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@ARTICLE{AlKassou:267507,
      author       = {Al-Kassou, Baravan and Al-Kassou, Lara and Mahn, Thorsten
                      and Lütjohann, Dieter and Shamekhi, Jasmin and Willemsen,
                      Nicola and Niepmann, Sven Thomas and Baldus, Stephan and
                      Kelm, Malte and Nickenig, Georg and Latz, Eicke and Zimmer,
                      Sebastian},
      title        = {{C}holesterol {C}rystal {D}issolution {R}ate of {S}erum
                      {P}redicts {O}utcomes in {P}atients {W}ith {A}ortic
                      {S}tenosis {U}ndergoing {T}ranscatheter {A}ortic {V}alve
                      {R}eplacement.},
      journal      = {Journal of the American Heart Association},
      volume       = {13},
      number       = {3},
      issn         = {2047-9980},
      address      = {New York, NY},
      publisher    = {Association},
      reportid     = {DZNE-2024-00153},
      pages        = {e031997},
      year         = {2024},
      abstract     = {Aortic stenosis has pathophysiological similarities with
                      atherosclerosis, including the deposition of
                      cholesterol-containing lipoproteins. The resulting
                      cholesterol crystals activate the NLRP3 (NOD-like receptor
                      protein 3) inflammasome, leading to inflammation and
                      cardiovascular diseases. We aimed to investigate the
                      cholesterol crystal dissolution rate (CCDR) of serum in
                      patients with aortic stenosis and to assess the prognostic
                      value of this biomarker.The study included 348 patients with
                      aortic stenosis undergoing transcatheter aortic valve
                      replacement. The CCDR was measured using flow cytometry to
                      enumerate cholesterol crystals that were added to a serum
                      solution, at baseline and after 2 hours of incubation. Based
                      on the median CCDR, the cohort was stratified into high and
                      low cholesterol crystal dissolvers. The incidence of the
                      primary end point, a composite of 1-year all-cause mortality
                      and major vascular complication, was significantly lower in
                      the high CCDR group (7.3 per 100 person-years) compared with
                      the low CCDR group (17.0 per 100 person-years, P=0.01). This
                      was mainly driven by a lower 1-year mortality rate in
                      patients with a high CCDR (7.3 versus 15.1 per 100
                      person-years, P=0.04). Unplanned endovascular interventions
                      were significantly less frequent in high cholesterol crystal
                      dissolvers (12.8 versus 22.6 per 100 person-years, P=0.04).
                      Although low-density lipoprotein cholesterol levels were
                      comparable in both groups (101.8±37.3 mg/dL versus
                      97.9±37.6 mg/dL, P=0.35), only patients with a low CCDR
                      showed a benefit from statin treatment. In multivariate
                      analysis, low CCDR (hazard ratio, 2.21 $[95\%$ CI,
                      0.99-4.92], P=0.04) was significantly associated with 1-year
                      mortality.The CCDR is a novel biomarker associated with
                      outcome in patients with aortic stenosis undergoing
                      transcatheter aortic valve replacement. It may provide new
                      insights into patients' anti-inflammatory capacity and
                      additional prognostic information beyond classic risk
                      assessment.},
      keywords     = {Humans / Transcatheter Aortic Valve Replacement / Treatment
                      Outcome / Aortic Valve Stenosis / Risk Assessment /
                      Biomarkers / Aortic Valve: surgery / Risk Factors / TAVR
                      (Other) / calcific aortic stenosis (Other) / cholesterol
                      crystal dissolution rate (Other) / cholesterol crystals
                      (Other) / Biomarkers (NLM Chemicals)},
      cin          = {AG Latz ; AG Latz},
      ddc          = {610},
      cid          = {I:(DE-2719)1013024},
      pnm          = {351 - Brain Function (POF4-351)},
      pid          = {G:(DE-HGF)POF4-351},
      typ          = {PUB:(DE-HGF)16},
      pmc          = {pmc:PMC11056150},
      pubmed       = {pmid:38240198},
      doi          = {10.1161/JAHA.123.031997},
      url          = {https://pub.dzne.de/record/267507},
}