ABSTRACT
The extent of intervention effects on carotid intima-media thickness (CIMT) can predict the degree of atherosclerotic cardiovascular risk-reduction. We hypothesized that regular lipoprotein apheresis over the course of 10 years might slow down progression of CIMT in patients with severe hypercholesterolemia. This case series describes 10 Caucasian patients (mean age 60 ± 9 years, 70% female, 80% statin intolerant) with a severe hypercholesterolemia phenotype treated with lipoprotein apheresis between 2005 and 2020 (mean duration, 10 ± 4 years). The median pretreatment low-density lipoprotein cholesterol (LDL-C) level was 214 mg/100 ml (95% confidence interval, 145 to 248), lipoprotein(a) (Lp[a]), 26 mg/100 ml (15 to 109; 40% with Lp(a)>60 mg/100 ml). Three patients were diagnosed with a monogenic cause. The baseline mean CIMT was 850 ± 170 µm, and maximum CIMT was 1,040 ± 220 µm across the age range of 46 to 70 years. Acute effects of lipoprotein apheresis determined as a difference before and immediately after the procedure were estimated as a median of 72 ± 8% and 75 ± 7% reduction in the LDL-C and Lp(a) levels, respectively. Using the imputed trajectories, period-specific on-treatment time-weighted averages for LDL-C and Lp(a) were 141 mg/100 ml (interquartile range, 89 to 152; 38% reduction from the baseline) and 24 mg/100 ml (interquartile range, 12 to 119; 19% reduction from baseline), respectively. The number of patients with CIMT above their "vascular age" decreased from 80% to 30% over the treatment course. In conclusion, an increase in CIMT seen with advanced age and severe hypercholesterolemia was halted with lipoprotein apheresis with an estimated annual rate of change in mean common CIMT of -4 µm/y and maximum CIMT of -3 µm/y.
Subject(s)
Blood Component Removal , Hydroxymethylglutaryl-CoA Reductase Inhibitors , Hypercholesterolemia , Blood Component Removal/methods , Carotid Intima-Media Thickness , Cholesterol, LDL , Female , Humans , Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use , Hypercholesterolemia/complications , Hypercholesterolemia/therapy , Lipoprotein(a) , MaleABSTRACT
One aspect of higher order social cognition is empathy, a psychological construct comprising a cognitive (recognizing emotions) and an affective (responding to emotions) component. The complex nature of empathy complicates the accurate measurement of these components. The most widely used measure of empathy is the Interpersonal Reactivity Index (IRI). However, the factor structure of the IRI as it is predominantly used in the psychological literature differs from Davis's original four-factor model in that it arbitrarily combines the subscales to form two factors: cognitive and affective empathy. This two-factor model of the IRI, although popular, has yet to be examined for psychometric support. In the current study, we examine, for the first time, the validity of this alternative model. A confirmatory factor analysis showed poor model fit for this two-factor structure. Additional analyses offered support for the original four-factor model, as well as a hierarchical model for the scale. In line with previous findings, females scored higher on the IRI than males. Our findings indicate that the IRI, as it is currently used in the literature, does not accurately measure cognitive and affective empathy and highlight the advantages of using the original four-factor structure of the scale for empathy assessments.
Subject(s)
Cognition , Empathy , Interpersonal Relations , Models, Psychological , Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Sex FactorsABSTRACT
Chrysikou, E. G., & Thompson, W. J. (2016). Assessing cognitive and affective empathy through the interpersonal reactivity index: An argument against a two-factor model. Assessment, 23(6), 769-777. doi:1073191115599055.
