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Why and how increased plasma ceramides predict future cardiovascular events?

      Plasma ceramides (CER), a class of sphingolipid molecules, have been identified as markers of future cardiovascular (CV) events and measurement of certain ceramide species and their ratios in plasma samples can predict major acute CV events and CV mortality [
      • Laaksonen R.
      • Ekroos K.
      • Sysi-Aho M.
      • et al.
      Plasma ceramides predict cardiovascular death in patients with stable coronary artery disease and acute coronary syndromes beyond LDL-cholesterol.
      ,
      • Peterson L.R.
      • Xanthakis V.
      • Duncan M.S.
      • et al.
      Ceramide remodeling and risk of cardiovascular events and mortality.
      ,
      • Havulinna A.S.
      • Sysi-Aho M.
      • Hilvo M.
      • et al.
      Circulating ceramides predict cardiovascular outcomes in the population-based FINRISK 2002 cohort.
      ,
      • de Carvalho L.P.
      • Tan S.H.
      • Ow G.S.
      • et al.
      Plasma ceramides as prognostic biomarkers and their arterial and myocardial tissue correlates in acute myocardial infarction.
      ]. The data suggest that plasma ceramide levels may predict CV events more accurately than traditional risk biomarkers at least in patients with known atherosclerotic CV disease (CVD). In this issue of Atherosclerosis, Li et al. [
      • Li Q.
      • Wang X.
      • Pang J.
      • et al.
      Associations between Plasma Ceramides and Mortality in Patients with Coronary Artery Disease.
      ] have examined in a prospective study the association between various plasma ceramide species and cardiovascular and all-cause mortality in a Chinese cohort of about 1700 CVD patients aged 40–85 years. The authors collected plasma samples, analyzed the concentrations of various ceramide species with HPLC-mass spectrometry method, and followed the patients for an average of 9.3 years. In accordance with data from earlier studies performed largely in Caucasian cohorts, high concentrations of ceramides containing fatty acids 16:0, 18:0, and 24:1 (CER16:0, CER18:0, and CER24:1) and low concentration of CER24:0 were associated with increased cardiovascular mortality. Based on the ratios of CER(16:0/24:0), CER(18:0/24:0), and CER(24:1/24:0), ceramide risk scores have been formulated and found to associate with an increased incidence of future cardiovascular events in earlier studies [
      • Laaksonen R.
      • Ekroos K.
      • Sysi-Aho M.
      • et al.
      Plasma ceramides predict cardiovascular death in patients with stable coronary artery disease and acute coronary syndromes beyond LDL-cholesterol.
      ,
      • Peterson L.R.
      • Xanthakis V.
      • Duncan M.S.
      • et al.
      Ceramide remodeling and risk of cardiovascular events and mortality.
      ,
      • Havulinna A.S.
      • Sysi-Aho M.
      • Hilvo M.
      • et al.
      Circulating ceramides predict cardiovascular outcomes in the population-based FINRISK 2002 cohort.
      ,
      • de Carvalho L.P.
      • Tan S.H.
      • Ow G.S.
      • et al.
      Plasma ceramides as prognostic biomarkers and their arterial and myocardial tissue correlates in acute myocardial infarction.
      ], and now also in the study by Li et al. [
      • Li Q.
      • Wang X.
      • Pang J.
      • et al.
      Associations between Plasma Ceramides and Mortality in Patients with Coronary Artery Disease.
      ].

      Keywords

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