Martin Christ

Obesity, commonly defined by body mass index (BMI), promotes cardiovascular disease through chronic inflammation and oxidative stress, which impair high-density lipoprotein (HDL) function and favor oxidative modification. Oxidized HDL (HDLox) may link adiposity to cardiovascular risk. However, the association between BMI and HDLox across the adiposity spectrum remains unclear. We therefore examined this relationship in a Coronary-Suspected Cohort. This study included 1227 consecutive patients undergoing elective coronary angiography. Participants were stratified into five predefined BMI categories. HDLox was quantified using a validated fluorometric assay assessing HDL lipid peroxide content. Associations between BMI and HDLox were analyzed using univariable and multivariable linear regression across the full BMI range and within a restricted BMI interval (15–35 kg/m²). HDLox levels were significantly higher in overweight and obese individuals compared with normal-weight participants (p = 0.002 and p < 0.001). HDLox increased from normal weight to obesity class I (BMI 30–34.9 kg/m²) and plateaued at higher BMI levels, indicating a non-linear relationship. In the overall cohort, BMI showed a weak but significant association with HDLox (β = 0.064, p = 0.024). Within the restricted BMI interval, the association was more pronounced (β = 0.158, p < 0.001). In multivariable models, BMI, high-sensitivity C-reactive protein, and male sex remained independently associated with HDLox, whereas traditional cardiovascular risk factors were not. HDL oxidation increases early during weight gain and may represent a functional marker linking adiposity-related inflammation and oxidative stress to cardiovascular vulnerability.

Background: Obesity, commonly defined by body mass index (BMI), promotes cardiovascular disease through chronic inflammation and oxidative stress, which impair high-density lipoprotein (HDL) function and favor oxidative modification. Oxidized HDL (HDLox) may link adiposity to cardiovascular risk. However, the association between BMI and HDLox across the adiposity spectrum remains unclear. We therefore examined this relationship in a Coronary-Suspected Cohort. Methods: This study included 1,227 consecutive patients undergoing elective coronary angiography. Participants were stratified into five predefined BMI categories. HDLox was quantified using a validated fluorometric assay assessing HDL lipid peroxide content. Associations between BMI and HDLox were analyzed using univariable and multivariable linear regression across the full BMI range and within a restricted BMI interval (15–35 kg/m²). Results: HDLox levels were significantly higher in overweight and obese individuals compared with normal-weight participants (p = 0.002 and p < 0.001). HDLox increased from normal weight to obesity class I (BMI 30–34.9 kg/m²) and plateaued at higher BMI levels, indicating a non-linear relationship. In the overall cohort, BMI showed a weak but significant association with HDLox (β = 0.064, p = 0.024). Within the restricted BMI interval, the association was more pronounced (β = 0.158, p < 0.001). In multivariable models, BMI, high-sensitivity C-reactive protein, and male sex remained independently associated with HDLox, whereas traditional cardiovascular risk factors were not. Conclusions: HDL oxidation increases early during weight gain and may represent a functional marker linking adiposity-related inflammation and oxidative stress to cardiovascular vulnerability.

RESULTS. Participants with CAD ( n = 723) had 12% higher mean relative levels of nHDL _ox compared with those with invasively excluded CAD ( n = 502, P < 0.001). Patients presenting with symptoms of an ACS had the highest nHDL _ox values when compared with the elective cohort (median 1.35, IQR 0.97 to 1.85, P < 0.001). In multivariate analysis adjusted for age, sex, body mass index, and hypertension, nHDL _ox was a strong independent predictor of ACS ( P < 0.001) but not of CAD ( P > 0.05).CONCLUSION. HDL antioxidant function is reduced in patients with CAD. nHDL _ox is strongly associated with ACS. TRIAL REGISTRATION. German Clinical Trials Register DRKS00014037. FUNDING. Brandenburg Medical School Theodor Fontane, the BIOX Stiftung, and NIH grants R01AG059501 and R03AG059462. BACKGROUND. High-density lipoprotein (HDL) function rather than its concentration plays an important role in the pathogenesis of coronary artery disease (CAD). The aim of the present study was to determine whether reduced antioxidant function of HDL is associated with the presence of a stable CAD or acute coronary syndrome (ACS).METHODS. HDL function was measured in 2 cohorts: 1225 patients admitted electively for coronary angiography and 196 patients with ACS. A validated cell-free biochemical assay was used to determine reduced HDL antioxidant function, as assessed by increased HDL-lipid peroxide content (HDL _ox ), which was normalized by HDL-C levels and the mean value of a pooled serum control from healthy participants (nHDL _ox ; unitless). Results are expressed as median with interquartile range (IQR).

Blood purification by hemoadsorption therapy seems to improve outcomes in selected patients undergoing cardiac surgery with cardiopulmonary bypass. Here, we report the successful application of hemoadsorption in the severe systemic inflammatory response during coronary artery bypass surgery in a patient with reactivated herpes zoster.

Es ist nur wenig darüber bekannt, wie häufig ein supraglottisches Atemwegssystem (SGA) oder ein intraossärer (i.o.) Zugang bei Patienten nach außerklinischem Herz-Kreislauf-Stillstand (OHCA) zur Anwendung kommen.