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  1. Article: Implementation of a biochemical, clinical, and genetic screening programme for familial hypercholesterolemia in 26 centres in Spain: The ARIAN study.

    Arrobas Velilla, Teresa / Brea, Ángel / Valdivielso, Pedro

    Frontiers in genetics

    2022  Volume 13, Page(s) 971651

    Abstract: Background: ...

    Abstract Background:
    Language English
    Publishing date 2022-08-29
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2606823-0
    ISSN 1664-8021
    ISSN 1664-8021
    DOI 10.3389/fgene.2022.971651
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  2. Article ; Online: Implantation of a biochemical and genetic screening programme for family hypercholesterolaemia. Collaboration between the clinical laboratory and lipid units: Design of the ARIAN Project.

    Arrobas Velilla, Teresa / Brea, Ángel / Valdivielso, Pedro

    Clinica e investigacion en arteriosclerosis : publicacion oficial de la Sociedad Espanola de Arteriosclerosis

    2021  Volume 33, Issue 6, Page(s) 289–295

    Abstract: Introduction and objective: Familial hypercholesterolaemia (FH) is the most common genetic disorder associated with premature coronary artery disease due to the presence of LDL-C cholesterol increased from birth. It is underdiagnosed and undertreated. ... ...

    Title translation Implantación de un programa de cribado bioquímico y genético de hipercolesterolemia familiar. Colaboración entre el laboratorio clínico y las unidades de lípidos: diseño del Proyecto ARIAN.
    Abstract Introduction and objective: Familial hypercholesterolaemia (FH) is the most common genetic disorder associated with premature coronary artery disease due to the presence of LDL-C cholesterol increased from birth. It is underdiagnosed and undertreated. The primary objective of the ARIAN project was to determine the number of patients diagnosed with FH after implementing a new screening procedure from the laboratory.
    Material and methods: This project was designed as a retrospective analysis by consulting the computer system. We selected from databases serum samples from patients ≥ 18 years with direct or calculated LDL-C>250mg/dL from 1 January 2017 to 31 December 2018. Once secondary causes had been ruled out, the requesting primary care physician was notified that their patient might have FH and to arrange a priority appointment in the lipid unit. All patients with a score of ≥ 6 points according to the Dutch Lipid Clinic Criteria were proposed for a genetic study RESULTS: By December 30th, 2020, 24 centres out of the initial 55 had submitted results. The number of patients analysed up to that point was 3,266,341, which represents 34% of the population served in those health areas (9,727,434).
    Conclusions: The identification of new subjects with FH through this new strategy from the laboratory and their referral to lipid units should increase the number of patients treated in lipid units and initiate familial cascade screening.
    MeSH term(s) Cholesterol, LDL ; Genetic Testing ; Humans ; Hypercholesterolemia ; Hyperlipoproteinemia Type II/diagnosis ; Hyperlipoproteinemia Type II/genetics ; Laboratories, Clinical ; Lipids ; Retrospective Studies
    Chemical Substances Cholesterol, LDL ; Lipids
    Language Spanish
    Publishing date 2021-06-03
    Publishing country Spain
    Document type Journal Article
    ISSN 1578-1879
    ISSN (online) 1578-1879
    DOI 10.1016/j.arteri.2021.03.004
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  3. Article ; Online: Handling of lipemic samples in the clinical laboratory.

    Fernández Prendes, Carla / Castro Castro, María José / Sánchez Navarro, Lourdes / Rapún Mas, Loreto / Morales Indiano, Cristian / Arrobas Velilla, Teresa

    Advances in laboratory medicine

    2023  Volume 4, Issue 1, Page(s) 5–27

    Abstract: Interferences in the clinical laboratory may lead physicians misinterpret results for some biological analytes. The most common analytical interferences in the clinical laboratory include hemolysis, icterus and lipemia. Lipemia is defined as turbidity in ...

    Abstract Interferences in the clinical laboratory may lead physicians misinterpret results for some biological analytes. The most common analytical interferences in the clinical laboratory include hemolysis, icterus and lipemia. Lipemia is defined as turbidity in a sample caused by the accumulation of lipoproteins, mainly very-low density lipoproteins (VLDL) and chylomicrons. Several methods are available for the detection of lipemic samples, including the lipemic index, or triglyceride quantification in serum or plasma samples, or mean corpuscular hemoglobin (MCHC) concentration in blood samples. According to the European Directive 98/79/CE, it is the responsibility of clinical laboratories to monitor the presence of interfering substances that may affect the measurement of an analyte. There is an urgent need to standardize interference studies and the way interferences are reported by manufacturers. Several methods are currently available to remove interference from lipemia and enable accurate measurement of biological quantities. The clinical laboratory should establish a protocol for the handling of lipemic samples according to the biological quantity to be tested.
    Language Spanish
    Publishing date 2023-02-20
    Publishing country Germany
    Document type Journal Article
    ISSN 2628-491X
    ISSN (online) 2628-491X
    DOI 10.1515/almed-2023-0003
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  4. Article ; Online: SmartLab 2.0 in cardiovascular prevention of atherogenic dyslipidemia.

    Galván Toribio, Raquel / Arrobas Velilla, Teresa / Morales Porillo, Cristóbal / Rico, Miguel Ángel / Martínez Quesada, Mar / León Justel, Antonio

    Clinica e investigacion en arteriosclerosis : publicacion oficial de la Sociedad Espanola de Arteriosclerosis

    2022  Volume 35, Issue 3, Page(s) 123–128

    Abstract: Introduction: SmartLab 2.0 is an innovative concept of multidisciplinary collaboration between the clinical laboratory and the diabetes day unit that was born with the aim of identifying patients at high cardiovascular risk who require priority ... ...

    Title translation SmartLab 2.0 en prevención cardiovascular de dislipemia aterogénica.
    Abstract Introduction: SmartLab 2.0 is an innovative concept of multidisciplinary collaboration between the clinical laboratory and the diabetes day unit that was born with the aim of identifying patients at high cardiovascular risk who require priority attention, such as patients with atherogenic dyslipidemia, in order to create a cardiovascular prevention strategy.
    Objective: Implementation in the Laboratory Information System (LIS) of an automated biochemical algorithm for the identification of patients with atherogenic dyslipidemia in routine analyses and priority referral to the diabetes day unit.
    Material and methods: The algorithm designed in the SIL was: HBA1c>9.3 +TG>150mg/dl +HDLc<40mg/dl +LDL/ApoB<1.3. A comment was inserted alerting the requesting physician of the diagnosis of atherogenic dyslipidemia and priority referral was made from the laboratory to the diabetes day unit in the necessary cases.
    Results: In the 1-year period, a total of 899 patients with HBA1c>7 and atherogenic dyslipidemia criteria were identified. Of these, 203 patients from primary care with HbA1c>9.3 were referred to the diabetes day hospital.
    Conclusions: Reinforcement of cardiovascular prevention is necessary at all levels. The clinical laboratory should play a fundamental role in the diagnosis of dyslipidemias. Early detection of patients at high cardiovascular risk is essential and collaboration between the different clinical units is fundamental to guarantee patient safety.
    MeSH term(s) Humans ; Risk Factors ; Glycated Hemoglobin ; Atherosclerosis/diagnosis ; Diabetes Mellitus ; Dyslipidemias/drug therapy ; Cardiovascular Diseases/prevention & control
    Chemical Substances Glycated Hemoglobin
    Language Spanish
    Publishing date 2022-11-03
    Publishing country Spain
    Document type Journal Article
    ISSN 1578-1879
    ISSN (online) 1578-1879
    DOI 10.1016/j.arteri.2022.09.004
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  5. Article ; Online: Geostatistical analysis from the clinical laboratory in cardiovascular prevention for primary care.

    Martín Pérez, Salomón / Arrobas Velilla, Teresa / Fabiani de la Iglesia, Juan / Vázquez Rico, Ignacio / Varo Sánchez, Gema / León-Justel, Antonio

    Clinica e investigacion en arteriosclerosis : publicacion oficial de la Sociedad Espanola de Arteriosclerosis

    2022  Volume 35, Issue 2, Page(s) 75–84

    Abstract: Introduction and objectives: Cardiovascular diseases continue to lead the ranking of mortality in Spain. The implementation of geostatistical analysis techniques in the clinical laboratory are innovative tools that allow the design of new strategies in ... ...

    Title translation Análisis geoestadístico desde el laboratorio clínico en prevención cardiovascular para atención primaria.
    Abstract Introduction and objectives: Cardiovascular diseases continue to lead the ranking of mortality in Spain. The implementation of geostatistical analysis techniques in the clinical laboratory are innovative tools that allow the design of new strategies in primary prevention of cardiovascular disease. The aim of this study was to study the prevalence and geolocation of severe dyslipidemia in the health areas under study in order to implement prevention strategies in primary care. A retrospective cohort study of low-density protein-bound cholesterol, triglyceride and lipoprotein (a) levels in the years 2019 and 2020 were carried out. In addition, a geostatistical analysis was performed including representation in choropleth maps and the detection of clustering clusters, using geographic information in zip code format included in the demographic data of each analytic.
    Results: The analytical data included in the study were triglycerides (n=365,384), low density protein-bound cholesterol (n=289,594) and lipoprotein to lipoprotein (a) (n=502). Areas with the highest and lowest percentage of cases were identified for the established cut-off points of LDL-C>190mg/dL and TG>150mg/dL. Two clustering clusters with statistical significance were detected for cLDL>190mg/dL and a total of 6 clusters for TG values>150mg/dL.
    Conclusions: The detection of clusters, as well as the representation of choropleth maps, can be of great help in detecting geographic areas that require greater attention to intervene and improve cardiovascular risk.
    MeSH term(s) Humans ; Cholesterol, LDL ; Cholesterol, HDL ; Laboratories, Clinical ; Retrospective Studies ; Triglycerides ; Cardiovascular Diseases/epidemiology ; Cardiovascular Diseases/prevention & control ; Primary Health Care
    Chemical Substances Cholesterol, LDL ; Cholesterol, HDL ; Triglycerides
    Language Spanish
    Publishing date 2022-09-29
    Publishing country Spain
    Document type Journal Article
    ISSN 1578-1879
    ISSN (online) 1578-1879
    DOI 10.1016/j.arteri.2022.08.003
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  6. Article ; Online: Consensus on lipoprotein(a) of the Spanish Society of Arteriosclerosis. Literature review and recommendations for clinical practice.

    Delgado-Lista, Javier / Mostaza, Jose M / Arrobas-Velilla, Teresa / Blanco-Vaca, Francisco / Masana, Luis / Pedro-Botet, Juan / Perez-Martinez, Pablo / Civeira, Fernando / Cuende-Melero, Jose I / Gomez-Barrado, Jose J / Lahoz, Carlos / Pintó, Xavier / Suarez-Tembra, Manuel / Lopez-Miranda, Jose / Guijarro, Carlos

    Clinica e investigacion en arteriosclerosis : publicacion oficial de la Sociedad Espanola de Arteriosclerosis

    2024  

    Abstract: The irruption of lipoprotein(a) (Lp(a)) in the study of cardiovascular risk factors is perhaps, together with the discovery and use of proprotein convertase subtilisin/kexin type 9 (iPCSK9) inhibitor drugs, the greatest novelty in the field for decades. ... ...

    Title translation Consenso sobre lipoproteína (a) de la Sociedad Española de Arteriosclerosis. Revisión bibliográfica y recomendaciones para la práctica clínica.
    Abstract The irruption of lipoprotein(a) (Lp(a)) in the study of cardiovascular risk factors is perhaps, together with the discovery and use of proprotein convertase subtilisin/kexin type 9 (iPCSK9) inhibitor drugs, the greatest novelty in the field for decades. Lp(a) concentration (especially very high levels) has an undeniable association with certain cardiovascular complications, such as atherosclerotic vascular disease (AVD) and aortic stenosis. However, there are several current limitations to both establishing epidemiological associations and specific pharmacological treatment. Firstly, the measurement of Lp(a) is highly dependent on the test used, mainly because of the characteristics of the molecule. Secondly, Lp(a) concentration is more than 80% genetically determined, so that, unlike other cardiovascular risk factors, it cannot be regulated by lifestyle changes. Finally, although there are many promising clinical trials with specific drugs to reduce Lp(a), currently only iPCSK9 (limited for use because of its cost) significantly reduces Lp(a). However, and in line with other scientific societies, the SEA considers that, with the aim of increasing knowledge about the contribution of Lp(a) to cardiovascular risk, it is relevant to produce a document containing the current status of the subject, recommendations for the control of global cardiovascular risk in people with elevated Lp(a) and recommendations on the therapeutic approach to patients with elevated Lp(a).
    Language Spanish
    Publishing date 2024-04-09
    Publishing country Spain
    Document type Practice Guideline
    ISSN 1578-1879
    ISSN (online) 1578-1879
    DOI 10.1016/j.arteri.2024.03.002
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  7. Article: Role of lipoprotein lipase activity measurement in the diagnosis of familial chylomicronemia syndrome.

    Rioja, José / Ariza, María José / Benítez-Toledo, María José / Espíldora-Hernández, Javier / Coca-Prieto, Inmaculada / Arrobas-Velilla, Teresa / Camacho, Ana / Olivecrona, Gunilla / Sánchez-Chaparro, Miguel Ángel / Valdivielso, Pedro

    Journal of clinical lipidology

    2023  Volume 17, Issue 2, Page(s) 272–280

    Abstract: Background: Activity assays for lipoprotein lipase (LPL) are not standardised for use in clinical settings.: Objective: This study sought to define and validate a cut-off points based on a ROC curve for the diagnosis of patients with familial ... ...

    Abstract Background: Activity assays for lipoprotein lipase (LPL) are not standardised for use in clinical settings.
    Objective: This study sought to define and validate a cut-off points based on a ROC curve for the diagnosis of patients with familial chylomicronemia syndrome (FCS). We also evaluated the role of LPL activity in a comprehensive FCS diagnostic workflow.
    Methods: A derivation cohort (including an FCS group (n = 9), a multifactorial chylomicronemia syndrome (MCS) group (n = 11)), and an external validation cohort (including an FCS group (n = 5), a MCS group (n = 23) and a normo-triglyceridemic (NTG) group (n = 14)), were studied. FCS patients were previously diagnosed by the presence of biallelic pathogenic genetic variants in the LPL and GPIHBP1 genes. LPL activity was also measured. Clinical and anthropometric data were recorded, and serum lipids and lipoproteins were measured. Sensitivity, specificity and cut-offs for LPL activity were obtained from a ROC curve and externally validated.
    Results: All post-heparin plasma LPL activity in the FCS patients were below 25.1 mU/mL, that was cut-off with best performance. There was no overlap in the LPL activity distributions between the FCS and MCS groups, conversely to the FCS and NTG groups.
    Conclusion: We conclude that, in addition to genetic testing, LPL activity in subjects with severe hypertriglyceridemia is a reliable criterium in the diagnosis of FCS when using a cut-off of 25.1 mU/mL (25% of the mean LPL activity in the validation MCS group). We do not recommend the NTG patient based cut-off values due to low sensitivity.
    MeSH term(s) Humans ; Hyperlipoproteinemia Type I/diagnosis ; Hyperlipoproteinemia Type I/genetics ; Lipoprotein Lipase/genetics ; Hypertriglyceridemia/genetics ; Genetic Testing ; Receptors, Lipoprotein/genetics ; Triglycerides
    Chemical Substances Lipoprotein Lipase (EC 3.1.1.34) ; Receptors, Lipoprotein ; Triglycerides
    Language English
    Publishing date 2023-01-26
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2365061-8
    ISSN 1876-4789 ; 1933-2874
    ISSN (online) 1876-4789
    ISSN 1933-2874
    DOI 10.1016/j.jacl.2023.01.005
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  8. Article ; Online: Incorporation of biochemical parameters and diagnostic algorithms in the laboratory computer system for the early detection of lipid abnormalities from the lipid units.

    Arrobas Velilla, Teresa / Bonet Estruch, Elena / Roa Garrido, Jessica / Romero Jiménez, Manuel / Varo Sánchez, Gema María / Vázquez Rico, Ignacio

    Clinica e investigacion en arteriosclerosis : publicacion oficial de la Sociedad Espanola de Arteriosclerosis

    2021  Volume 33, Issue 6, Page(s) 273–281

    Abstract: Introduction: The combination of biochemical markers, together with the design and implementation of diagnostic algorithms in laboratory computer systems could become very powerful tools in the stratification of cardiovascular risk.: Objectives: To ... ...

    Title translation Incorporación de parámetros bioquímicos y algoritmos diagnósticos en el sistema informático de laboratorio para la detección precoz de alteraciones lipídicas desde las unidades de lípidos.
    Abstract Introduction: The combination of biochemical markers, together with the design and implementation of diagnostic algorithms in laboratory computer systems could become very powerful tools in the stratification of cardiovascular risk.
    Objectives: To implement new biochemical markers and diagnostic algorithms not yet available, in order to provide an estimation of cardiovascular risk and the diagnostic orientation of lipid alterations.
    Material and methods: Study of the implementation of apolipoprotein B and lipoprotein (a), as well as the inclusion of different diagnostic algorithms. This was carried out jointly by the different Lipid Units of the Spanish Society of Atherosclerosis, Hospital Virgen Macarena in Seville, Hospital Juan Ramón Jiménez, Hospital Infanta Elena, and Hospital de Río Tinto during 2018 and 2019.
    Results: The 4diagnostic algorithms entered into the Laboratory Information System, showed a total of 9,985 patients with c-LDL>200mg/dl. The diagnostic algorithm was extended to include Apo B, with 8,182 determinations showing an apolipoprotein B>100mg/dl). A total of 747 lipoprotein (a) were determined, of which 30.65% were> 50mg/dl. More than 2/3 (71.80%) showed results compatible with small and dense LDL particles.
    Conclusions: The implementation of new analytical parameters and algorithms in Primary Care laboratory results can identify a considerable number of patients with different alterations in lipid metabolism. This, together with the classic risk factors, could contribute to a correct risk stratification in preventing the progression of cardiovascular disease.
    MeSH term(s) Algorithms ; Apolipoproteins B ; Biomarkers ; Computer Systems ; Humans ; Laboratories ; Lipids ; Lipoprotein(a)
    Chemical Substances Apolipoproteins B ; Biomarkers ; Lipids ; Lipoprotein(a)
    Language Spanish
    Publishing date 2021-04-02
    Publishing country Spain
    Document type Journal Article
    ISSN 1578-1879
    ISSN (online) 1578-1879
    DOI 10.1016/j.arteri.2021.01.001
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  9. Article ; Online: Prevalence of severe hypercholesterolemia observed in different hospitals in Andalusia and Ceuta.

    Arrobas Velilla, Teresa / Varo Sánchez, Gema / Romero García, Irene / Melguizo Madrid, Enrique / Rodríguez Sánchez, Firma Isabel / León Justel, Antonio

    Clinica e investigacion en arteriosclerosis : publicacion oficial de la Sociedad Espanola de Arteriosclerosis

    2021  Volume 33, Issue 5, Page(s) 217–223

    Abstract: Severe hypercholesterolaemia is a major cardiovascular risk factor. Early detection and treatment can reduce the incidence of cardiovascular disease. Given the high prevalence of hypercholesterolaemia in Andalusia, the development of a screening strategy ...

    Title translation Prevalencia de hipercolesterolemias severas observadas en los distintos hospitales de Andalucía y Ceuta.
    Abstract Severe hypercholesterolaemia is a major cardiovascular risk factor. Early detection and treatment can reduce the incidence of cardiovascular disease. Given the high prevalence of hypercholesterolaemia in Andalusia, the development of a screening strategy for its detection in Primary Care may be an efficient measure.
    Objective: To identify patients in Primary Care with severe hypercholesterolaemia that may increase their cardiovascular risk by reviewing LDL-cholesterol results in computerised laboratory systems.
    Material and methods: Observational, retrospective, multi-centre study in 16 hospitals in Andalusia and Ceuta. Anonymous analytical data were acquired from the different laboratory computer systems for the year 2018, and exclusively from Macarena Hospital for the year 2019.
    Results: From a total of 1,969,035 determinations on≥18 years old, 2,791 patients (0.14%) were detected with LDL-cholesterol>250mg/dl and from a total of 2.327.211 determinations studied in children under 18 years old, 3,804 patients (0.16%) were detected with LDL-cholesterol>135mg/dL. The highest incidence of possible genetic hypercholesterolaemia in adults corresponded to the province of Seville with 23.6 cases/1,000 determinations, while in minors, the highest incidence corresponded to the province of Cadiz with 75 possible cases/1,000 determinations. A geographical triangle of greater prevalence is observed between the provinces of Seville, Huelva and Cadiz.
    Conclusions: The development of a screening strategy using a computerised review of LDL-cholesterol in Primary Care detects a large number of subjects with severe hypercholesterolaemia that could benefit from an early intervention.
    MeSH term(s) Adolescent ; Adult ; Child ; Cholesterol, LDL ; Hospitals ; Humans ; Hypercholesterolemia/epidemiology ; Prevalence ; Retrospective Studies ; Risk Factors
    Chemical Substances Cholesterol, LDL
    Language Spanish
    Publishing date 2021-04-02
    Publishing country Spain
    Document type Journal Article ; Multicenter Study ; Observational Study
    ISSN 1578-1879
    ISSN (online) 1578-1879
    DOI 10.1016/j.arteri.2020.12.009
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  10. Article ; Online: Lipoprotein(a) in a selection of hospitals in Andalusia and Extremadura. Underdiagnosed and underused?

    Arrobas Velilla, Teresa / Fabiani de la Iglesia, Juan / Martín Pérez, Salomon / Calbo Caballos, Luis / Gómez Barrado, Jose Javier / León Justel, Antonio

    Revista espanola de cardiologia (English ed.)

    2022  Volume 75, Issue 10, Page(s) 844–845

    MeSH term(s) Hospitals ; Humans ; Lipoprotein(a) ; Spain/epidemiology
    Chemical Substances Lipoprotein(a)
    Language Spanish
    Publishing date 2022-05-21
    Publishing country Spain
    Document type Case Reports
    ZDB-ID 2592481-3
    ISSN 1885-5857 ; 1885-5857
    ISSN (online) 1885-5857
    ISSN 1885-5857
    DOI 10.1016/j.rec.2022.05.001
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