Clinical Lipidology
A Companion to Braunwald’s Heart Disease
- 3rd Edition - January 6, 2023
- Imprint: Elsevier
- Author: Christie M. Ballantyne
- Language: English
- Hardback ISBN:9 7 8 - 0 - 3 2 3 - 8 8 2 8 6 - 6
- eBook ISBN:9 7 8 - 0 - 3 2 3 - 8 8 2 8 7 - 3
Part of the renowned Braunwald family of references, Clinical Lipidology: A Companion to Braunwald’s Heart Disease provides today’s clinicians with clear, authoritative guidance on… Read more
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Request a sales quotePart of the renowned Braunwald family of references, Clinical Lipidology: A Companion to Braunwald’s Heart Disease provides today’s clinicians with clear, authoritative guidance on the therapeutic management of patients with high cholesterol levels and other atherogenic lipid disorders. An invaluable resource for cardiologists, lipidologists, endocrinologists, and internal medicine physicians, this one-stop reference covers everything from basic science and the pathogenesis of atherothrombotic disease to risk assessment and the latest therapy options. Now fully updated from cover to cover, the 3rd Edition offers unparalleled coverage of lipidology in an accessible and user-friendly manner.
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Thoroughly covers the assessment, diagnosis, and treatment of patients with elevated levels of lipids and lipoproteins, including all the latest research-based recommendations, therapeutic breakthroughs, and related clinical advances.
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Presents the latest data on clinical guidelines, risk assessments, and established and emerging pharmacologic and nonpharmacologic therapies—all from internationally recognized experts in the field.
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Features condensed, streamlined content that focuses on clinical applications and applying concepts to the practice setting. Chapters have now been completely reorganized into sections on risk assessment; therapy; new and evolving therapeutic targets and platforms; and special populations.
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Includes new chapters on Polygenic Risk Scores; Inclisiran; Bempedoic Acid; Selective Peroxisome Proliferator–Activated Receptor–α Modulator: Pemafibrate; Evolving Therapeutic Targets: Lp(a), ANGPTL3, and ApoC-III; New Therapeutic Platforms: Gene Therapy and Genome Editing; and more.
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Contains new or expanded content on inflammation; genetic testing; troponins for risk assessment; statins and role of bile acid sequestrants, niacin, and fibrates; mAbs; CANTOS and CIRT; colchicine; IL-6; and cellular, molecular, and genetic therapy.
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Provides treatment algorithms throughout, as well as case vignettes that highlight the most common clinical questions in each chapter.
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Incorporates the latest guidelines from the AHA, ACC, ESC, and EAS, as well as future directions for ongoing research and emerging applications.
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Enhanced eBook version included with purchase. Your enhanced eBook allows you to access all of the text, figures, and references from the book on a variety of devices.
- Cover image
- Title page
- Table of Contents
- Copyright
- Contributors
- Foreword
- Dedication
- Preface
- Braunwald’s Heart Disease Family of Books
- Section I. Introduction/Basic Mechanisms
- 1. Overview of Lipids and Atherosclerosis
- Introduction
- Inflammation: A Final Common Path that Links Many Risk Factors to Atherogenesis
- Lipoproteins and the Initiation of Atherosclerosis: Response to Low-Density Lipoprotein Retention and Beyond
- High-Density Lipoprotein: An Antiatherogenic Lipoprotein?
- Triglycerides and Triglyceride-Rich Lipoproteins: Causal Risk Factors for Atherosclerosis?
- Fatty Streak Formation
- Links Between Lipids and Lesion Progression
- Atherothrombosis: The Complications of the Atherosclerotic Plaque
- Effects of Lipid Lowering on the Atherosclerotic Plaque
- Perspectives on Links Between Lipoproteins and Mechanisms of Atherosclerosis
- Acknowledgments
- Conflicts of Interest
- Section II. Risk Assessment
- 2. Overview of Risk Assessment
- Introduction
- Risk Assessment by Age Group
- Risk-Enhancing Features
- Risk Reclassification with Coronary Artery Calcium Score
- Genetics
- Conclusion And Summary
- 3. Measurement of Low-Density Lipoprotein Cholesterol, Non–High-Density Lipoprotein Cholesterol, Apolipoprotein B, and Low-Density Lipoprotein Particle Concentration
- Introduction: The Major Atherogenic Lipids and Lipoproteins
- Low-Density Lipoprotein Cholesterol (LDL-C)
- Non–High-Density Lipoprotein Cholesterol (Non-HDL-C)
- Apolipoprotein B
- Low-Density Lipoprotein Particle (LDL-P) Concentration and Cardiovascular Risk
- Fasting Versus Nonfasting
- Summary of Clinical Recommendations
- Conclusion
- 4. Triglycerides, Triglyceride-Rich Lipoproteins, and High-Density Lipoprotein in Coronary Heart Disease Risk Assessment
- Introduction
- Assessment of Elevated Triglyceride-Rich Lipoproteins
- Population Distribution
- Nonfasting Versus Fasting
- Risk of Coronary Heart Disease, Atherosclerotic Cardiovascular Disease, and all-Cause Mortality
- Genetics DocumentS Causality
- Risk of Acute Pancreatitis
- High-Density Lipoprotein
- Mechanism
- Residual Atherosclerotic Cardiovascular Disease Risk
- Patient-Centered Clinical Applications
- Guidelines/Statements
- Future Research
- 5. Lipoprotein(a) in Cardiovascular Risk Assessment
- Overview
- How are Lipoprotein(a) Levels Determined?
- Evidence for Elevated Lipoprotein(a) as a Risk Factor
- Measurement of Lipoprotein(a)
- In Whom Should Lipoprotein(a) be Measured?
- Impact of Lipid-Lowering Therapy on Lipoprotein(a) Levels and Lipoprotein(a)-Attributable Risk
- 6. Clinical Evaluation for Genetic Testing and Secondary Causes of Dyslipidemia
- Introduction
- Genetic and Secondary Causes of Dyslipidemia: General Considerations
- The Genetic Basis of Dyslipidemia is Often Polygenic in Nature
- Rare Monogenic Dyslipidemias
- Selected Severe Dyslipidemias in more Depth
- Secondary Causes of Dyslipidemia
- Conclusions
- 7. Polygenic Risk Scores
- Introduction
- Early Use of Polygenic Risk Scores
- Genome-Wide Polygenic Risk Scores
- Evaluation of Polygenic Risk Score Compared with Clinical Risk Scores
- Limitations
- Future Directions
- 8. High-Sensitivity C-Reactive Protein
- Introduction
- Markers of Inflammation: High-Sensitivity C-Reactive Protein
- Measurement of High-Sensitivity C-Reactive Protein: cut Points, Laboratory Testing, and Variation
- Risks Associated with Elevated Levels of High-Sensitivity C-Reactive Protein
- Patient-Centered Clinical Applications
- High-Sensitivity C-Reactive Protein and Inflammatory Markers: the Guidelines
- Future Directions
- Conclusions
- 9. Emerging Assays for Risk Assessment
- Biomarkers as Clinical Tools
- Role of Cardiac Biomarkers of Subclinical Cardiac Injury/Disease In Lipid Therapy
- Application of -Omic Technologies to Biomarker Development
- Systems Biology: An Integrated Approach to Future Biomarker Discovery
- Summary/Conclusions
- 10. Imaging Atherosclerosis for Risk Stratification: Cardiac Computed Tomography and Carotid Ultrasound
- Introduction
- Coronary Calcium Score
- Carotid Ultrasound
- Conclusion
- Section III. Therapy
- 11. Overview of General Approach to Management of Dyslipidemias
- Introduction
- Elevated Low-Density Lipoprotein Cholesterol
- Mixed Dyslipidemia
- Severely Elevated Triglycerides
- Low High-Density Lipoprotein Cholesterol
- Elevated Lipoprotein(a)
- 12. Treatment Guidelines Overview: American Heart Association/American College of Cardiology/Multisociety Guideline and Updates
- Evolution of us Lipid Guidelines
- Secondary Prevention of Atherosclerotic Cardiovascular Disease
- Primary Prevention of Atherosclerotic Cardiovascular Disease
- Lipid Management in Selected Groups
- Monitoring Response and Adherence to Lipid-Lowering Therapy
- 13. Treatment Guidelines Overview: European Society of Cardiology/European Atherosclerosis Society Guidelines
- Introduction
- Defining the Cardiovascular Risk
- Evidence for the Causal Effects of Lipids and Lipoproteins on the Risk of Atherosclerotic Cardiovascular Disease
- Measuring Lipids and Lipoproteins for Cardiovascular Risk Estimation
- Lipid Targets and Goals
- Lifestyle Modifications to Improve the Plasma Lipid Profile
- Strategies to Control Plasma Lipid Levels
- High-Density Lipoprotein Cholesterol–Increasing Therapies
- Subgroups of Patients
- Inflammation
- Conclusions and Challenges
- 14. Dietary Patterns for the Prevention and Treatment of Cardiovascular Disease
- Introduction
- Dietary Guidelines and Recommendations
- Recommended Dietary Patterns
- Strategies for Implementing Healthful Dietary Patterns
- The Role of Registered Dietitians/Registered Dietitian Nutritionists or Nutrition Professionals In Nutrition Counseling
- The Role of Physicians in Facilitating Behavior Change Toward a Healthful Lifestyle
- Resources For Clinical Practice
- 15. Updated Clinical Guide to Exercise and Lipids
- Introduction
- Lipid Biomarkers: Pathophysiology and Impact on Cardiovascular Disease Outcomes
- Semantics in Exercise
- Impact of Exercise on Cardiovascular Disease Outcomes
- Impact of Exercise Training on Lipid Biomarkers
- Exercise Training and C-Reactive Protein
- Mechanisms of Lipid and C-Reactive Protein Attenuation During Aerobic Exercise Training
- Baseline and Trajectory Levels in Dyslipidemia
- Lipoprotein(a) and Proprotein Convertase Subtilisin/Kexin Type 9
- Therapeutic Strategies
- Conclusions
- Acknowledgment
- 16. Obesity, Lipids, and Cardiovascular Disease
- Definition of Obesity
- Effects of Obesity on the Cardiovascular System
- Diagnosis
- Obesity as a Contributor to Cardiovascular Disease
- Heart Failure with Preserved Ejection Fraction
- Obesity Paradox
- Nutrition
- Physical Activity
- Pharmacotherapy and Bariatric Surgery
- 17. Statins
- Mechanism of Action
- Pharmacokinetics
- Drug–Drug Interactions
- Lipid-Altering Efficacy
- Cardiovascular Effects
- Special Populations
- Statin Adherence, Intolerance, and Safety
- 18. Cholesterol Absorption Inhibitors
- Introduction
- Intestinal Cholesterol Absorption
- Agents Affecting Cholesterol Absorption
- Conclusions
- 19. Omega-3 Fatty Acids
- Introduction
- Definitions and Biochemistry
- Sources of Omega-3 Fatty Acids
- Effects on Lipids and Lipoproteins
- Effects on Lipids in Patients with Hyperlipidemia
- Effects on Cardiovascular Events
- Nonlipid Mechanisms
- Comparison of Omega-3 Fatty Acids
- Omega-3 Index
- Safety And Tolerability
- Recommended Intake
- Clinical Guidelines
- Case Discussion
- Future Directions
- Conclusions
- 20. Proprotein Convertase Subtilisin/Kexin Type 9 Inhibition
- Introduction
- Discovery of Proprotein Convertase Subtilisin/Kexin Type 9
- Mechanism of Action
- Dosing and Pharmacokinetics
- Lipid-Lowering Effects
- Cardiovascular Outcomes Trials
- Achieving Very low low-Density Lipoprotein Cholesterol
- Safety and Tolerability
- Additional Cardiovascular end Points
- Populations of Special Interest
- Proprotein Convertase Subtilisin/Kexin Type 9 Inhibitors in the Guidelines
- Future Directions
- Summary
- 21. Inclisiran
- Introduction
- Mode of Action
- Effect on Lipids, Apolipoproteins, and Atherosclerotic Cardiovascular Disease Biomarkers
- Safety, Tolerability, and Contraindications
- Indication
- Efficacy in Patients With Atherosclerotic Cardiovascular Disease and Atherosclerotic Cardiovascular Disease Risk Equivalents
- Efficacy in Patients With Heterozygous Familial Hypercholesterolemia
- Efficacy in Patients With Homozygous Familial Hypercholesterolemia
- Cost-Effectiveness
- Potential Opportunities for Patient Management and Population Health
- 22. Bempedoic Acid
- Introduction
- Impact of Acly Gene Variants on Lipid Profile and Cardiovascular Risk
- Pharmacokinetics of Bempedoic Acid
- Preclinical Studies
- Clinical Studies
- Conclusions
- 23. Pemafibrate: A New Selective Peroxisome Proliferator–Activated Receptor–α Modulator for Hypertriglyceridemia Management
- Introduction
- Mechanism of Action of Peroxisome Proliferator–Activated Receptor Agonists, Including Pemafibrate
- Pharmacokinetics and Metabolism Of Pemafibrate
- Safety and Tolerability of Pemafibrate
- Comparison of Pemafibrate With Fenofibrate
- Combination of Pemafibrate with a Statin
- Use of Pemafibrate in Patients with Comorbidities
- Lipid-Lowering Effects of Pemafibrate
- Nonlipoprotein Effects of Pemafibrate
- Clinical Application
- Ongoing Trials of Pemafibrate
- Summary and Conclusion
- Conflicts of Interest
- 24. Anti-inflammatory Therapy for Cardiovascular Disease
- Introduction: The Evolving Clinical Paradigm of “Residual Inflammatory Risk”
- The Relationship of High-Sensitivity C-Reactive Protein Levels to Future Vascular Risk, Metabolic Syndrome, and Diabetes
- When Should High-Sensitivity C-Reactive Protein Test be Ordered and How Should High-Sensitivity C-Reactive Protein Test Results be Interpreted?
- Primordial Prevention: Diet, Exercise, and Smoking Cessation all Reduce Inflammation and Lower Cardiovascular Event Rates
- Pharmacological Interventions, Part I: Statins are a “Two-Fer” Therapy that Reduces Both Cholesterol and High-Sensitivity C-Reactive Protein
- Pharmacological Interventions, Part II: What do the CANTOS, CIRT, COLCOT, and LoDoCo2 Trials Teach US?
- Other Available Pharmacological Approaches to High-Sensitivity C-Reactive Protein Lowering: Ezetimibe, Bempedoic Acid, and Glucagon-Like Peptide–1 Analogs
- Are There Other Useful Biomarkers for Systemic Vascular Inflammation?
- What is the Future for Inflammation Inhibition and Atherosclerosis?
- 25. Nutraceuticals and Functional Foods for Cholesterol Reduction
- Introduction
- Plant Sterols
- Viscous Fiber
- Soy Protein
- Pulses (Non-Oilseed Legumes)
- Nuts
- Other Foods or Food Components with Cholesterol-Lowering Properties
- The Need to Improve the Effectiveness of Diet
- The “Combination,” or “Dietary Portfolio,” Approach to Cholesterol Reduction
- Portfolio: Practical Application
- Similar Combination Approaches
- Conclusion
- Section IV. New and Evolving Therapeutic Targets and Platforms
- 26. Evolving Therapeutic Targets: Lipoprotein(a)
- Proprotein Convertase Subtilisin/Kexin Type 9 Inhibitors
- Outcomes Studies
- RNA Therapy
- Conclusion
- 27. Inhibition of ANGPTL3 as a Target for Treating Dyslipidemias
- Introduction: Context
- Biology of Angptl3
- Rationale for Angptl3 as a Therapeutic Target
- Clinical Pharmacology of Angptl3 Inhibitors
- Clinical Trials
- Putative Mode of Action of Angptl3 Inhibition on Plasma Lipids and Lipoproteins
- Therapeutic Perspectives
- Conclusion: Research Questions
- Conflicts of Interest
- Acknowledgment
- 28. Evolving Therapeutic Targets: Apolipoprotein C-III
- Introduction: Background
- Structure and Role of Apolipoprotein C-Iii In Human Biology
- Rationale for Apolipoprotein C-Iii as a Therapeutic Target
- Pharmacotherapy Targeting Apolipoprotein C-Iii
- Conclusion
- 29. Evolving Therapeutic Targets: Cholesteryl Ester Transfer Protein Inhibition
- Introduction
- Cholesteryl Ester Transfer Protein and Plasma Lipoproteins
- Evidence Supporting Development of Cholesteryl Ester Transfer Protein Inhibitors
- Torcetrapib
- Dalcetrapib
- Evacetrapib
- Anacetrapib
- Obicetrapib
- Recent Developments
- Conclusion
- 30. Gene Therapy and Therapeutic Genome Editing in Liver for Lipid Disorders
- Introduction
- Gene Therapy For Lipid Disorders
- Therapeutic Genome Editing
- Section V. Special Patient Populations
- 31. Special Patient Populations: Diabetes and Metabolic Syndrome
- History of the Metabolic Syndrome
- Epidemiology of Metabolic Syndrome and its Relationship to Cardiovascular Disease
- The Role of Insulin Resistance in Dyslipidemia of Metabolic Syndrome and Type 2 Diabetes Mellitus
- Therapeutic Approaches to Treating the Dyslipidemia of Metabolic Syndrome and Type 2 Diabetes Mellitus
- Summary
- 32. Special Patient Populations: Women and Older Adults
- Introduction
- Women
- Older Adults
- Conclusions
- 33. Special Patient Populations: Children and Adolescents
- Introduction
- Definition of Dyslipidemia in Childhood
- Screening for Dyslipidemia
- Differential Diagnosis
- Common Genetic Causes of Dyslipidemia in Childhood
- Special Population: Combined Dyslipidemia of Obesity
- Therapy for Dyslipidemia
- Conclusion
- 34. Special Patient Populations: Familial Hypercholesterolemia and Other Severe Hypercholesterolemias
- Introduction
- Familial Hypercholesterolemia
- Familial Combined Hyperlipidemia
- Familial Dysbetalipoproteinemia Syndrome
- Lipoprotein X Syndrome
- Lipoprotein Apheresis
- 35. Special Patient Populations: Treatment of Familial Chylomicronemia Syndrome and Sustained Chylomicronemia
- Introduction
- Principle of Treatment of Sustained Chylomicronemia
- Nutritional Management and Use of Medium-Chain Triglyceride Oil
- Limits of Fibrates And Traditional Triglyceride-Lowering Agents in The Treatment Of Patients with Sustained Chylomicronemia
- Insulin Infusion and Lipoprotein Apheresis in Patients with Sustained Chylomicronemia at Very High Risk of Acute Pancreatitis
- Overview of Emerging Therapeutics for Treatment of Sustained Chylomicronemia
- Apolipoprotein C-Iii Inhibitors
- Angptl3 Inhibitors and Angptl8 Modulators
- Angptl3 Versus Apolipoprotein C-III Inhibitors For Treatment of Sustained Chylomicronemia
- Apolipoprotein C-II Peptide Mimetics and Dual Apolipoprotein C-II Agonist/Apolipoprotein C-III Antagonist
- Agents Affecting Chylomicron Formation in the Enterocyte
- Gene-Based Therapeutics
- Conclusion
- 36. Special Patient Populations: Acute Coronary Syndromes
- Definition, Scope of Problem, and Risk of Recurrent Events
- High-Intensity Statin Therapy in Acute Coronary Syndrome
- Ezetimibe
- Proprotein Convertase Subtilisin/Kexin Type 9 Inhibitors
- High-Density Lipoprotein–Based Therapies after Acute Coronary Syndrome
- Triglyceride-Rich Lipoproteins
- Conflicts of Interest
- 37. Special Patient Populations: Transplant Recipients
- Introduction
- Renal Transplantation
- Heart Transplantation
- Liver Transplantation
- Pediatric and Adolescent Transplant Recipients
- Conclusions
- 38. Special Populations: Chronic Kidney Disease
- Introduction
- Chronic Kidney Disease and Lipid Metabolism
- Mechanisms of Dyslipidemia
- Altered Enzyme Function
- Altered Receptor Function
- Cardiovascular Outcomes in People with Chronic Kidney Disease
- Impact of Lipid-Lowering Agents on Lipid Markers
- Cardiovascular Outcome Trials of Lipid Lowering Specific to Chronic Kidney Disease
- Cardiovascular Outcome Trials of Proprotein Convertase Subtilisin/Kexin 9 Inhibitors and Icosapent Ethyl in Subgroups with Chronic Kidney Disease
- Effect of Lipid Lowering on Progression of Chronic Kidney Disease
- Conclusions
- 39. Special Patient Populations: Lipid Abnormalities in High-Risk Racial/Ethnic Groups
- Introduction
- Racial/Ethnic Lipid Abnormalities and Atherosclerotic Cardiovascular Disease Risk Calculation
- Heart-Healthy Diet and Statin Therapy
- New and Emerging Pharmacotherapies for Lipid Abnormalities
- Acknowledgment
- 40. Persons With Human Immunodeficiency Virus
- Introduction
- Antiretroviral Therapy, Cardiovascular Disease Risk, and Implications for Management
- Cardiovascular Risk Assessments
- Current Screening Guidelines
- Primary Prevention and Screening for Clinical Practice
- Cardiovascular Disease Risk Reduction Interventions in Persons with Human Immunodeficiency Virus
- Statin Therapy
- Implications for Future Research
- Clinical Assessments
- Conclusion
- Index
- Edition: 3
- Published: January 6, 2023
- Imprint: Elsevier
- No. of pages: 432
- Language: English
- Hardback ISBN: 9780323882866
- eBook ISBN: 9780323882873
CB
Christie M. Ballantyne
Affiliations and expertise
Chief, Section of Cardiology, Chief, Section of Cardiovascular Research, Professor of Cardiovascular Medicine, Baylor College of Medicine, Houston, TexasRead Clinical Lipidology on ScienceDirect