Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
Digestive Diseases and Sciences
Published in: Digestive Diseases and Sciences 1/2018

01-01-2018 | Review

Abnormalities of Lipoprotein Levels in Liver Cirrhosis: Clinical Relevance

Authors: Graziella Privitera, Luisa Spadaro, Simona Marchisello, Giuseppe Fede, Francesco Purrello

Published in: Digestive Diseases and Sciences | Issue 1/2018

Login to get access

Abstract

Progressive lipoprotein impairment occurs in liver cirrhosis and is associated with increased morbidity and mortality. The present review aims to summarize the current evidence regarding the prognostic value of lipoprotein abnormalities in liver cirrhosis and to address the need of a better prognostic stratification of patients, including lipoprotein profile assessment. Low levels of lipoproteins are usual in cirrhosis. Much evidence supports the prognostic role of hypolipidemia in cirrhotic patients. In particular, hypocholesterolemia represents an independent predictor of survival in cirrhosis. In cirrhotic patients, lipoprotein impairment is associated with several complications: infections, malnutrition, adrenal function, and spur cell anemia. Alterations of liver function are associated with modifications of circulating lipids. Decreased levels of lipoproteins significantly impact the survival of cirrhotic patients and play an important role in the pathogenesis of some cirrhosis-related complications.
Literature
1.
Bassani L, Fernandes SA, Raimundo FV, et al. Lipid profile of cirrhotic patients and its association with prognostic scores: a cross-sectional study. Arq Gastroenterol. 2015;52:210–215.CrossRefPubMed
2.
Abbasi A, Bhutto AR, Butt N, et al. Serum cholesterol: could it be a sixth parameter of Child–Pugh scoring system in cirrhotics due to viral hepatitis? J Coll Physicians Surg Pak. 2012;22:484–487.PubMed
3.
Dixon JL, Ginsberg HN. Hepatic synthesis of lipoproteins and apolipoproteins. Semin Liver Dis. 1992;12:364–372.CrossRefPubMed
4.
Bechmann LP, Hannivoort RA, Gerken G, Hotamisligil GS, Trauner M, Canbay A. The interaction of hepatic lipid and glucose metabolism in liver diseases. J Hepatol. 2012;56:952–964.CrossRefPubMed
5.
Marzo A, Ghirardi P, Sardini D, et al. Serum lipids and total fatty acids in chronic alcoholic liver disease at different stages of cell damage. Klin Wochenschr. 1970;48:949–950.CrossRefPubMed
6.
7.
Day RC, Harry DS, Owen JS, et al. Lecithin-cholesterol acyltransferase and lipoprotein abnormalities of parenchymal liver disease. Clin Sci (Lond). 1979;56:575–583.CrossRef
8.
Tahara C, Nakanishi T, Akazawa S, et al. Lecithin-cholesterol acyltransferase and lipid transfer protein activities in liver disease. Metabolism. 1993;42:19–23.CrossRefPubMed
9.
Sabesin SM, Hawkins HL, Kuiken L, et al. Abnormal plasma lipoproteins and lecithin- cholesterol acyltransferase deficiency in alcoholic liver disease. Gastroenterology. 1977;2:510–518.
10.
Agorastos J, Boswell C, Harry DS, et al. Plasma lipoproteins in liver disease. Biochem Soc Trans. 1976;4:593–596.CrossRefPubMed
11.
Ac Spòsito, Vinagre CG, Pandullo FL, et al. Apolipoprotein and lipid abnormalities in chronic liver failure. Braz J Med Biol Res. 1997;30:1287–1290.CrossRef
12.
Ghadir MR, Riahin AA, Havaspour A, Nooranipour M, Habibinejad AA. The relationship between lipid profile and severity of liver damage in cirrhotic patients. Hepat Mon. 2010;10:285–288.PubMedPubMedCentral
13.
Papadopoulos NM, Charles MA. Serum lipoprotein patterns in liver disease. Proc Soc Exp Biol Med. 1970;134:797–799.CrossRefPubMed
14.
Perales J, Angel Lasuncion M, Cano A, Martìn- Scapa MA, Matìes M, Herrera E. Changes in the lipid profile in chronic hepatopathies. Med Clin. 1994;102:364–368.
15.
Vere CC, Streba CT, Streba L, Rogoveanu I. Lipid serum profile in patients with viral liver cirrhosis. Med Princ Pract. 2012;21:566–568.CrossRefPubMed
16.
Cicognani C, Malavolti M, Morselli-Labate AM, Zamboni L, Sama C, Barbara L. Serum lipid and lipoprotein patterns in patients with liver cirrhosis and chronic active hepatitis. Arch Intern Med. 1997;157:792–796.CrossRefPubMed
17.
Chrostek L, Supronowicz L, Panasiuk A, Cylwik B, Gruszewska E, Flisiak R. The effect of the severity of liver cirrhosis on the level of lipids and lipoproteins. Clin Exp Med. 2014;14:417–421.CrossRefPubMed
18.
Varghese JS, Krishnaprasad K, Upadhuyay R, et al. Lipoprotein profile in cirrhosis of liver. Eur J Gastroenterol. 2007;19:521–522.CrossRef
19.
Applebaum-Bowden D. Lipases and lecithin cholesterol acyltransferase in the control of lipoprotein metabolism. Curr Opin Lipidol. 1995;6:130–135.CrossRefPubMed
20.
Simon JB, Scheig R. Serum cholesterol esterification in liver disease. N Engl J Med. 1970;283:841–846.CrossRefPubMed
21.
Negro F. Abnormalities of lipid metabolism in hepatitis C virus infection. Gut. 2010;59:1279–1287.CrossRefPubMed
22.
Bassendine MF, Sheridan DA, Felmlee DJ, Bridge SH, Toms GL, Neely RD. HCV and the hepatic lipid pathway as a potential treatment target. J Hepatol. 2011;55:1428–1440.CrossRefPubMed
23.
Maggi G, Bottelli D, Gola D, et al. Serum cholesterol and chronic hepatitis C. Ital J Gastroenterol. 1996;28:436–440.PubMed
24.
Soardo G, Pirisi M, Fonda M, et al. Changes in blood lipid composition and response to interferon treatment in chronic hepatitis C. J Interferon Cytokine Res. 1995;15:705–712.CrossRefPubMed
25.
Serfaty L, Andreani T, Giral P, Carbonell N, Chazouillères O, Poupon R. Hepatitis C virus induced hypobetalipoproteinemia: a possible mechanism for steatosis in chronic hepatitis C. J Hepatol. 2011;34:428–434.CrossRef
26.
Dai CY, Chuang WL, Ho CK, et al. Associations between hepatitis C viremia and low serum triglyceride and cholesterol levels: a community-based study. J Hepatol. 2008;49:9–16.CrossRefPubMed
27.
Siagris D, Christofidou M, Theocharis NP, et al. Serum lipid pattern in chronic hepatitis C: histological and virological correlations. J Viral Hepatitis. 2006;13:56–61.CrossRef
28.
Petit JM, Benichou M, Duvillard L, et al. Hepatitis C virus-associated hypobetalipoproteinemia is correlated with plasma viral load, steatosis and liver fibrosis. Am J Gastroenterol. 2003;98:1150–1154.PubMed
29.
Loria P, Marchesini G, Nascimbeni F, et al. Cardiovascular risk, lipidemic phenotype and steatosis. A comparative analysis of cirrhotic and non-cirrhotic liver disease due to varying etiology. Atherosclerosis. 2014;232:99–109.CrossRefPubMed
30.
Poynard T, Aubert A, Bedossa P, et al. A simple biological index for detection of alcoholic liver disease in drinkers. Gastroenterology. 1991;100:1397–1402.CrossRefPubMed
31.
Poynard T, Bedossa P, Mathurin P, Ratziu V, Paradis V. Apolipoprotein AI and hepatic fibrosis. J Hepatol. 1995;22:107–110.PubMed
32.
Bedossa P, Poynard T, Abella A, et al. Apolipoprotein AI is a serum and tissue marker of liver fibrosis in alcoholic patients. Alcohol Clin Exp Res. 1989;13:829–833.CrossRefPubMed
33.
Paradis V, Mathurin P, Ratziu V, Poynard T, Bedossa P. Binding of apolipoprotein A-I and acetaldehyde- modified apolipoprotein A-I to liver extracellular matrix. Hepatology. 1996;23:1232–1238.CrossRefPubMed
34.
Koruk M, Savas MC, Yilmaz O, et al. Serum lipids, lipoproteins and apolipoproteins levels in patients with nonalcoholic steatohepatitis. J Clin Gastroenterol. 2003;37:177–182.CrossRefPubMed
35.
Corey KE, Lai M, Gelrud L, et al. Non-high density lipoprotein cholesterol as a biomarker for non-alcoholic steatohepatitis. Clin Gastroenterol Hepatol. 2012;10:651–656.CrossRefPubMedPubMedCentral
36.
Mannisto VT, Simonen M, Soininen P, et al. Lipoprotein subclass metabolism in nonalcoholic steatohepatitis. J Lipid Research. 2014;55:2676–2684.CrossRef
37.
Sorokin A, Brown JL, Thompson PD. Primary biliary cirrhosis, hyperlipidemia, and atherosclerotic risk: a systematic review. Atherosclerosis. 2007;194:293–299.CrossRefPubMed
38.
Cash WJ, McCance DR, Young IS, et al. Primary biliary cirrhosis is associated with oxidative stress and endothelial dysfunction but not increased cardiovascular risk. Hepatol Res. 2010;40:1098–1106.CrossRefPubMed
39.
Floreani A, Cazzagon N, Franceschet I, et al. Metabolic syndrome associated with primary biliary cirrhosis. J Clin Gastroenterol. 2015;49:57–60.CrossRefPubMed
40.
Crippin JS, Lindor KD, Jorgensen R, et al. Hypercholesterolemia and atherosclerosis in primary biliary cirrhosis: what is the risk? Hepatology. 1992;15:858–862.CrossRefPubMed
41.
42.
Chang PY, Lu SC, Su TC, et al. Lipoprotein-X reduces LDL atherogenicity in primary biliary cirrhosis by preventing LDL oxidation. J Lipid Res. 2004;45:2116–2122.CrossRefPubMed
43.
Solaymani-Dodaran MA, Thal GP, Card T, et al. Risk of cardiovascular and cerebrovascular events in primary biliary cirrhosis: a population- based cohort study. Am J Gastroenterol. 2008;103:2784–2788.CrossRefPubMed
44.
Gylling H, Farkkila M, Vuoristo M, Miettinen TA. Metabolism of cholesterol and low- and high- density lipoproteins in primary biliary cirrhosis: cholesterol absorption and synthesis related to lipoprotein levels and their kinetics. Hepatology. 1995;21:89–95.PubMed
45.
Tacikowski T, Milewski B, Dzieniszewski J, Nowicka G, Walewska- Zielecka B. Comparative analysis of plasma lipoprotein components assessed by ultracentrifugation in primary biliary cirrhosis and chronic hepatitis. Med Sci Monit. 2000;6:325–329.PubMed
46.
Jiang M, Liu F, Xiong WJ, et al. Combined MELD and blood lipid level in evaluation the prognosis of decompensated cirrhosis. World J Gastroenterol. 2010;16:1397–1401.CrossRefPubMedPubMedCentral
47.
Selcuk H, Uruc I, Temel MA, et al. Factors prognostic of survival in patients awaiting liver transplantation for end-stage liver disease. Dig Dis Sci. 2007;52:3217–3223.CrossRefPubMed
48.
Habib A, Mihas AA, Abou- Assi SG, et al. High-density lipoprotein cholesterol as an indicator of liver function and prognosis in noncholestatic cirrhosis. Clin Gastroenterol Hepatol. 2005;3:286–291.CrossRefPubMed
49.
Tietge UJ, Boker KH, Bahr MJ, et al. Lipid parameters predicting liver function in patients with cirrhosis and after liver transplantation. Hepatogastroenterology. 1998;45:2255–2260.PubMed
50.
D’Arienzo A, Manquso F, Scaglione G, Vicinanza G, Bennato R, Mazzacca G. Prognostic value of progressive decrease in serum cholesterol in predicting survival in Child–Pugh C viral cirrhosis. Scand J Gastroenterol. 1998;33:1213–1218.CrossRefPubMed
51.
Merli M, Lucidi C, Giannelli V, et al. Cirrhotic patients are at risk of health care-associated bacterial infections. Clin Gastroenterol Hepatol. 2010;8:979–985.CrossRefPubMed
52.
Kang CI, Song JH, Chung DR, et al. Liver cirrhosis as a risk factor for mortality in a national cohort of patients with bacteraemia. J Infect. 2011;63:336–343.CrossRefPubMed
53.
54.
Angus DC. Early, goal-directed therapy for septic shock—a patient level meta analysis. N Engl J Med. 2017;377:995.PubMed
55.
Kleber G, Braillon A, Gaudin C, Champigneulle B, Caimail S, Lebrec D. Hemodynamic effects of endotoxin and platelet activating factor in cirrhotic rats. Gastroenterol. 1992;103:282–289.CrossRef
56.
Fukui H, Tsujita S, Matsumoto M, et al. Endotoxin inactivating action of plasma in patients with liver cirrhosis. Liver. 1995;15:104–109.CrossRefPubMed
57.
Read TE, Harris HW, Grunfeld C, Fwingold KR, Kane JP, Rapp JH. The protective effect of serum lipoproteins against bacterial lipopolysaccharide. Eur Heart J. 1993;14:125–129.PubMed
58.
Flegel WA, Wolpl A, Mannel DN, Northoff H. Inhibition of endotoxin-induced activation of human monocytes by human lipoproteins. Infect Immun. 1989;57:2237–2245.PubMedPubMedCentral
59.
60.
Ramìrez MJ, Ibànez A, Navasa M, et al. High-density lipoproteins reduce the effect of endotoxin on cytokine production and systemic hemodynamics in cirrhotic rats with ascites. J Hepatol. 2004;40:424–430.CrossRefPubMed
61.
Thabut D, Tazi KA, Bonnefont-Rousselot D, et al. High-density lipoprotein administration attenuates liver proinflammatory response, restores liver endothelial nitric oxide synthase activity, and lowers portal pressure in cirrhotic rats. Hepatology. 2007;46:1893–1906.CrossRefPubMed
62.
Galbois A, Thabut D, Tazi KA, et al. Ex vivo effects of high-density lipoprotein exposure on the lipopolysaccharide- induced inflammatory response in patients with severe cirrhosis. Hepatology. 2009;49:175–184.CrossRefPubMed
63.
Tsai MH, Peng YS, Chen YC, et al. Low serum concentration of apolipoprotein A-I is an indicator of poor prognosis in cirrhotic patients with severe sepsis. J Hepatol. 2009;50:906–915.CrossRefPubMed
64.
Maharshi S, Sharma BC, Srivastava S. Malnutrition in cirrhosis increases morbidity and mortality. J Gastroenterol Hepatol. 2015;30:1507–1513.CrossRefPubMed
65.
Hanai T, Shiraki M, Nishimura K, et al. Free fatty acid as a marker of energy malnutrition in liver cirrhosis. Hepatol Res. 2014;44:218–228.CrossRefPubMed
66.
67.
Kawaguchi T, Itou M, Taniguchi E, et al. Serum level of free fatty acids is associated with nocturnal hypoglycaemia in cirrhotic patients with HCV infection: a pilot study. Hepatogastroenterology. 2011;58:103–108.PubMed
68.
Muller MJ, Lautz HU, Plogmann B, et al. Energy expendure and substrate oxidation in patients with cirrhosis: the impact of cause, clinical staging and nutritional state. Hepatology. 1992;15:782–794.CrossRefPubMed
69.
Merli M, Riggio O, Romiti A, et al. Basal energy production rate and substrate use in stable cirrhotic patients. Hepatology. 1990;12:106–112.CrossRefPubMed
70.
Riggio O, Merli M, Cantafora A, et al. Total and individual free fatty acid concentrations in liver cirrhosis. Metabolism. 1984;33:646–651.CrossRefPubMed
71.
Schneeweiss B, Graninger W, Ferenci P, et al. Energy metabolism in patients with acute and chronic liver disease. Hepatology. 1990;11:387–393.CrossRefPubMed
72.
73.
Rachakonda V, Gabbert C, Raina A, et al. Stratification of risk of death in severe acute alcoholic hepatitis using a panel of adipokines and cytokines. Alcohol Clin Exp Res. 2014;38:2712–2721.CrossRefPubMedPubMedCentral
74.
Taniguchi E, Kawaguchi T, Sakata M, Itou M, Oriishi T, Sata M. Lipid profile is associated with the incidence of cognitive dysfunction in viral cirrhotic patients: a data-mining analysis. Hepatol Res. 2013;43:418–424.CrossRefPubMed
75.
Gonzàlez J, Periago JL, Gil A, et al. Malnutrition-related polyunsatured fatty acid changes in plasma lipid fractions of cirrhotic patients. Metabolism. 1992;41:954–960.CrossRefPubMed
76.
Cabrè E, Nuñez M, Gonzàlez- Huix F, et al. Clinical and nutritional factors predictive of plasma lipid unsaturation deficiency in advanced liver cirrhosis: a logistic regression analysis. Am J Gastroenterol. 1993;88:1738–1743.PubMed
77.
Plump AS, Erickson SK, Weng W, Partin JS, Breslow JL, Williams DL. Apolipoprotein A-I is required for cholesteryl ester accumulation in steroidogenic cells and for normal adrenal steroid production. J Clin Invest. 1996;97:2660–2671.CrossRefPubMedPubMedCentral
78.
Leitersdorf E, Israeli A, Stein O, Eisenberg S, Stein Y. The role of apolipoproteins of HDL in the selective uptake of cholesteryl linoleyl ether by cultured rat and bovine adrenal cells. Biochim Biophys Acta. 1986;878:320–329.CrossRefPubMed
79.
Pittman RC, Glass CK, Atkinson D, Small DM. Synthetic high density lipoprotein particles. Application to studies of the apoprotein specificity for selective uptake of cholesterol esters. J Biol Chem. 1987;262:2435–2442.PubMed
80.
Temel RE, Parks JS, Williams DL. Enhancement of scavenger receptor class B type I-mediated selective cholesteryl ester uptake from Apo-AI (-/-) high density lipoprotein (HDL) by apolipoprotein A-I requires HDL reorganization by lecithin cholesterol acyltransferase. J Biol Chem. 2003;278:4792–4799.CrossRefPubMed
81.
Hoekstra M, Zhao Y, Van Eck M, Van Berkel TJ. Plasma lipoprotein are required for both basal and stress-induced adrenal glucocorticoid synthesis and protection against endotoxemia in mice. Am J Physiol Endocrinol Metab. 2010;299:E1038–E1043.CrossRefPubMed
82.
Marik PE. Adrenal-exhaustion syndrome in patients with liver disease. Intensive Care Med. 2006;32:275–280.CrossRefPubMed
83.
Etogo-Asse FE, Vincent RP, Hughes SA, et al. High density lipoprotein in patients with liver failure; relation to sepsis, adrenal function and outcome of illness. Liver Int. 2012;32:128–136.CrossRefPubMed
84.
Tan T, Chang L, Woodward A, et al. Characterising adrenal function using directly measured plasma free cortisol in stable severe liver disease. J Hepatol. 2010;53:841–848.CrossRefPubMed
85.
Acevedo J, Fernàndez J, Prado V, et al. Relative adrenal insufficiency in decompensated cirrhosis: relationship to short-term risk of severe sepsis, hepatorenal syndrome and death. Hepatology. 2013;58:1757–1765.CrossRefPubMed
86.
Spadaro L, Noto D, Privitera G, et al. Apolipoprotein A1 and HDL are reduced in stable cirrhotic patients with adrenal insufficiency: a possible role in glucocorticoid deficiency. Scand J Gastroenterol. 2015;50:347–354.CrossRefPubMed
87.
Cooper RA. Hemolytic syndromes and red cell membrane abnormalities in liver disease. Semin Hematol. 1980;17:103–112.PubMed
88.
Arienti G, Carlini E, Scionti L, Puxeddu E, Brunetti P. Liver alcoholic cirrhosis and spur-cell (acanthocytic) anaemia. A study of erythrocyte ghost composition and fluidity. Scand J Gastroenterol. 1995;30:1204–1209.CrossRefPubMed
89.
Duhamel G, Forgez P, Nalpas B, Laplaud PM, Berthelot P, Chapman MJ. Spur cells in patients with alcoholic liver cirrhosis are associated with reduced plasma levels of apoA-II, HDL3, and LDL. J Lipid Res. 1983;24:1612–1625.PubMed
Metadata
Title
Abnormalities of Lipoprotein Levels in Liver Cirrhosis: Clinical Relevance
Authors
Graziella Privitera
Luisa Spadaro
Simona Marchisello
Giuseppe Fede
Francesco Purrello
Publication date
01-01-2018
Publisher
Springer US
Published in
Digestive Diseases and Sciences / Issue 1/2018
Print ISSN: 0163-2116
Electronic ISSN: 1573-2568
DOI
https://doi.org/10.1007/s10620-017-4862-x

Other articles of this Issue 1/2018

Digestive Diseases and Sciences 1/2018 Go to the issue

Original Article

Effect of Low-Dose Aspirin on Chronic Acid Reflux Esophagitis in Rats

Original Article

Role of Angiogenesis in Chronic Radiation Proctitis: New Evidence Favoring Inhibition of Angiogenesis Ex Vivo

Original Article

Impact of Bacterial Translocation on Hepatopulmonary Syndrome: A Prospective Observational Study

Original Article

ASPP2 Inhibits the Profibrotic Effects of Transforming Growth Factor-β1 in Hepatic Stellate Cells by Reducing Autophagy

Case Report

Case Report of Successful Medical Management of Progressive Gastric Band Penetration-to-Perforation After Band Insertion at Bariatric Surgery: Documentation by 12 Serial EGDs During 50 months of Observation

Original Article

Genetic Variation and Gene Expression Levels of Tight Junction Genes Indicates Relationships Between PTEN as well as MAGI1 and Microscopic Colitis
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Reserve your place

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

Read more

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Pediatric Cardiology Video

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

Cardiopulmonary Comorbidity Video

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Valvular Heart Disease Video

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

Watch now

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

16-04-2024 Type 2 Diabetes News

Incentivised to exercise

11-04-2024 Lifestyle Modifications News

New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

» View more highlights on the ACC 2024 congress hub page

Image Credits