patients.

Animals↗

PubMed2003

[Achievement of the therapeutic goals for dyslipidemia in clinical practice: results of a survey among general practice physicians from Lombardy].

BACKGROUND: Currently available guidelines suggest that hypolipidemic drugs should be used in subjects at high risk for coronary heart disease (CHD). Very often, however, physicians fail to comply with the targets (total or LDL cholesterol) that are proposed by the Consensus Panels. The aim of this survey was to evaluate the efficacy of a hypocholesterolemic treatment in achieving the therapeutic target according to Adult Treatment Panel II guidelines in a sample of general practitioners from Lombardy, a region of northern Italy. METHODS: Eighty-five general practitioners reported in a standardized manner data on the presence of major and minor coronary risk factors from at least 15 patients from their database for a total of 1275 patients. Treatment targets for LDL cholesterol were 100 mg/dl in patients with existing cardiovascular disease (class I), 130 mg/dl for patients with > or = 2 CHD risk factors (class II), and 160 mg/dl for the others (class III). Results on the efficacy of the therapy were divided into the following categories: 1) to target, 2) failure to reach the target by < or = 30 mg/dl, 3) failure to reach the target by > 30 mg/dl. Data were analyzed by means of the CSS statistical software. RESULTS: Overall 58.2% of the patients were males and the average age of the population was 59.2 +/- 10.1 years; 20.4% were diabetics, 34.5% smokers, 48.8% hypertensives, 16.9% had a previous myocardial infarction, 14.9% were suffering of stable angina, and 8.1% had undergone coronary artery bypass grafting and/or coronary angioplasty. Moreover 33.9% had a positive family history for CHD. Class I patients were 31.7% of the population, class II 52.9%, and class III 15.4%. Plasma lipid levels before treatment were on average 294 +/- 37 mg/dl for total cholesterol, 211 +/- 37 mg/dl for LDL cholesterol, 45 +/- 16 mg/dl for HDL cholesterol, and 195 +/- 104 mg/dl for plasma triglycerides. Of the patients 78.8% received dietary counseling, while 94.7% received hypolipidemic treatment (89.9% were only on statins). The average post-treatment value for total cholesterol was 225 +/- 33 mg/dl (-23%), LDL cholesterol 145 +/- 34 mg/dl (-31%), HDL cholesterol 50 +/- 15 (+15%), and plasma triglycerides 151 +/- 55 (-17%). When patients were stratified according to their LDL cholesterol target, 29.9% were on target, 34.0% missed it by < or = 30 mg/dl, and 36.1% by > 30 mg/dl. In class I only 14.9% achieved the target, in class II 31.2%, in class III 61.8%. CONCLUSIONS: These data show that general practitioners do not aim at an aggressive lipid lowering in patients at high risk, perhaps because of the limited knowledge of the need for modulating treatment according to the global CHD risk.

Adolescent↗

PubMed2002

Novel statins: pharmacological and clinical results.

Rosuvastatin (ZD4522) and pitavastatin (NK-104) are novel HMG-CoA reductase inhibitors with a peculiar pharmacological profile. In particular, they show a high potency in decreasing LDL-C and their catabolism is not mediated by the cytochrome P-450 3A4, thus reducing the potential for drug-drug interaction and improving the management of blood cholesterol. As the magnitude of LDL-C reduction is directly associated with the decrease in the incidence of myocardial infarction and mortality for CAD, statins with increased LDL-C lowering potency may ensure the achievement of target LDL-C levels and offer a more aggressive cholesterol control, further improving CAD morbidity and mortality.

Animals↗