Role of Triglyceriod in CAD patients.pptx

TRIGLYCERIDES - DO THEY MATTER IN CAD

1. TRIGLYCERIDES - DO THEY MATTER IN CAD

2. Comparison of cell metabolism in M1 versus M2 macrophages. Pro-inflammatory M1 macrophages (e.g., induced by LPS and oxLDL ) show increased glycolysis with enhanced pyruvate to lactate conversion, triggered by ROS production and HIF1α accumulation, as well as an activated PPP.

3. Summary of cellular metabolism in neutrophils. Mature neutrophils mainly depend on glycolysis for energy production. Glucose uptake and glycolysis increases in neutrophils stimulated with PMA.

4. Summary of cellular metabolism in endothelial cells. In healthy conditions glycolysis accounts for ∼80% of the total energy production in endothelial cells.

5. Summary of cellular metabolism in vascular smooth muscle cells and T-lymphocytes. (A) Overall, 90% of the glucose taken up by VSMCs is converted to lactate by aerobic glycolysis. Dai, Y., Junho , C.V.C., Schieren , L., Wollenhaupt , J., Sluimer , J.C., van der Vorst, E.P. and Noels, H., 2024. Cellular metabolism changes in atherosclerosis and the impact of comorbidities. Frontiers in Cell and Developmental Biology , 12 , p.1446964.

6. Overview of triglyceride metabolism. Overview of triglyceride metabolism. Apo A-V indicates apolipoprotein A-V; CMR, chylomicron remnant; FFAs, free fatty acids; HTGL, hepatic triglyceride lipase; IDL, intermediate-density lipoprotein; LDL, low-density lipoprotein; LDL-R, low-density lipoprotein receptor; LPL, lipoprotein lipase; LRP, LDL receptor–related protein; VLDL, very low-density lipoprotein; and VLDL-R, very low-density lipoprotein receptor.

7. Practical algorithm for screening and management of elevated triglycerides. TFA indicates trans fatty acid; SFA, saturated fatty acid; MUFA, monounsaturated fatty acid; PUFA, polyunsaturated fatty acid; and EPA/DHA, eicosapentaenoic acid/ docosahexaenoic acid. Miller, M., Stone, N.J., Ballantyne , C., Bittner, V., Criqui , M.H., Ginsberg, H.N., Goldberg, A.C., Howard, W.J., Jacobson, M.S., Kris- Etherton , P.M. and Lennie, T.A., 2011. Triglycerides and cardiovascular disease: a scientific statement from the American Heart Association. Circulation , 123 (20), pp.2292-2333.

8. Filtz A, Parihar S, Greenberg GS, Park CM, Scotti A, Lorenzatti D, Badimon JJ, Soffer DE, Toth PP, Lavie CJ, Bittner V, Virani SS, Slipczuk L. New approaches to triglyceride reduction: Is there any hope left? Am J Prev Cardiol . 2024 Mar 22;18:100648. doi : 10.1016/j.ajpc.2024.100648. PMID: 38584606; PMCID: PMC10998004. ABSORPTION, TRANSPORT, AND METABOLISM OF TRIGLYCERIDES.

9. Filtz A, Parihar S, Greenberg GS, Park CM, Scotti A, Lorenzatti D, Badimon JJ, Soffer DE, Toth PP, Lavie CJ, Bittner V, Virani SS, Slipczuk L. New approaches to triglyceride reduction: Is there any hope left? Am J Prev Cardiol . 2024 Mar 22;18:100648. doi : 10.1016/j.ajpc.2024.100648. PMID: 38584606; PMCID: PMC10998004. Pathophysiology of triglyceride pro- atherogenic effects.

10. Class Mechanism of action Reduction in TG ( %) Weight loss of 5-10 % Reduced dietary intake, enhanced insulin sensitivity 20 % Mediterranean diet Reduced dietary intake of unfavorable fats 12 % Statins Inhibit HMG-CoA reductase, which limits hepatic cholesterol biosynthesis 20-50 % Fibrates Activate peroxisome proliferator-activated receptors and enhance lipid metabolism 30-50 % Omega-3 fatty acids Unclear mechanism 20-30 % TREATMENTS CURRENTLY AVAILABLE FOR HYPERTRIGLYCERIDEMIA. TG=triglycerides; HMG-CoA= 3-hydroxy-3-methyl-glutaryl-coenzyme A reductase . Filtz A, Parihar S, Greenberg GS, Park CM, Scotti A, Lorenzatti D, Badimon JJ, Soffer DE, Toth PP, Lavie CJ, Bittner V, Virani SS, Slipczuk L. New approaches to triglyceride reduction: Is there any hope left? Am J Prev Cardiol . 2024 Mar 22;18:100648. doi : 10.1016/j.ajpc.2024.100648. PMID: 38584606; PMCID: PMC10998004.

11. Filtz A, Parihar S, Greenberg GS, Park CM, Scotti A, Lorenzatti D, Badimon JJ, Soffer DE, Toth PP, Lavie CJ, Bittner V, Virani SS, Slipczuk L. New approaches to triglyceride reduction: Is there any hope left? Am J Prev Cardiol . 2024 Mar 22;18:100648. doi : 10.1016/j.ajpc.2024.100648. PMID: 38584606; PMCID: PMC10998004.

12. The Endogenous Pathway (Very LDL Biosynthesis) Exogenous Pathway (Chylomicron Biosynthesis) Gabani M, Shapiro MD, Toth PP. The Role of Triglyceride-rich Lipoproteins and Their Remnants in Atherosclerotic Cardiovascular Disease. Eur Cardiol . 2023 Sep 28;18:e56. doi : 10.15420/ecr.2023.16. PMID: 37860700; PMCID: PMC10583159.