101
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Wah-Suarez MI, Galarza-Delgado DA, Azpiri-Lopez JR, Colunga-Pedraza IJ, Abundis-Marquez EE, Davila-Jimenez JA, Guillen-Gutierrez CY, Elizondo-Riojas G. Carotid ultrasound findings in rheumatoid arthritis and control subjects: A case-control study. Int J Rheum Dis 2018; 22:25-31. [DOI: 10.1111/1756-185x.13377] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Revised: 07/22/2018] [Accepted: 08/01/2018] [Indexed: 12/31/2022]
Affiliation(s)
- Martin I. Wah-Suarez
- Internal Medicine Department; University Hospital Dr.Jose Eleuterio Gonzalez UANL; Monterrey Mexico
| | - Dionicio A. Galarza-Delgado
- Internal Medicine Department; Rheumatology Division; University Hospital Dr. Jose Eleuterio Gonzalez UANL; Monterrey Mexico
| | - Jose R. Azpiri-Lopez
- Internal Medicine Department; Cardiology Division; University Hospital Dr. Jose Eleuterio Gonzalez UANL; Monterrey Mexico
| | - Iris J. Colunga-Pedraza
- Internal Medicine Department; Rheumatology Division; University Hospital Dr. Jose Eleuterio Gonzalez UANL; Monterrey Mexico
| | - Estefania E. Abundis-Marquez
- Internal Medicine Department; Rheumatology Division; University Hospital Dr. Jose Eleuterio Gonzalez UANL; Monterrey Mexico
| | - Jose A. Davila-Jimenez
- Internal Medicine Department; Cardiology Division; University Hospital Dr. Jose Eleuterio Gonzalez UANL; Monterrey Mexico
| | - Cinthia Y. Guillen-Gutierrez
- Department of Radiology and Medical Imaging; University Hospital Dr. Jose Eleuterio Gonzalez UANL; Monterrey Mexico
| | - Guillermo Elizondo-Riojas
- Department of Radiology and Medical Imaging; University Hospital Dr. Jose Eleuterio Gonzalez UANL; Monterrey Mexico
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102
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Lee M, Hong N, Lee YH, Kang ES, Cha BS, Lee BW. Elevated N-acetyl-β-d-glucosaminidase, a urinary tubular damage marker, is a significant predictor of carotid artery atherosclerosis in type 1 diabetes, independent of albuminuria: A cross-sectional study. J Diabetes Complications 2018; 32:777-783. [PMID: 29980431 DOI: 10.1016/j.jdiacomp.2018.05.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2017] [Revised: 05/03/2018] [Accepted: 05/27/2018] [Indexed: 01/07/2023]
Abstract
AIMS Recent evidence has shown that renal tubulointerstitial injuries play an important role in diabetic nephropathy. In this study, we evaluated the association between urinary N-acetyl-β-d-glucosaminidase (uNAG), an early renal tubular damage marker, and carotid artery atherosclerosis in patients with type 1 diabetes (T1D). METHODS This was a cross-sectional study of 88 patients with T1D. Demographic and laboratory data; urinary indices, including urinary NAG-to-creatinine ratio (uNCR), and albumin-to-creatinine ratio (uACR); and carotid ultrasonography were investigated. RESULTS Eighty-eight subjects were divided into three groups based on uNCR tertiles. Subjects belonging to the highest tertile of uNCR had the highest average mean and maximum carotid intima-media thickness (IMT). An elevated uNCR was also significantly correlated with increased average mean and maximum carotid IMT, whereas an elevated uACR was not. Even after adjusting for confounding factors, uNCR continued to be a meaningful predictive marker for increased average mean and maximum IMT. Conversely, the uACR could not predict carotid IMT after adjustment for confounding factors. CONCLUSIONS Elevated levels of uNAG are significantly associated with carotid artery atherosclerosis in patients with T1D independently of albuminuria, a marker of glomerular damage.
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Affiliation(s)
- Minyoung Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Graduate School, Yonsei University College of Medicine, 50-1, Yonsei-ro, Seodaemun-gu, Seoul 03722, South Korea.
| | - Namki Hong
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Graduate School, Yonsei University College of Medicine, 50-1, Yonsei-ro, Seodaemun-gu, Seoul 03722, South Korea.
| | - Yong-Ho Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Graduate School, Yonsei University College of Medicine, 50-1, Yonsei-ro, Seodaemun-gu, Seoul 03722, South Korea.
| | - Eun Seok Kang
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Graduate School, Yonsei University College of Medicine, 50-1, Yonsei-ro, Seodaemun-gu, Seoul 03722, South Korea.
| | - Bong Soo Cha
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Graduate School, Yonsei University College of Medicine, 50-1, Yonsei-ro, Seodaemun-gu, Seoul 03722, South Korea.
| | - Byung-Wan Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Graduate School, Yonsei University College of Medicine, 50-1, Yonsei-ro, Seodaemun-gu, Seoul 03722, South Korea.
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103
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Abstract
Carotid atherosclerosis (CAS) is associated with increased cardiovascular risk, and therefore, assessing the genetic versus environmental background of CAS traits is of key importance. Carotid intima-media-thickness and plaque characteristics seem to be moderately heritable, with remarkable differences in both heritability and presence or severity of these traits among ethnicities. Although the considerable role of additive genetic effects is obvious, based on the results so far, there is an important emphasis on non-shared environmental factors as well. We aimed to collect and summarize the papers that investigate twin and family studies assessing the phenotypic variance attributable to genetic associations with CAS. Genes in relation to CAS markers were overviewed with a focus on genetic association studies and genome-wide association studies. Although the role of certain genes is confirmed by studies conducted on large populations and meta-analyses, many of them show conflicting results. A great focus should be on future studies elucidating the exact pathomechanism of these genes in CAS in order to imply them as novel therapeutic targets.
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104
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Blekkenhorst LC, Sim M, Bondonno CP, Bondonno NP, Ward NC, Prince RL, Devine A, Lewis JR, Hodgson JM. Cardiovascular Health Benefits of Specific Vegetable Types: A Narrative Review. Nutrients 2018; 10:nu10050595. [PMID: 29751617 PMCID: PMC5986475 DOI: 10.3390/nu10050595] [Citation(s) in RCA: 74] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 05/06/2018] [Accepted: 05/09/2018] [Indexed: 12/12/2022] Open
Abstract
Adequate vegetable consumption is one of the cornerstones of a healthy diet. The recommendation to increase vegetable intake is part of most dietary guidelines. Despite widespread and long-running public health messages to increase vegetable intake, similar to other countries worldwide, less than 1 in 10 adult Australians manage to meet target advice. Dietary guidelines are predominantly based on studies linking diets high in vegetables with lower risk of chronic diseases. Identifying vegetables with the strongest health benefits and incorporating these into dietary recommendations may enhance public health initiatives around vegetable intake. These enhanced public health initiatives would be targeted at reducing the risk of chronic diseases, such as cardiovascular diseases (CVD). Specific vegetable types contain high levels of particular nutrients and phytochemicals linked with cardiovascular health benefits. However, it is not clear if increasing intake of these specific vegetable types will result in larger benefits on risk of chronic diseases. This review presents an overview of the evidence for the relationships of specific types of vegetables, including leafy green, cruciferous, allium, yellow-orange-red and legumes, with subclinical and clinical CVD outcomes in observational epidemiological studies.
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Affiliation(s)
- Lauren C Blekkenhorst
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA 6027, Australia.
- Medical School, Royal Perth Hospital Unit, The University of Western Australia, Perth, WA 6000, Australia.
| | - Marc Sim
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA 6027, Australia.
| | - Catherine P Bondonno
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA 6027, Australia.
- School of Biomedical Sciences, Royal Perth Hospital Unit, The University of Western Australia, Perth, WA 6000, Australia.
| | - Nicola P Bondonno
- School of Biomedical Sciences, Royal Perth Hospital Unit, The University of Western Australia, Perth, WA 6000, Australia.
| | - Natalie C Ward
- Medical School, Royal Perth Hospital Unit, The University of Western Australia, Perth, WA 6000, Australia.
- School of Public Health & Curtin Health Innovation Research Institute, Curtin University, Bentley, WA 6102, Australia.
| | - Richard L Prince
- Medical School, Queen Elizabeth Medical Centre Unit, The University of Western Australia, Nedlands, WA 6009, Australia.
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, WA 6009, Australia.
| | - Amanda Devine
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA 6027, Australia.
| | - Joshua R Lewis
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA 6027, Australia.
- Medical School, Royal Perth Hospital Unit, The University of Western Australia, Perth, WA 6000, Australia.
- Centre for Kidney Research, Children's Hospital at Westmead, Westmead, NSW 2145, Australia.
- School of Public Health, Sydney Medical School, University of Sydney, Sydney, NSW 2006, Australia.
| | - Jonathan M Hodgson
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA 6027, Australia.
- Medical School, Royal Perth Hospital Unit, The University of Western Australia, Perth, WA 6000, Australia.
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105
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Ihle-Hansen H, Vigen T, Ihle-Hansen H, Rønning OM, Berge T, Thommessen B, Lyngbakken MN, Orstad EB, Enger S, Nygård S, Røsjø H, Tveit A. Prevalence of Carotid Plaque in a 63- to 65-Year-Old Norwegian Cohort From the General Population: The ACE (Akershus Cardiac Examination) 1950 Study. J Am Heart Assoc 2018; 7:JAHA.118.008562. [PMID: 29739796 PMCID: PMC6015330 DOI: 10.1161/jaha.118.008562] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background New data on extracranial carotid atherosclerosis are needed, as improved ultrasound techniques may detect more atherosclerosis, the definition of plaque has changed over the years, and better cardiovascular risk control in the population may have changed patterns of carotid arterial wall disease and actual prevalence of established cardiovascular disease. We investigated the prevalence of atherosclerotic carotid plaques and carotid intima–media thickness (cIMT) and their relation to cardiovascular risk factors in a middle‐aged cohort from the general population. Methods and Results We performed carotid ultrasound in 3683 participants who were born in 1950 and included in a population‐based Norwegian study. Carotid plaque and cIMT were assessed according to the Mannheim Carotid Intima–Media Thickness and Plaque Consensus, and a carotid plaque score was used to calculate atherosclerotic burden. The participants were aged 63 to 65 years, and 49% were women. The prevalence of established cardiovascular disease was low (10%), but 62% had hypertension, 53% had hypercholesterolemia, 11% had diabetes mellitus, and 23% were obese. Mean cIMT was 0.73±0.11 mm, and atherosclerotic carotid plaques were present in 87% of the participants (median plaque score: 2; interquartile range: 3). Most of the cardiovascular risk factors, with the exception of diabetes mellitus, obesity and waist–hip ratio, were independently associated with the plaque score. In contrast, only sex, hypertension, obesity, current smoking, and cerebrovascular disease were associated with cIMT. Conclusions We found very high prevalence of carotid plaque in this middle‐aged population, and our data support a greater association between cardiovascular risk factors and plaque burden, compared with cIMT. Clinical Trial Registration URL: https://www.clinicaltrials.gov. Unique identifier: NCT01555411.
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Affiliation(s)
- Håkon Ihle-Hansen
- Department of Medical Research, Bærum Hospital, Vestre Viken Hospital Trust, Drammen, Norway .,Institute of Clinical Medicine, University of Oslo, Norway
| | - Thea Vigen
- Institute of Clinical Medicine, University of Oslo, Norway.,Division of Medicine, Akershus University Hospital, Lørenskog, Norway
| | - Hege Ihle-Hansen
- Department of Medical Research, Bærum Hospital, Vestre Viken Hospital Trust, Drammen, Norway
| | - Ole Morten Rønning
- Institute of Clinical Medicine, University of Oslo, Norway.,Division of Medicine, Akershus University Hospital, Lørenskog, Norway
| | - Trygve Berge
- Department of Medical Research, Bærum Hospital, Vestre Viken Hospital Trust, Drammen, Norway.,Institute of Clinical Medicine, University of Oslo, Norway
| | - Bente Thommessen
- Division of Medicine, Akershus University Hospital, Lørenskog, Norway
| | - Magnus Nakrem Lyngbakken
- Institute of Clinical Medicine, University of Oslo, Norway.,Division of Medicine, Akershus University Hospital, Lørenskog, Norway
| | | | - Steve Enger
- Department of Medical Research, Bærum Hospital, Vestre Viken Hospital Trust, Drammen, Norway
| | - Ståle Nygård
- Bioinformatics core facility, Oslo University Hospital and the University of Oslo, Norway
| | - Helge Røsjø
- Institute of Clinical Medicine, University of Oslo, Norway.,Division of Medicine, Akershus University Hospital, Lørenskog, Norway
| | - Arnljot Tveit
- Department of Medical Research, Bærum Hospital, Vestre Viken Hospital Trust, Drammen, Norway.,Institute of Clinical Medicine, University of Oslo, Norway
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106
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Blekkenhorst LC, Bondonno CP, Lewis JR, Woodman RJ, Devine A, Bondonno NP, Lim WH, Zhu K, Beilin LJ, Thompson PL, Prince RL, Hodgson JM. Cruciferous and Total Vegetable Intakes Are Inversely Associated With Subclinical Atherosclerosis in Older Adult Women. J Am Heart Assoc 2018; 7:JAHA.117.008391. [PMID: 29618474 PMCID: PMC6015430 DOI: 10.1161/jaha.117.008391] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Background Dietary patterns rich in fruits and vegetables are considered to reduce atherosclerotic disease presentation and are reported to be inversely associated with subclinical measures of atherosclerosis, such as carotid artery intima‐media thickness (IMT) and plaque. However, the effect of vegetable intake alone, and relationships to specific types of vegetables containing different phytochemical profiles, is important. The aim of this study was to investigate the associations of total vegetable intake and specific vegetables grouped according to phytochemical constituents with common carotid artery IMT (CCA‐IMT) and carotid plaque severity in a cohort of older adult women (aged ≥70 years). Methods and Results Total vegetable intake was calculated at baseline (1998) using a validated food frequency questionnaire. Vegetable types included cruciferous, allium, yellow/orange/red, leafy green, and legumes. In 2001, CCA‐IMT (n=954) and carotid focal plaque (n=968) were assessed using high‐resolution B‐mode carotid ultrasonography. Mean (SD) total vegetable intake was 199.9 (78.0) g/d. Women consuming ≥3 servings of vegetables each day had ≈4.6% to 5.0% lower mean CCA‐IMT (P=0.014) and maximum CCA‐IMT (P=0.004) compared with participants consuming <2 servings of vegetables. For each 10 g/d higher in cruciferous vegetable intake, there was an associated 0.006 mm (0.8%) lower mean CCA‐IMT (P<0.01) and 0.007 mm (0.8%) lower maximum CCA‐IMT (P<0.01). Other vegetable types were not associated with CCA‐IMT (P>0.05). No associations were observed between vegetables and plaque severity (P>0.05). Conclusions Increasing vegetables in the diet with a focus on consuming cruciferous vegetables may have benefits for the prevention of subclinical atherosclerosis in older adult women. Clinical Trial Registration URL: http://www.anzctr.org.au. Unique identifier: ACTRN12615000750583.
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Affiliation(s)
- Lauren C Blekkenhorst
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia .,Medical School, Royal Perth Hospital Unit, University of Western Australia, Perth, Western Australia, Australia.,Medical School, Queen Elizabeth Medical Centre Unit, University of Western Australia, Nedlands, Western Australia, Australia
| | - Catherine P Bondonno
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia.,Medical School, Royal Perth Hospital Unit, University of Western Australia, Perth, Western Australia, Australia
| | - Joshua R Lewis
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia.,Medical School, Queen Elizabeth Medical Centre Unit, University of Western Australia, Nedlands, Western Australia, Australia.,Centre for Kidney Research, Children's Hospital at Westmead, New South Wales, Australia.,School of Public Health, Sydney Medical School, University of Sydney, New South Wales, Australia
| | - Richard J Woodman
- Flinders Centre for Epidemiology and Biostatistics, Flinders University, Adelaide, South Australia, Australia
| | - Amanda Devine
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Nicola P Bondonno
- Medical School, Royal Perth Hospital Unit, University of Western Australia, Perth, Western Australia, Australia
| | - Wai H Lim
- Department of Renal Medicine, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
| | - Kun Zhu
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
| | - Lawrence J Beilin
- Medical School, Royal Perth Hospital Unit, University of Western Australia, Perth, Western Australia, Australia
| | - Peter L Thompson
- Department of Cardiovascular Medicine, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
| | - Richard L Prince
- Medical School, Queen Elizabeth Medical Centre Unit, University of Western Australia, Nedlands, Western Australia, Australia.,Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
| | - Jonathan M Hodgson
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia.,Medical School, Royal Perth Hospital Unit, University of Western Australia, Perth, Western Australia, Australia
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107
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Saba L, Sanfilippo R, Tallapally N, Molinari F, Montisci R, Mallarini G, Suri JS. Evaluation of Carotid Wall Thickness by using Computed Tomography and Semiautomated Ultrasonographic Software. ACTA ACUST UNITED AC 2018. [DOI: 10.1177/154431671103500302] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Purpose The increased thickness of the carotid artery is associated with the development of coronary and cerebrovascular events. In this study our purpose was to evaluate the carotid artery wall thickness (CAWT) by using multidetector-row computed tomography angiography (MDCTA) and the intima media thickness (IMT) by using semiautomated ultrasonography (SA-US) to evaluate the agreement between the two methods. Methods This is a retrospective study, and the institutional review board approval was obtained. Twenty-one patients (age range, 59–81 years) were analyzed with the use of a 16-detector row CT and a sonographic scanner. In total, 14 subjects had shown cerebral ischemic symptoms. The IMT was quantified by the use of specific semiautomated software (ImgTracer™, Global Biomedical Technologies, Roseville, CA) by four expert observers, and the CAWT was measured by use of the MDCTA. Data were compared with the Wilcoxon test for paired samples. Bland–Altman statistics was used to measure the agreement between MDCTA and SA-US. A p value < 0.05 was considered significant. Results Forty-two carotids were analyzed, and the CAWT ranged from 0.64 to 2.99 mm, with a mean value of 1.438 mm. By analyzing the Bland–Altman plots, we observed a good agreement between SA-US and correlation coefficient r were 0.9250 (95% confidence interval [CI] 0.864–0.959; p < 0.0001), 0.9265 (95% CI 0.866–0.961; p < 0.0001), 0.9466 (95% CI 0.902–0.971; p < 0.0001), and 0.8621 (95% CI: 0.756–0.924; p < 0.0001) for observer 1, observer 2, observer 3 and observer 4 respectively. Conclusions Data of this preliminary study by using SA-US and MDCTA demonstrated a good agreement between in the measurement of CAWT and IMT.
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Affiliation(s)
- Luca Saba
- Departments of Radiology, Azienda Ospedaliero Universitaria (A.O.U.), di Cagliari – Polo di Monserrato, s.s. 554 Monserrato (Cagliari) 09045, Italy
| | - Roberto Sanfilippo
- Departments of Vascular Surgery, Azienda Ospedaliero Universitaria (A.O.U.), di Cagliari – Polo di Monserrato, s.s. 554 Monserrato (Cagliari) 09045, Italy
| | | | - Filippo Molinari
- Departments of Biolab, Department of Electronics, Politecnico di Torino, Torino, Italy
| | - Roberto Montisci
- Departments of Vascular Surgery, Azienda Ospedaliero Universitaria (A.O.U.), di Cagliari – Polo di Monserrato, s.s. 554 Monserrato (Cagliari) 09045, Italy
| | - Giorgio Mallarini
- Departments of Radiology, Azienda Ospedaliero Universitaria (A.O.U.), di Cagliari – Polo di Monserrato, s.s. 554 Monserrato (Cagliari) 09045, Italy
| | - Jasjit S. Suri
- Departments of CTO, Global Biomedical Technologies Inc., California
- Departments of Biomedical Engineering Department, Idaho State University (Aff.), Idaho
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108
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Oxidative DNA Damage and Carotid Intima Media Thickness as Predictors of Cardiovascular Disease in Prediabetic Subjects. J Cardiovasc Dev Dis 2018. [PMID: 29518984 PMCID: PMC5872363 DOI: 10.3390/jcdd5010015] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Prediabetes is considered as a risk factor for the development of diabetes mellitus and cardiovascular disease. The present study was conducted with the aim of finding out the relationship between oxidative DNA damage and carotid intima media thickness for the prediction of cardiovascular disease in prediabetic subjects. The study included 100 prediabetic subjects and 100 normal individuals as controls. In both cases and controls, 8-OHdG was measured by ELISA, and CIMT was measured by B mode ultrasonography. Both 8-OHdG and CIMT were significantly higher in subjects with prediabetes as compared to controls (185.80 ± 10.72 pg/mL vs. 126.13 ± 16.01 pg/mL, p < 0.001 and 0.70 ± 0.04 mm vs. 0.57 ± 0.03 mm, p < 0.001, respectively). There was significant and positive correlation of IGT with 8-OHdG (r = 0.783; p < 0.001) and CIMT (r = 0.787; p < 0.001) in prediabetic subjects. Moreover, 8-OHdG showed significant positive correlation with CIMT (r = 0.704; p < 0.001) in prediabetic subjects. In conclusion, increased 8-OHdG and CIMT in prediabetic subjects indicate that biochemical changes of atherosclerosis start even before the onset of diabetes mellitus. Hence, 8-OHdG and CIMT could be used as indicators of cardiovascular disease risk in these subjects.
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109
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Zhang J, Liu Y, Wang A, Wang D, Jiang R, Jia J, Chen S, Zhao X. Association between H-type Hypertension and Asymptomatic Extracranial Artery Stenosis. Sci Rep 2018; 8:1328. [PMID: 29358636 PMCID: PMC5778020 DOI: 10.1038/s41598-018-19740-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Accepted: 01/08/2018] [Indexed: 12/13/2022] Open
Abstract
Asymptomatic extracranial artery stenosis (ECAS) is a well-known risk factor for stroke and H-type hypertension, which is defined as hypertension with hyperhomocysteinemia, is associated with cardio-cerebrovascular diseases. However, the impact of H-type hypertension on ECAS is mostly unknown. We designed this study to investigate the association between H-type hypertension and prevalence of ECAS. We included 2330 participants in this study and classified them into four groups: the control group without hypertension or hyperhomocysteinemia, isolated hypertension group, isolated hyperhomocysteinemia group and H-type hypertension group. We measured the baseline plasma total homocysteine levels and assessed ECAS by carotid duplex sonography twice at baseline and during follow up. We used a Cox regression model to analyse the association between H-type hypertension and ECAS. At baseline, 608 subjects suffered from H-type hypertension. Within two years of follow-up, asymptomatic ECAS occurred in 250 (10.73%) participants. After adjusting for relevant risk factors, we found H-type hypertension to be an independent risk factor for asymptomatic ECAS (relative risk (RR) 3.16, 95% confidence interval (95% CI) 2.00-5.00). Our findings provide direct evidence for the importance of H-type hypertension in the occurrence of ECAS and as a potential therapeutic target for carotid atherosclerosis.
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Affiliation(s)
- Jia Zhang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100050, China
- China National Clinical Research Center for Neurological Diseases, Beijing, 100050, China
- Center of Stroke, Beijing Institute for Brain Disorders, Beijing, 100050, China
- Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, 100050, China
| | - Yanfang Liu
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100050, China
- China National Clinical Research Center for Neurological Diseases, Beijing, 100050, China
- Center of Stroke, Beijing Institute for Brain Disorders, Beijing, 100050, China
- Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, 100050, China
| | - Anxin Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100050, China
- China National Clinical Research Center for Neurological Diseases, Beijing, 100050, China
- Center of Stroke, Beijing Institute for Brain Disorders, Beijing, 100050, China
- Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, 100050, China
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, 100050, China
| | - Dandan Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100050, China
- China National Clinical Research Center for Neurological Diseases, Beijing, 100050, China
- Center of Stroke, Beijing Institute for Brain Disorders, Beijing, 100050, China
- Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, 100050, China
| | - Ruixuan Jiang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100050, China
- China National Clinical Research Center for Neurological Diseases, Beijing, 100050, China
- Center of Stroke, Beijing Institute for Brain Disorders, Beijing, 100050, China
- Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, 100050, China
| | - Jiaokun Jia
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100050, China
- China National Clinical Research Center for Neurological Diseases, Beijing, 100050, China
- Center of Stroke, Beijing Institute for Brain Disorders, Beijing, 100050, China
- Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, 100050, China
| | - Shengyun Chen
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100050, China.
- China National Clinical Research Center for Neurological Diseases, Beijing, 100050, China.
- Center of Stroke, Beijing Institute for Brain Disorders, Beijing, 100050, China.
- Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, 100050, China.
| | - Xingquan Zhao
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100050, China.
- China National Clinical Research Center for Neurological Diseases, Beijing, 100050, China.
- Center of Stroke, Beijing Institute for Brain Disorders, Beijing, 100050, China.
- Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, 100050, China.
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110
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Chi X, Li M, Zhan X, Man H, Xu S, Zheng D, Bi J, Wang Y, Liu C. Relationship between carotid artery sclerosis and blood pressure variability in essential hypertension patients. Comput Biol Med 2018; 92:73-77. [DOI: 10.1016/j.compbiomed.2017.03.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Revised: 03/16/2017] [Accepted: 03/17/2017] [Indexed: 11/24/2022]
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111
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Assessment of subclinical atherosclerosis in systemic lupus erythematosus: A systematic review and meta-analysis. Joint Bone Spine 2017; 85:155-163. [PMID: 29288864 DOI: 10.1016/j.jbspin.2017.12.009] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Accepted: 12/13/2017] [Indexed: 10/18/2022]
Abstract
OBJECTIVES To determine whether subclinical atherosclerosis is increased in patients with systemic lupus erythematosus (SLE) compared to healthy individuals, using carotid intima-media thickness (CIMT), carotid plaque (CP) presence or flow-mediated dilatation (FMD). METHODS A systematic literature search was performed using MedLine, Embase and Cochrane databases. Two reviewers independently screened the articles to identify studies that compared the rates of atherosclerosis in SLE patients versus healthy controls. The results were pooled in a meta-analysis. Factors influencing the CIMT, CP or FMD results were collected. RESULTS Of the 203 articles initially identified, 68 were selected for the meta-analysis. Compared to healthy controls, SLE patients had a significantly increased CIMT (mean difference [MD] of 0.08mm, 95% CI [0.06-0.09], P<0.05), more CP (odds ratio 2.01, 95% CI [1.63-2.47], P<0.05) and decreased FMD (MD -3.96%, 95% CI [-5.37 to -2.54)], P<0.05). There was marked heterogeneity among the studies. However, the results of the meta-analysis that included only the CIMT per new international recommendations also showed an increased CIMT in SLE patients, but the heterogeneity was low (MD 0.04mm, 95% CI [0.02-0.06], P<0.05; I2=23%). CONCLUSION SLE patients exhibit increased subclinical atherosclerosis compared to healthy controls. CIMT is a promising measure for cardiovascular risk evaluations because non-invasive, non-radiation-based, reproducible. Thus, CIMT can be proposed as an alternative to the reliable CP evaluation and to FMD, which is influenced by independent factors such as smoking. Future studies should focus on reducing the heterogeneity of these measures using standardized procedures.
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Serum Interleukin-23 in Polish Patients with Systemic Lupus Erythematosus: Association with Lupus Nephritis, Obesity, and Peripheral Vascular Disease. Mediators Inflamm 2017; 2017:9401432. [PMID: 29430084 PMCID: PMC5752988 DOI: 10.1155/2017/9401432] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Revised: 11/07/2017] [Accepted: 11/27/2017] [Indexed: 01/23/2023] Open
Abstract
Objectives To analyze the correlation between the serum concentration of interleukin- (IL-) 23 and atherosclerotic changes, traditional atherosclerotic risk factors, the autoantibody profile, and involvement of selected organs in systemic lupus erythematosus (SLE) patients. Patients and Methods We studied 94 SLE patients and 27 controls. We analyzed the IL-23 serum concentration, autoantibodies, carotid intima-media thickness and atherosclerotic plaque, the ankle-brachial index, atherosclerotic risk factors, and organ manifestations. Results Concentrations of IL-23 significantly differed between SLE patients and the controls (p = 0.0015). On the basis of multivariate stepwise analysis, we revealed that high levels of IL-23 were associated with atherosclerotic plaque in common femoral arteries (OR = 12.67; 95% CI: 1.41-113.84), lupus nephritis (OR = 3.69; 95% CI: 1.16-12.22), and obesity (OR = 4.21; 95% CI: 1.40-12.67). Autoantibodies related to IL-23 were anti-phosphatidylethanolamine antibodies (OR = 11.06; 95% CI: 1.24-98.65) and anti-SS-B/La antibodies (OR = 15.43; 95% CI: 1.73-137.25). Conclusions IL-23 may be involved in lupus nephritis pathogenesis. Through its association with obesity and selected antiphospholipid antibodies, IL-23 might promote a hypercoagulable state contributing to atherothrombosis development in SLE patients.
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Ellins EA, Smith KE, Lennon LT, Papacosta O, Wannamethee SG, Whincup PH, Halcox JP. Arterial pathophysiology and comparison of two devices for pulse wave velocity assessment in elderly men: the British regional heart study. Open Heart 2017; 4:e000645. [PMID: 29344365 PMCID: PMC5761282 DOI: 10.1136/openhrt-2017-000645] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Revised: 10/20/2017] [Accepted: 11/07/2017] [Indexed: 01/27/2023] Open
Abstract
Objective Vascular disease is highly prevalent in the elderly. This study aimed to evaluate arterial phenotype in elderly men and compare carotid–femoral pulse wave velocity (cfPWV) assessed by two techniques (Sphygmocor (S)and Vicorder (V)). Methods 1722 men (72–92 years), participants in the British Regional Heart Study, underwent ultrasound assessment of carotid intima–media thickness (cIMT), carotid distensibility coefficient and presence of carotid plaque. cfPWV and ankle brachial pressure index (ABPI) were also assessed. 123 men returned for between visit reproducibility assessments. Results Good reproducibility was demonstrated in all measures (Gwet’s agreement=0.8 for plaque, intraclass correlation=0.65 for ABPI and coefficient of variation <13% for all other measures). Measurements were obtained in >90% of men for all measures except cfPWV(S) and ABPI. In 1122 men with both cfPWV(V) and cfPWV(S) data, cfPWV(S) was greater than cfPWV(V) (mean difference=0.23,95%CI 0.10 to 0.37 m/s). cfPWV(V) was higher at low cfPWV values and cfPWV(S) was higher at high cfPWV values. Correlation of V transit time (TT) against S carotid and femoral TT demonstrated that the slope of the regression line for femoral TT was steeper than for carotid TT, resulting in a proportionally greater subtraction of carotid TT from femoral TT at higher PWVs. Conclusions Reproducible, satisfactory quality non-invasive measurements of vascular phenotype were obtainable in a large proportion of elderly men. The discrepancy in results between the two PWV measures may partly be due to the differential impact of subtracting carotid TT when deriving cfPWV(S) across the clinical PWV range.
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Affiliation(s)
- Elizabeth A Ellins
- Institute of Life Sciences, Swansea University Medical School, Swansea, UK
| | - Kirsten E Smith
- Institute of Life Sciences, Swansea University Medical School, Swansea, UK
| | - Lucy T Lennon
- UCL Department of Primary Care & Population Health, UCL Medical School, London, UK
| | - Olia Papacosta
- UCL Department of Primary Care & Population Health, UCL Medical School, London, UK
| | - S Goya Wannamethee
- UCL Department of Primary Care & Population Health, UCL Medical School, London, UK
| | - Peter H Whincup
- Division of Population Health Sciences and Education, Population Health Research Institute, St George's University of London, London, UK
| | - Julian P Halcox
- Institute of Life Sciences, Swansea University Medical School, Swansea, UK
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Sturlaugsdottir R, Aspelund T, Bjornsdottir G, Sigurdsson S, Thorsson B, Eiriksdottir G, Gudnason V. Predictors of carotid plaque progression over a 4-year follow-up in the Reykjavik REFINE-study. Atherosclerosis 2017; 269:57-62. [PMID: 29274849 DOI: 10.1016/j.atherosclerosis.2017.12.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Revised: 11/29/2017] [Accepted: 12/05/2017] [Indexed: 01/08/2023]
Abstract
BACKGROUND AND AIMS Carotid plaque is an arterial marker suggested as a surrogate end point for cardiovascular disease. The aim of this study was to examine the association of risk factors at visit 1 with plaque formation and progression of total plaque area (TPA) during follow-up. METHODS We examined 1894 participants (50-69 years of age) in the population-based REFINE (Risk Evaluation For INfarct Estimates)-Reykjavik study. RESULTS Among those with no plaque at baseline, plaque formation was associated with low density lipoprotein, sex, waist, former smoker and physical activity. Furthermore, both the Icelandic Heart Association (IHA) coronary heart disease (CHD) risk score and the atherosclerotic cardiovascular disease (ASCVD) risk score were highly associated with plaque formation in these individuals (p < 0.001) and a better cardiovascular health score was protective. In those with plaque present at baseline, metabolic syndrome was associated with increased risk, while older age and statin use were associated with reduced risk of new plaque formation. Statin use was the only factor associated with the relative TPA progression, where participants not on treatment had 5.7% (p=0.029) greater rate of progression compared with statin users. CONCLUSIONS A number of conventional risk factors at visit 1 were individually associated with plaque formation, also when combined into CHD and ASCVD risk scores, but not with the relative progression in TPA. Medical intervention with statins can reduce the relative progression rate of TPA in the general population with low grade of atherosclerosis, supporting statin use to slow progression of atherosclerosis.
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Affiliation(s)
- Ran Sturlaugsdottir
- Icelandic Heart Association, Kopavogur, Iceland; University of Iceland, Reykjavik, Iceland
| | - Thor Aspelund
- Icelandic Heart Association, Kopavogur, Iceland; University of Iceland, Reykjavik, Iceland
| | - Gudlaug Bjornsdottir
- Icelandic Heart Association, Kopavogur, Iceland; University of Iceland, Reykjavik, Iceland
| | | | | | | | - Vilmundur Gudnason
- Icelandic Heart Association, Kopavogur, Iceland; University of Iceland, Reykjavik, Iceland.
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Evaluation of atherosclerosis risk by measurement of intima media thickness and pulse wave velocity in lichen planus patients; A prospective case-control study. JOURNAL OF SURGERY AND MEDICINE 2017. [DOI: 10.28982/josam.344718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Ishikawa M, Sugawara H, Tsuji T, Nagai M, Kusaka G, Naritaka H. Clinical significance of the coexistence of carotid artery plaque and white matter disease in patients with symptomatic cerebral infarction. Clin Neurol Neurosurg 2017; 163:179-185. [PMID: 29132058 DOI: 10.1016/j.clineuro.2017.10.027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Revised: 09/23/2017] [Accepted: 10/25/2017] [Indexed: 12/19/2022]
Abstract
OBJECTIVES Symptomatic cerebral infarction (CI) can occur in patients without main cerebral artery stenosis or occlusion. This study investigated the unique features of carotid artery plaque and white matter disease (WMD) in patients with symptomatic CI and transient ischemic attack (TIA) but without stenosis or occlusion of a main cerebral artery. PATIENTS AND METHODS We studied 647 patients who underwent both carotid ultrasound examination and brain magnetic resonance images. Plaque score (PS), plaque number, maximal plaque intima-media thickness and grades of WMD were examined. Subjects were divided into four groups, the CI group, TIA group, myocardial infarction (MI) group and risk factor (RF) group. Plaque and WMD were analyzed in cerebral ischemia group (CI and TIA), compared to non-cerebral ischemia groups and to a high PS group and a high WMD grade group from the RF group. RESULTS Both of each value of plaque and grades of WMD in the cerebral ischemia group were significantly higher than those in other groups. Grades of WMD in the cerebral ischemia group were significantly higher than those in the high PS group, although there was no significant difference of the each value of plaque between the two groups. The each value of plaque in the cerebral ischemia group was also significantly higher than those in the high WMD grade group, although there was no significant difference of grade of WMD between the two groups. CONCLUSION Simultaneous increases in carotid artery plaque and WMD are associated with symptomatic CI, which is not caused by stenosis or occlusion of a main cerebral artery.
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Affiliation(s)
- Mami Ishikawa
- Department of Neurosurgery, Edogawa Hospital, Japan; Department of Neurosurgery, Saitama Medical Center, Jichi Medical University, Japan.
| | - Hitoshi Sugawara
- Division of General Medicine, Department of the Comprehensive Medicine 1, Saitama Medical Center, Jichi Medical University, Japan
| | - Toshiyuki Tsuji
- Department of Neurosurgery, Saitama Medical Center, Jichi Medical University, Japan
| | - Mutsumi Nagai
- Department of Neurosurgery, Saitama Medical Center, Jichi Medical University, Japan
| | - Gen Kusaka
- Department of Neurosurgery, Saitama Medical Center, Jichi Medical University, Japan
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Mostaza JM, Lahoz C, Salinero-Fort MA, Laguna F, Estirado E, García-Iglesias F, González Alegre T, Sabín C, López S, Cornejo V. Risk factors associated with the carotid intima-media thickness and plaques: ESPREDIA Study. CLINICA E INVESTIGACION EN ARTERIOSCLEROSIS 2017; 30:49-55. [PMID: 28939054 DOI: 10.1016/j.arteri.2017.07.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Revised: 06/29/2017] [Accepted: 07/18/2017] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To evaluate whether there were any differences in the risk factor profile associated with either the intima-media thickness (IMT) or the presence of carotid plaques. METHODS Cross-sectional study in 1475 subjects between 45 and 75years, randomly selected from the population of the Northwest area of Madrid (Spain). They had a physical exam, blood analysis, and ultrasound measurement of the IMT and of the presence of plaques. RESULTS Mean IMT was 0.725±0.132mm. Forty seven percent of the participants had carotid plaques. In multivariate analysis, factors directly associated with the IMT were, age (β0.227, P<.0001), sex (β0.104, P<.0001), presence of hypertension (β0.082, P=.002), diabetes (β0.130, P<.0001) and current smoking (β0.107, P<.0001), systolic blood pressure (SBP) (β0.219, P<.0001) and LDL-cholesterol levels (β0.074, P=.003), and inversely, diastolic blood pressure (DBP) (β-0.124, P=.001), HDL-cholesterol (β-0.111, P<.0001) and triglyceride levels (β-0.060, P=.028). The presence of plaques was directly associated with age (OR1.08; 95%CI: 1.05-1.10), sex (OR1.95; 95%CI: 1.52-2.51), current smoking (OR2.75; 95%CI: 1.92-3.95), history of hypertension (OR1.58; 95%CI: 1.22-2.04) or diabetes (OR1.84; 95%CI: 1.31-2.58), statin treatment (OR1.56; 95%CI: 1.19-2.04) and SBP (OR1.03; 95%CI: 1.02-1.05), and inversely with DBP (OR0.98; 95%CI: 0.96-0.99). CONCLUSION Factors associated with the IMT and the presence of plaques are similar, a finding that support a continuum between muscular layer hypertrophy and arteriosclerosis development.
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Affiliation(s)
- Jose M Mostaza
- Unidad de Lípidos y Riesgo Cardiovascular, Servicio de Medicina Interna, Hospital Carlos III, Madrid, España.
| | - Carlos Lahoz
- Unidad de Lípidos y Riesgo Cardiovascular, Servicio de Medicina Interna, Hospital Carlos III, Madrid, España
| | - Miguel A Salinero-Fort
- Gerencia Adjunta de Planificación y Calidad, Atención Primaria, Servicio Madrileño de Salud, Madrid, España
| | - Fernando Laguna
- Unidad de Lípidos y Riesgo Cardiovascular, Servicio de Medicina Interna, Hospital Carlos III, Madrid, España
| | - Eva Estirado
- Unidad de Lípidos y Riesgo Cardiovascular, Servicio de Medicina Interna, Hospital Carlos III, Madrid, España
| | - Francisca García-Iglesias
- Unidad de Lípidos y Riesgo Cardiovascular, Servicio de Medicina Interna, Hospital Carlos III, Madrid, España
| | - Teresa González Alegre
- Unidad de Lípidos y Riesgo Cardiovascular, Servicio de Medicina Interna, Hospital Carlos III, Madrid, España
| | | | - Silvia López
- Unidad de día, Hospital Carlos III, Madrid, España
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Efremov L, Yang WY, Jacobs L, Thijs L, Kuznetsova T, Struijker-Boudier HAJ, Staessen JA. Post-processing reproducibility of the structural characteristics of the common carotid artery in a Flemish population. Artery Res 2017; 19:9-17. [PMID: 28868090 PMCID: PMC5567409 DOI: 10.1016/j.artres.2017.04.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Introduction Common carotid artery (CCA) intima-media thickness (IMT), lumen diameter, and maximum plaque thickness were assessed on ultrasound images. The objective of the study was to evaluate the intra- and inter-reader reproducibility of the measurements following a standardised protocol. Methods Two readers performed the off-line measurements on B-mode ultrasound images of the distal CCA, in a randomly selected subset (n = 60) from a Flemish population cohort (FLEMENGHO). We calculated the coefficient of variation, the interclass correlation coefficient (ICC) and reproducibility according to the Bland–Altman method. Results The intra-reader bias for the measurements of left and right side CCA IMT were −0.003 ± 0.04 mm (p = 0.55) and 0.01 ± 0.04 mm (p = 0.03), respectively. The intra-reader bias of the lumen diameter was −0.04 ± 0.25 mm (p = 0.27) for the left and 0.02 ± 0.22 mm (p = 0.45) for the right side. The measurements for the maximum plaque thickness showed no intra-reader differences with bias 0.07 ± 0.2 mm (p = 0.26) for the left and −0.03 ± 0.2 mm (p = 0.55) for the right side. The inter-reader analysis showed good reproducibility for the left and right side CCA IMT with bias 0.004 ± 0.06 mm (p = 0.57) and −0.008 ± 0.05 mm (p = 0.19), respectively, but the lumen diameter measurements showed inter-reader differences, with bias 0.17 ± 0.27 mm (p < 0.0001) for the left and 0.10 ± 0.21 mm (p = 0.0006) for the right side. The inter-reader bias for the maximum plaque thickness were 0.07 ± 0.2 mm (p = 0.21) and −0.1 ± 0.4 mm (p = 0.26) for the left and right side, respectively. Conclusion The results demonstrated a reliable reproducibility of carotid wall structural measurements, allowing for an adequate further analysis of the entire population cohort. The reproducibility of carotid arterial characteristics was evaluated. A sample of participants was chosen from a population cohort. The readers followed a standardised protocol, using commercially available software. The reproducibility of all characteristics was satisfactory.
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Affiliation(s)
- Ljupcho Efremov
- Studies Coordinating Centre, Research Unit of Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
| | - Wen-Yi Yang
- Studies Coordinating Centre, Research Unit of Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
| | - Lotte Jacobs
- Studies Coordinating Centre, Research Unit of Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
| | - Lutgarde Thijs
- Studies Coordinating Centre, Research Unit of Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
| | - Tatiana Kuznetsova
- Studies Coordinating Centre, Research Unit of Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
| | | | - Jan A Staessen
- Studies Coordinating Centre, Research Unit of Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium.,R & D Group VitaK, Maastricht University, Maastricht, The Netherlands
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Garshick M, Wu F, Demmer R, Parvez F, Ahmed A, Eunus M, Hasan R, Nahar J, Shaheen I, Sarwar G, Desvarieux M, Ahsan H, Chen Y. The association between socioeconomic status and subclinical atherosclerosis in a rural Bangladesh population. Prev Med 2017; 102. [PMID: 28645628 PMCID: PMC7605117 DOI: 10.1016/j.ypmed.2017.06.022] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
BACKGROUND In Bangladesh, CVD accounts for the majority of non-communicable mortality. The purpose of this study was to determine the role of socioeconomic status (SES) on subclinical atherosclerosis measured as carotid intima-media thickness (IMT) in a rural Bangladesh population. METHODS Carotid IMT was measured between 2010 and 2011 in 1022 participants (average age 46, 40% male) randomly selected from the Health Effects of Arsenic Longitudinal Study (HEALS), a population-based prospective cohort study based in rural Bangladesh. SES was measured as occupation type, land ownership, educational attainment, and television ownership. RESULTS Half of the participants received formal education (53%) and under half owned land (48%) and a television (44%). Women were primarily homemakers (95%) and men worked as factory workers (24%), laborers (18%), or in business (55%). In univariate analysis, those owning greater than one acre of land (p=0.03), owning a television (p=0.02), or laborers and business owners compared to factory workers had higher levels of carotid IMT (p<0.01). In multivariate analysis after adjustment for confounders, only men employed in the business sector had elevated carotid IMT compared to factory workers. The association was strongest in older men (58.7μm, 95% CI 17.2-100.0, ≥50years old) compared to younger men (13.7μm, 95% CI -7.8-35.2, <50years old). CONCLUSION Business sector employment was positively associated with subclinical atherosclerosis after adjustment for confounders. This finding is consistent with evidence from other developing nations suggesting that certain SES factors are independent predictors of CVD.
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Affiliation(s)
- Michael Garshick
- Leon H. Charney Division of Cardiology, New York University Langone Medical Center, New York City, NY, USA.
| | - Fen Wu
- Department of Population Health and Environmental Health, New York University School of Medicine, New York, NY, USA.
| | - Ryan Demmer
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA.
| | - Faruque Parvez
- Department of Environrmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA.
| | | | - Mahbub Eunus
- U-Chicago Research Bangladesh, Ltd., Dhaka, Bangladesh.
| | - Rabiul Hasan
- U-Chicago Research Bangladesh, Ltd., Dhaka, Bangladesh
| | - Jabun Nahar
- U-Chicago Research Bangladesh, Ltd., Dhaka, Bangladesh.
| | | | - Golam Sarwar
- U-Chicago Research Bangladesh, Ltd., Dhaka, Bangladesh.
| | - Moise Desvarieux
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA.
| | - Habibul Ahsan
- Department of Health Studies, Center for Cancer Epidemiology and Prevention, The University of Chicago, Chicago, IL, USA.
| | - Yu Chen
- Department of Population Health and Environmental Health, New York University School of Medicine, New York, NY, USA.
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Mateen FJ, Grau-Perez M, Pollak JS, Moon KA, Howard BV, Umans JG, Best LG, Francesconi KA, Goessler W, Crainiceanu C, Guallar E, Devereux RB, Roman MJ, Navas-Acien A. Chronic arsenic exposure and risk of carotid artery disease: The Strong Heart Study. ENVIRONMENTAL RESEARCH 2017; 157:127-134. [PMID: 28554006 PMCID: PMC5546150 DOI: 10.1016/j.envres.2017.05.020] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Revised: 05/15/2017] [Accepted: 05/16/2017] [Indexed: 05/27/2023]
Abstract
BACKGROUND Inorganic arsenic exposure from naturally contaminated groundwater is related to vascular disease. No prospective studies have evaluated the association between arsenic and carotid atherosclerosis at low-moderate levels. We examined the association of long-term, low-moderate inorganic arsenic exposure with carotid arterial disease. METHODS American Indians, 45-74 years old, in Arizona, Oklahoma, and North and South Dakota had arsenic concentrations (sum of inorganic and methylated species, μg/g urine creatinine) measured from baseline urine samples (1989-1991). Carotid artery ultrasound was performed in 1998-1999. Vascular disease was assessed by the carotid intima media thickness (CIMT), the presence of atherosclerotic plaque in the carotid, and by the number of segments containing plaque (plaque score). RESULTS 2402 participants (mean age 55.3 years, 63.1% female, mean body mass index 31.0kg/m2, diabetes 45.7%, hypertension 34.2%) had a median (interquintile range) urine arsenic concentration of 9.2 (5.00, 17.06) µg/g creatinine. The mean CIMT was 0.75mm. 64.7% had carotid artery plaque (3% with >50% stenosis). In fully adjusted models comparing participants in the 80th vs. 20th percentile in arsenic concentrations, the mean difference in CIMT was 0.01 (95% confidence interval (95%CI): 0.00, 0.02) mm, the relative risk of plaque presence was 1.04 (95%CI: 0.99, 1.09), and the geometric mean ratio of plaque score was 1.05 (95%CI: 1.01, 1.09). CONCLUSIONS Urine arsenic was positively associated with CIMT and increased plaque score later in life although the association was small. The relationship between urinary arsenic and the presence of plaque was not statistically significant when adjusted for other risk factors. Arsenic exposure may play a role in increasing the severity of carotid vascular disease.
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Affiliation(s)
- Farrah J Mateen
- Department of Neurology, Massachusetts General Hospital, Boston, MA, United States; Harvard Medical School, Boston, MA, United States
| | - Maria Grau-Perez
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY, United States
| | - Jonathan S Pollak
- Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Katherine A Moon
- Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States; Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Medical Institutions, Baltimore, MD, United States
| | - Barbara V Howard
- MedStar Health Research Institute and Georgetown/Howard Universities Center for Clinical and Translational Sciences, Washington DC, United States
| | - Jason G Umans
- MedStar Health Research Institute and Georgetown/Howard Universities Center for Clinical and Translational Sciences, Washington DC, United States
| | - Lyle G Best
- Missouri Breaks Industries Research, Inc, Eagle Butte, SD, United States
| | | | | | - Ciprian Crainiceanu
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Eliseo Guallar
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States; Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Medical Institutions, Baltimore, MD, United States
| | - Richard B Devereux
- Division of Cardiology, Weill Cornell Medical College, New York, NY, United States
| | - Mary J Roman
- Division of Cardiology, Weill Cornell Medical College, New York, NY, United States
| | - Ana Navas-Acien
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY, United States; Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States; Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Medical Institutions, Baltimore, MD, United States.
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Yoon HJ, Kim KH, Park H, Cho JY, Hong YJ, Park HW, Kim JH, Ahn Y, Jeong MH, Cho JG, Park JC. Carotid plaque rather than intima-media thickness as a predictor of recurrent vascular events in patients with acute ischemic stroke. Cardiovasc Ultrasound 2017; 15:19. [PMID: 28738808 PMCID: PMC5525267 DOI: 10.1186/s12947-017-0110-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Accepted: 07/13/2017] [Indexed: 11/13/2022] Open
Abstract
Background To investigate the impacts of carotid plaque and intima-media thickness (IMT) on future vascular events (VEs) in the patients with acute ischemic stroke. Methods A total of 479 consecutive Korean patients with acute ischemic stroke were divided into 2 groups according to development of VEs; VE group (65.4 ± 10.9 years) vs no VE group (62.8 ± 13.2 years). VEs were defined as the development of recurrent stroke, coronary events, peripheral arterial disease, and death. Clinical, laboratory, and imaging findings were compared between the groups. Results During 105.5 ± 29.0 months of follow up, VEs were developed in 142 patients (29.6%). In univariate analysis, VEs were significantly associated with age, gender, diabetes, renal function, lipid levels, left ventricular function, carotid plaque or IMT. In multivariate analysis, the presence of carotid plaque, diabetes, renal function and male gender were independent predictors of future VEs in the patients with ischemic stroke, but carotid IMT was not a predictor of future VEs. Event free survival was significantly lower in patients with carotid plaque than without carotid plaque on Kaplan-Meier analysis (log rank p < 0.001). Conclusion The present study demonstrated that diabetes, impaired renal function, male gender, and the presence of carotid plaque rather than IMT were independent predictors of future VEs in Korean patients with acute ischemic stroke. Active medical management and careful monitoring for the development of recurrent VEs are strongly recommended in patients with acute ischemic stroke and carotid plaque.
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Affiliation(s)
- Hyun Ju Yoon
- Department of Cardiovascular Medicine, Chonnam National University Hospital, 42 Jaebong-ro, Donggu, Gwangju, 501-757, South Korea.,Translational Research Center on Aging, Chonnam National University Hospital, 42 Jaebong-ro, Donggu, Gwangju, 501-757, South Korea
| | - Kye Hun Kim
- Department of Cardiovascular Medicine, Chonnam National University Hospital, 42 Jaebong-ro, Donggu, Gwangju, 501-757, South Korea. .,Translational Research Center on Aging, Chonnam National University Hospital, 42 Jaebong-ro, Donggu, Gwangju, 501-757, South Korea.
| | - Hyukjin Park
- Department of Cardiovascular Medicine, Chonnam National University Hospital, 42 Jaebong-ro, Donggu, Gwangju, 501-757, South Korea
| | - Jae Yeong Cho
- Department of Cardiovascular Medicine, Chonnam National University Hospital, 42 Jaebong-ro, Donggu, Gwangju, 501-757, South Korea.,Translational Research Center on Aging, Chonnam National University Hospital, 42 Jaebong-ro, Donggu, Gwangju, 501-757, South Korea
| | - Young Joon Hong
- Department of Cardiovascular Medicine, Chonnam National University Hospital, 42 Jaebong-ro, Donggu, Gwangju, 501-757, South Korea
| | - Hyung Wook Park
- Department of Cardiovascular Medicine, Chonnam National University Hospital, 42 Jaebong-ro, Donggu, Gwangju, 501-757, South Korea
| | - Ju Han Kim
- Department of Cardiovascular Medicine, Chonnam National University Hospital, 42 Jaebong-ro, Donggu, Gwangju, 501-757, South Korea
| | - Youngkeun Ahn
- Department of Cardiovascular Medicine, Chonnam National University Hospital, 42 Jaebong-ro, Donggu, Gwangju, 501-757, South Korea
| | - Myung Ho Jeong
- Department of Cardiovascular Medicine, Chonnam National University Hospital, 42 Jaebong-ro, Donggu, Gwangju, 501-757, South Korea
| | - Jeong Gwan Cho
- Department of Cardiovascular Medicine, Chonnam National University Hospital, 42 Jaebong-ro, Donggu, Gwangju, 501-757, South Korea.,Translational Research Center on Aging, Chonnam National University Hospital, 42 Jaebong-ro, Donggu, Gwangju, 501-757, South Korea
| | - Jong Chun Park
- Department of Cardiovascular Medicine, Chonnam National University Hospital, 42 Jaebong-ro, Donggu, Gwangju, 501-757, South Korea.,Translational Research Center on Aging, Chonnam National University Hospital, 42 Jaebong-ro, Donggu, Gwangju, 501-757, South Korea
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Subclinical Atherosclerosis Burden by 3D Ultrasound in Mid-Life. J Am Coll Cardiol 2017; 70:301-313. [DOI: 10.1016/j.jacc.2017.05.033] [Citation(s) in RCA: 69] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Revised: 05/05/2017] [Accepted: 05/12/2017] [Indexed: 11/21/2022]
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123
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Body mass index, carotid plaque, and clinical outcomes in patients with coronary artery disease. Coron Artery Dis 2017; 28:278-286. [DOI: 10.1097/mca.0000000000000467] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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124
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LeBlanc S, Bibeau K, Bertrand OF, Lévesque V, Deschênes St-Pierre B, Pibarot P, Després JP, Larose E. Carotid versus coronary atherosclerosis burdens in acute compared with chronic symptomatic coronary artery disease. Can J Physiol Pharmacol 2017; 95:878-887. [PMID: 28520469 DOI: 10.1139/cjpp-2016-0588] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Prediction of coronary events remains elusive. Carotid atherosclerosis may be a surrogate for coronary risk, as carotid and coronary diseases occur simultaneously - albeit at times with a weak association - depending on clinical presentation. We investigated carotid and coronary atherosclerosis in men with new-onset unstable coronary artery disease (CAD) presenting with acute ST-segment elevation myocardial infarction (STEMI) vs. long-standing severe chronic stable angina (CSA). Bilateral carotid artery and 3-vessel coronary artery atherosclerosis burdens were measured within 1 month, respectively, by 3D-volumetric carotid magnetic resonance imaging and coronary angiography-derived modified CASS-50 score. Men with STEMI (n = 50) and long-standing CSA (n = 50), matched for age, were enrolled (58.6 ± 8.8 years). All of them had carotid atherosclerosis. Atherosclerosis burden was greater in the carotid arteries of STEMI vs. CSA (wall volume: 196.2 ± 44.4 vs. 169.2 ± 38.0 mm3/4 mm, p = 0.002), but greater in the coronary arteries of CSA vs. STEMI (modified CASS-50 score: 3 vs. 1, p < 0.0001). Normalized wall index (NWI) of internal carotid was associated with modified CASS-50 score in STEMI (ρ = 0.40, p = 0.022) and in CSA (ρ = -0.39, p = 0.031). Carotid atherosclerosis was observed in all CAD patients, and atherosclerosis burden in carotid and in coronary arteries varied according to clinical presentation.
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Affiliation(s)
- Stéphanie LeBlanc
- a Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec - Université Laval, Québec City, QC G1V 4G5, Canada.,b Département de médecine, Faculté de médecine, Université Laval, Québec City, QC G1V 0A6, Canada
| | - Karine Bibeau
- a Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec - Université Laval, Québec City, QC G1V 4G5, Canada
| | - Olivier F Bertrand
- a Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec - Université Laval, Québec City, QC G1V 4G5, Canada.,b Département de médecine, Faculté de médecine, Université Laval, Québec City, QC G1V 0A6, Canada
| | - Valérie Lévesque
- a Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec - Université Laval, Québec City, QC G1V 4G5, Canada.,b Département de médecine, Faculté de médecine, Université Laval, Québec City, QC G1V 0A6, Canada
| | - Béatrice Deschênes St-Pierre
- a Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec - Université Laval, Québec City, QC G1V 4G5, Canada.,b Département de médecine, Faculté de médecine, Université Laval, Québec City, QC G1V 0A6, Canada
| | - Philippe Pibarot
- a Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec - Université Laval, Québec City, QC G1V 4G5, Canada.,b Département de médecine, Faculté de médecine, Université Laval, Québec City, QC G1V 0A6, Canada
| | - Jean-Pierre Després
- a Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec - Université Laval, Québec City, QC G1V 4G5, Canada.,b Département de médecine, Faculté de médecine, Université Laval, Québec City, QC G1V 0A6, Canada
| | - Eric Larose
- a Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec - Université Laval, Québec City, QC G1V 4G5, Canada.,b Département de médecine, Faculté de médecine, Université Laval, Québec City, QC G1V 0A6, Canada
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Sun K, Song J, Liu K, Fang K, Wang L, Wang X, Li J, Tang X, Wu Y, Qin X, Wu T, Gao P, Chen D, Hu Y. Associations between homocysteine metabolism related SNPs and carotid intima-media thickness: a Chinese sib pair study. J Thromb Thrombolysis 2017; 43:401-410. [PMID: 27822905 PMCID: PMC5337241 DOI: 10.1007/s11239-016-1449-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Carotid intima-media thickness (CIMT) is a good surrogate for atherosclerosis. Hyperhomocysteinemia is an independent risk factor for cardiovascular diseases. We aim to investigate the relationships between homocysteine (Hcy) related biochemical indexes and CIMT, the associations between Hcy related SNPs and CIMT, as well as the potential gene–gene interactions. The present study recruited full siblings (186 eligible families with 424 individuals) with no history of cardiovascular events from a rural area of Beijing. We examined CIMT, intima-media thickness for common carotid artery (CCA-IMT) and carotid bifurcation, tested plasma levels for Hcy, vitamin B6 (VB6), vitamin B12 (VB12) and folic acid (FA), and genotyped 9 SNPs on MTHFR, MTR, MTRR, BHMT, SHMT1, CBS genes. Associations between SNPs and biochemical indexes and CIMT indexes were analyzed using family-based association test analysis. We used multi-level mixed-effects regression model to verify SNP-CIMT associations and to explore the potential gene–gene interactions. VB6, VB12 and FA were negatively correlated with CIMT indexes (p < 0.05). rs2851391 T allele was associated with decreased plasma VB12 levels (p = 0.036). In FABT, CBS rs2851391 was significantly associated with CCA-IMT (p = 0.021) and CIMT (p = 0.019). In multi-level mixed-effects regression model, CBS rs2851391 was positively significantly associated with CCA-IMT (Coef = 0.032, se = 0.009, raw p < 0.001) after Bonferoni correction (corrected α = 0.0056). Gene–gene interactions were found between CBS rs2851391 and BHMT rs10037045 for CCA-IMT (p = 0.011), as well as between CBS rs2851391 and MTR rs1805087 for CCA-IMT (p = 0.007) and CIMT (p = 0.022). Significant associations are found between Hcy metabolism related genetic polymorphisms, biochemical indexes and CIMT indexes. There are complex interactions between genetic polymorphisms for CCA-IMT and CIMT.
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Affiliation(s)
- Kexin Sun
- Department of Epidemiology and Biostatistics, Peking University Health Science Center, 38 Xueyuan Road, Beijing, 100191, China
| | - Jing Song
- Department of Epidemiology and Biostatistics, Peking University Health Science Center, 38 Xueyuan Road, Beijing, 100191, China
| | - Kuo Liu
- Department of Epidemiology and Biostatistics, Capital Medical University, 10 You'anmenwai Xitoutiao, Beijing, 100069, China
| | - Kai Fang
- Beijing Center for Disease Prevention and Control, No.16 He Pingli Middle Street, Dongcheng District, Beijing, 100013, China
| | - Ling Wang
- Pingshan New District Center for Disease Control and Prevention, Shenzhen, 518118, Guangdong, China
| | - Xueyin Wang
- Department of Epidemiology and Biostatistics, Peking University Health Science Center, 38 Xueyuan Road, Beijing, 100191, China
| | - Jing Li
- Department of Epidemiology and Biostatistics, Peking University Health Science Center, 38 Xueyuan Road, Beijing, 100191, China
| | - Xun Tang
- Department of Epidemiology and Biostatistics, Peking University Health Science Center, 38 Xueyuan Road, Beijing, 100191, China
| | - Yiqun Wu
- Department of Epidemiology and Biostatistics, Peking University Health Science Center, 38 Xueyuan Road, Beijing, 100191, China
| | - Xueying Qin
- Department of Epidemiology and Biostatistics, Peking University Health Science Center, 38 Xueyuan Road, Beijing, 100191, China
| | - Tao Wu
- Department of Epidemiology and Biostatistics, Peking University Health Science Center, 38 Xueyuan Road, Beijing, 100191, China
| | - Pei Gao
- Department of Epidemiology and Biostatistics, Peking University Health Science Center, 38 Xueyuan Road, Beijing, 100191, China
| | - Dafang Chen
- Department of Epidemiology and Biostatistics, Peking University Health Science Center, 38 Xueyuan Road, Beijing, 100191, China
| | - Yonghua Hu
- Department of Epidemiology and Biostatistics, Peking University Health Science Center, 38 Xueyuan Road, Beijing, 100191, China.
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HOEHMANN CHRISTOPHERL, FUTTERMAN BENNETT, BEATTY BRIANLEE. Peripheral Arteries May Be Reliable Indicators of Coronary Vascular Disease. Anat Rec (Hoboken) 2017; 300:1230-1239. [DOI: 10.1002/ar.23584] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2016] [Revised: 12/20/2016] [Accepted: 01/03/2017] [Indexed: 01/13/2023]
Affiliation(s)
- CHRISTOPHER L. HOEHMANN
- Department of Anatomy; New York Institute of Technology College of Osteopathic Medicine; Old Westbury New York
| | - BENNETT FUTTERMAN
- Department of Anatomy; New York Institute of Technology College of Osteopathic Medicine; Old Westbury New York
| | - BRIAN LEE BEATTY
- Department of Anatomy; New York Institute of Technology College of Osteopathic Medicine; Old Westbury New York
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Ekin S, Arısoy A, Gunbatar H, Sertogullarindan B, Sunnetcioglu A, Sezen H, Asker S, Yıldız H. The relationships among the levels of oxidative and antioxidative parameters, FEV1 and prolidase activity in COPD. Redox Rep 2017; 22:74-77. [PMID: 26870880 PMCID: PMC6837489 DOI: 10.1080/13510002.2016.1139293] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
INTRODUCTION Chronic obstructive pulmonary disease (COPD) is a progressive condition characterized by poorly reversible airflow limitations associated with an abnormal inflammatory response of the lung. METHODS We investigated whether prolidase levels in serum, total antioxidant status, total oxidative status (TOS), and the oxidative stress index (OSI) were associated with the etiopathogenesis of COPD, and whether there is a relationship between prolidase activity and oxidative parameters and carotid artery intima-media thickness (CIMT) in patients with COPD. This study included 91 patients with COPD and 15 control cases. Routine haematological and biochemical parameters were determined in all patients. All subjects were fully informed about the study and provided consent. RESULTS The mean age of the patients with COPD was 61.3 ± 10.5 years and that of the control group was 56.2 ± 12.1 years. The control group had a significantly higher plasma prolidase level than that in the COPD group. TOS and OSI levels in the control group were significantly lower than those in the COPD group. However, no significant differences were found in TALs or CIMT levels between the COPD and control groups. A negative correlation was detected between prolidase activity and age; however, no significant difference in age was observed between the two groups. CONCLUSION These results indicate that prolidase activity decreases in patients with COPD.
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Affiliation(s)
- Selami Ekin
- Yuzuncu Yıl University, Pulmonary Medicine, 65080 Van, Turkey
| | - Ahmet Arısoy
- Yuzuncu Yıl University, Pulmonary Medicine, 65080 Van, Turkey
| | - Hulya Gunbatar
- Yuzuncu Yıl University, Pulmonary Medicine, 65080 Van, Turkey
| | | | | | - Hatice Sezen
- Department of Biochemistry, Harran University, Turkey
| | - Selvi Asker
- Yuzuncu Yıl University, Pulmonary Medicine, 65080 Van, Turkey
| | - Hanifi Yıldız
- Private Lokman Hekim Hospital, Pulmonary Medicine, Turkey
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128
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Kobayashi T, Yokokawa H, Fujibayashi K, Haniu T, Hisaoka T, Fukuda H, Naito T. Association between high cystatin C levels and carotid atherosclerosis. World J Cardiol 2017; 9:174-181. [PMID: 28289532 PMCID: PMC5329745 DOI: 10.4330/wjc.v9.i2.174] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2016] [Revised: 12/21/2016] [Accepted: 01/14/2017] [Indexed: 02/06/2023] Open
Abstract
AIM To investigate the association between carotid atherosclerosis and cystatin C (CysC) and to determine the optimal CysC cut-off value.
METHODS One hundred twenty-eight subjects were included in this study. Atherosclerosis was defined as a maximum carotid plaque thickness (MCPT) of greater than 2 mm. A receiver operating characteristic curve analysis was used to determine the diagnostic value of serum CysC for atherosclerosis. The subjects were divided into two groups according to the CysC cut-off value. We screened for diabetes, hypertension, dyslipidemia, smoking status, alcohol consumption, and exercise behavior. The association between atherosclerosis and CysC levels was assessed using multivariate analysis.
RESULTS The subjects were then divided into two groups according to the CysC cut-off value (0.73 mg/L). The median age of the high CysC group was 72 years (85% males), whereas that of the low CysC group was 61 years (63% males). The CysC levels were significantly correlated with Cr and estimated glomerular filtration rate (eGFR) values. Body-mass index, visceral fat area, hypertension, diabetes mellitus, and MCPT were significantly higher in the high CysC group than in the low CysC group. Furthermore, the eGFR was significantly lower in the high CysC group. Regarding lifestyle habits, only the exercise level was lower in the high CysC group than in the low CysC group. Multivariate analysis, adjusted for age and sex, revealed that high CysC levels were significantly associated with an MCPT of ≥ 2 mm (odds ratio: 2.92; 95%CI: 1.13-7.99).
CONCLUSION Higher CysC levels were associated with an MCPT of ≥ 2 mm. The CysC cut-off value of 0.73 mg/L appears to aid in the diagnosis of atherosclerosis.
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Mosepele M, Hemphill LC, Palai T, Nkele I, Bennett K, Lockman S, Triant VA. Cardiovascular disease risk prediction by the American College of Cardiology (ACC)/American Heart Association (AHA) Atherosclerotic Cardiovascular Disease (ASCVD) risk score among HIV-infected patients in sub-Saharan Africa. PLoS One 2017; 12:e0172897. [PMID: 28235058 PMCID: PMC5325544 DOI: 10.1371/journal.pone.0172897] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2016] [Accepted: 02/10/2017] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES HIV-infected patients are at increased risk for cardiovascular disease (CVD). However, general population CVD risk prediction equations that identify HIV-infected patients at elevated risk have not been widely assessed in sub-Saharan African (SSA). METHODS HIV-infected adults from 30-50 years of age with documented viral suppression were enrolled into a cross-sectional study in Gaborone, Botswana. Participants were screened for CVD risk factors. Bilateral carotid intima-media thickness (cIMT) was measured and 10-year predicted risk of cardiovascular disease was calculated using the Pooled Cohorts Equation for atherosclerotic CVD (ASCVD) and the 2008 Framingham Risk Score (FRS) (National Cholesterol Education Program III-NCEP III). ASCVD ≥7.5%, FRS ≥10%, and cIMT≥75th percentile were considered elevated risk for CVD. Agreement in classification of participants as high-risk for CVD by cIMT and FRS or ASCVD risk score was assessed using McNemar`s Test. The optimal cIMT cut off-point that matched ASCVD predicted risk of ≥7.5% was assessed using Youden's J index. RESULTS Among 208 HIV-infected patients (female: 55%, mean age 38 years), 78 (38%) met criteria for ASCVD calculation versus 130 (62%) who did not meet the criteria. ASCVD classified more participants as having elevated CVD risk than FRS (14.1% versus 2.6%, McNemar's exact test p = 0.01), while also classifying similar proportion of participants as having elevated CVD like cIMT (14.1% versus 19.2%, McNemar's exact test p = 0.34). Youden's J calculated the optimal cut point at the 81st percentile for cIMT to correspond to an ASCVD score ≥7.5% (sensitivity = 72.7% and specificity = 88.1% with area under the curve for the receiver operating characteristic [AUC] of 0.82, 95% Mann-Whitney CI: 0.66-0.99). CONCLUSION While the ASCVD risk score classified more patients at elevated CVD risk than FRS, ASCVD score classified similar proportion of patients as high risk when compared with established subclinical atherosclerosis. However, potential CVD risk category misclassification by established equations such as ASCVD may still exist among HIV-infected patients; hence there is still a need for development of a CVD risk prediction equation tailored to HIV-infected patients in SSA.
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Affiliation(s)
- Mosepele Mosepele
- Department of Medicine, Faculty of Medicine, University of Botswana, Gaborone, Botswana
- * E-mail:
| | - Linda C. Hemphill
- The Heart Center, Division of Cardiology, Massachusetts General Hospital & Harvard Medical School, Boston, Massachusetts, United States of America
| | - Tommy Palai
- Department of Medicine, Faculty of Medicine, University of Botswana, Gaborone, Botswana
| | - Isaac Nkele
- Botswana-Harvard AIDS Institute Partnership, Gaborone, Botswana
| | - Kara Bennett
- Bennett Statistical Consulting Inc, Ballston Lake, New York, United States of America
| | - Shahin Lockman
- Botswana-Harvard AIDS Institute Partnership, Gaborone, Botswana
- Division of Infectious Diseases, Brigham & Women`s Hospital, Boston, Massachusetts, United States of America
- Department of Immunology & Infectious Diseases, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Virginia A. Triant
- Division of General Internal Medicine & Division of Infectious Diseases, Massachusetts General Hospital & Harvard Medical School, Boston, Massachusetts, United States of America
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Pascual J, González I, Corona D, Hispán P, Ramos J, Sánchez-Paya J, Jemec G. Assessment of subclinical atherosclerosis in hidradenitis suppurativa. J Eur Acad Dermatol Venereol 2017; 31:1229-1238. [DOI: 10.1111/jdv.14076] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Accepted: 11/23/2016] [Indexed: 01/02/2023]
Affiliation(s)
- J.C. Pascual
- Department of Dermatology; Alicante University General Hospital; Alicante Institute for Health and Biomedical Research (ISABIAL-FISABIO Foundation); Alicante Spain
| | - I. González
- Department of Dermatology; Alicante University General Hospital; Alicante Institute for Health and Biomedical Research (ISABIAL-FISABIO Foundation); Alicante Spain
| | - D. Corona
- Department of Neurology; Alicante University General Hospital; Alicante Institute for Health and Biomedical Research (ISABIAL-FISABIO Foundation); Alicante Spain
| | - P. Hispán
- Department of Dermatology; Alicante University General Hospital; Alicante Institute for Health and Biomedical Research (ISABIAL-FISABIO Foundation); Alicante Spain
| | - J.M. Ramos
- Department of Internal Medicine; Alicante University General Hospital; Alicante Institute for Health and Biomedical Research (ISABIAL-FISABIO Foundation); Alicante Spain
| | - J. Sánchez-Paya
- Epidemiology Unit; Alicante University General Hospital; Alicante Institute for Health and Biomedical Research (ISABIAL-FISABIO Foundation); Alicante Spain
| | - G.B. Jemec
- Department of Dermatology; Zealand University Hospital Roskilde; Health Sciences Faculty; University of Copenhagen; Copenhagen Denmark
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Diagnostic accuracy of carotid intima media thickness in predicting coronary plaque burden on coronary computed tomography angiography in patients with obstructive sleep apnoea. J Cardiovasc Comput Tomogr 2017; 11:227-233. [PMID: 28229911 DOI: 10.1016/j.jcct.2017.02.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Revised: 02/03/2017] [Accepted: 02/07/2017] [Indexed: 01/07/2023]
Abstract
AIM To assess the diagnostic accuracy of common carotid artery intima media thickness (CIMT) for coronary artery disease (CAD) detection in patients with obstructive sleep apnoea (OSA). MATERIALS & METHODS Patients with clinically suspected OSA prospectively underwent polysomnography (PSG), ultrasound CIMT measurement and coronary computed tomography angiography (CTA). An average CIMT of ≥0.9 mm in either common carotid artery designated as a positive test. Coronary CTA was the reference standard for the presence of CAD. Coronary plaque presence, volume, density and type were correlated with CIMT findings. RESULTS 35 consecutive male patients were enrolled from sleep clinic. Two patients had no evidence of OSA on PSG (apnoea-hypopnea index [AHI]<5/hr), and were excluded. Of the remaining 33, 18 (54%) had mild-moderate OSA (AHI 5-30/hr) and 15 (46%) had severe OSA (AHI >30/hr). Eight (24%) patients had CAD on coronary CTA. Coronary plaques were predominantly non- or partly calcified, and located in proximal coronary artery segments. Sensitivity, specificity, positive and negative predictive and likelihood ratios for a positive CIMT (≥0.9 mm) in diagnosing CAD were 0.5 (95% confidence interval: 0.76-0.12), 0.96 (1-0.89), 80, 85.7, 12.5 and 0.52 respectively. The adjusted odds ratio was 40.8. CONCLUSION In patients with OSA, CIMT is a highly specific but poorly sensitive test for detecting CAD.
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Bots ML, Evans GW, Tegeler CH, Meijer R. Carotid Intima-media Thickness Measurements: Relations with Atherosclerosis, Risk of Cardiovascular Disease and Application in Randomized Controlled Trials. Chin Med J (Engl) 2017; 129:215-26. [PMID: 26830994 PMCID: PMC4799550 DOI: 10.4103/0366-6999.173500] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Advances in the field of carotid ultrasound have been incremental, resulting in a steady decrease in measurement variability. Improvements in edge detection algorithms point toward increasing automation of CIMT measurements. The major advantage of CIMT is that it is completely noninvasive and can be repeated as often as required. It provides a continuous measure since all subjects have a measurable carotid wall. It is also relatively inexpensive to perform, and the technology is widely available. A graded relation between raising LDL cholesterol and increased CIMT is apparent. Increased CIMT has been shown consistently to relate the atherosclerotic abnormalities elsewhere in the arterial system. Moreover, increased CIMT predicts future vascular events in both populations from Caucasian ancestry and those from Asian ancestry. Furthermore, lipid‑lowering therapy has been shown to affect CIMT progression within 12–18 months in properly designed trials with results congruent with clinical events trials. In conclusion, when one wants to evaluate the effect of a pharmaceutical intervention that is to be expected to beneficially affect atherosclerosis progression and to reduce CV event risk, the use of CIMT measurements over time is a valid, suitable, and evidence‑based choice.
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Affiliation(s)
- Michiel L Bots
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
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Stroescu R, Bizerea T, Doroş G, Marazan M, Lesovici M, Mãrginean O. Correlation between adipokines and carotid intima media thickness in a group of obese Romanian children: is small for gestational age status an independent factor for cardiovascular risk? ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2017; 61:14-20. [PMID: 27598978 PMCID: PMC10522116 DOI: 10.1590/2359-3997000000201] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Accepted: 03/06/2016] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To investigate the relationship between markers of adiposity and common carotid artery (CIMT) in obese children born small for gestational age (SGA) versus appropriate for gestational age (AGA), to establish cut-off values for CIMT in obese pediatric populations. SUBJECTS AND METHODS A cross-sectional study was carried out over a 1-year period (Jul 2013 - June 2014). We analyzed 122 obese patients aged 4-20 (mean age 14.9 ± 2.28). Twenty-six patients were born SGA. CIMT was measured in all the patients. Using ROC curve, cut-off values were obtained for both groups. RESULTS We demonstrated a correlation between CIMT and adiponectin, leptin and high sensitivity C-reactive protein (hsCRP) (r = -0.25, r = 0.279, r = 0.498) in obese children. CIMT in obese children born SGA were significantly increased as compared with obese children born AGA of similar age, sex and body mass index (BMI) (p = 0.0035). A CIMT cut off value of 0.049 cm has been obtained with a high sensitivity and specificity. CONCLUSION CIMT is a well-known marker of subclinical atherosclerosis and its measurement is a noninvasive and inexpensive method of detecting subclinical atherosclerosis. Being born SGA increases the atherogenic risk. Obese children with CIMT above 0.049 cm should be screened for metabolic syndrome (MetS).
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Affiliation(s)
- Ramona Stroescu
- “Louis Turcanu” Emergency Hospital for ChildrenTimişoaraRomânia“Louis Turcanu” Emergency Hospital for Children, Timişoara, România
- “Victor Babes” University of Medicine and PharmacyTimişoaraRomânia“Victor Babes” University of Medicine and Pharmacy, Timişoara, România
| | - Teofana Bizerea
- “Louis Turcanu” Emergency Hospital for ChildrenTimişoaraRomânia“Louis Turcanu” Emergency Hospital for Children, Timişoara, România
- “Victor Babes” University of Medicine and PharmacyTimişoaraRomânia“Victor Babes” University of Medicine and Pharmacy, Timişoara, România
| | - Gabriela Doroş
- “Louis Turcanu” Emergency Hospital for ChildrenTimişoaraRomânia“Louis Turcanu” Emergency Hospital for Children, Timişoara, România
- “Victor Babes” University of Medicine and PharmacyTimişoaraRomânia“Victor Babes” University of Medicine and Pharmacy, Timişoara, România
| | - Monica Marazan
- “Louis Turcanu” Emergency Hospital for ChildrenTimişoaraRomânia“Louis Turcanu” Emergency Hospital for Children, Timişoara, România
| | - Maria Lesovici
- “Louis Turcanu” Emergency Hospital for ChildrenTimişoaraRomânia“Louis Turcanu” Emergency Hospital for Children, Timişoara, România
| | - Otilia Mãrginean
- “Louis Turcanu” Emergency Hospital for ChildrenTimişoaraRomânia“Louis Turcanu” Emergency Hospital for Children, Timişoara, România
- “Victor Babes” University of Medicine and PharmacyTimişoaraRomânia“Victor Babes” University of Medicine and Pharmacy, Timişoara, România
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134
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Zhao W, Wu Y, Shi M, Bai L, Tu J, Guo Z, Jiang R, Zhang J, Ning X, Wang J. Sex Differences in Prevalence of and Risk Factors for Carotid Plaque among Adults: A Population-based Cross-Sectional Study in Rural China. Sci Rep 2016; 6:38618. [PMID: 27922121 PMCID: PMC5138635 DOI: 10.1038/srep38618] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Accepted: 11/11/2016] [Indexed: 01/07/2023] Open
Abstract
Although the associations between carotid plaque and cardiovascular disease risk factors have been identified in previous studies, there is limited information on sex-related differences in factors associated with the development of carotid plaque. We aimed to determine sex differences in the prevalence of carotid plaque and associated risk factors in rural China. A total of 3,789 subjects aged ≥45 years without history of stroke or cardiovascular disease were recruited to the study. B-mode ultrasonography was performed to determine the presence of carotid plaque. The mean age of male subjects was greater than that of female subjects. In addition, there was a higher prevalence of carotid plaque in men than in women (50.1% vs. 35.5%; P < 0.001) irrespective of age group, education level, and presence of risk factors. Older age, hypertension, diabetes mellitus, and high concentrations of low-density lipoprotein cholesterol were pronouncedly associated with the risk of carotid plaque in both men and women. These findings suggest that it is vital for physicians to be aware that conventional risk factors and other related factors are of equal importance among rural residents in China; patients should thus be treated accordingly so that reduce the burden of stroke and cardiovascular disease.
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Affiliation(s)
- Wei Zhao
- Department of Neurology, Tianjin TEDA Hospital, Tianjin, 300457, China
| | - Yanan Wu
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, 300052, China.,Department of Epidemiology, Tianjin Neurological Institute, Tianjin 300052, China
| | - Min Shi
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, 300052, China.,Department of Epidemiology, Tianjin Neurological Institute, Tianjin 300052, China
| | - Lingling Bai
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, 300052, China.,Department of Epidemiology, Tianjin Neurological Institute, Tianjin 300052, China
| | - Jun Tu
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, 300052, China.,Department of Epidemiology, Tianjin Neurological Institute, Tianjin 300052, China
| | - Zaiyu Guo
- Department of Neurology, Tianjin TEDA Hospital, Tianjin, 300457, China
| | - Rongcai Jiang
- Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin 300052, China.,Department of Neurotrauma, Tianjin Neurological Institute, Tianjin 300052, China
| | - Jianning Zhang
- Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin 300052, China.,Department of Neurotrauma, Tianjin Neurological Institute, Tianjin 300052, China.,Center of Clinical Epidemiology, Tianjin Medical University General Hospital, Tianjin, 300052, China
| | - Xianjia Ning
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, 300052, China.,Department of Epidemiology, Tianjin Neurological Institute, Tianjin 300052, China.,Center of Clinical Epidemiology, Tianjin Medical University General Hospital, Tianjin, 300052, China
| | - Jinghua Wang
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, 300052, China.,Department of Epidemiology, Tianjin Neurological Institute, Tianjin 300052, China.,Center of Clinical Epidemiology, Tianjin Medical University General Hospital, Tianjin, 300052, China
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135
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Zaid M, Fujiyoshi A, Kadota A, Abbott RD, Miura K. Coronary Artery Calcium and Carotid Artery Intima Media Thickness and Plaque: Clinical Use in Need of Clarification. J Atheroscler Thromb 2016; 24:227-239. [PMID: 27904029 PMCID: PMC5383538 DOI: 10.5551/jat.rv16005] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Atherosclerosis begins in early life and has a long latent period prior to onset of clinical disease. Measures of subclinical atherosclerosis, therefore, may have important implications for research and clinical practice of atherosclerotic cardiovascular disease (ASCVD). In this review, we focus on coronary artery calcium (CAC) and carotid artery intima-media thickness (cIMT) and plaque as many population-based studies have investigated these measures due to their non-invasive features and ease of administration. To date, a vast majority of studies have been conducted in the US and European countries, in which both CAC and cIMT/plaque have been shown to be associated with future risk of ASCVD, independent of conventional risk factors. Furthermore, these measures improve risk prediction when added to a global risk prediction model, such as the Framingham risk score. However, no clinical trial has assessed whether screening with CAC or cIMT/plaque will lead to improved clinical outcomes and healthcare costs. Interestingly, similar levels of CAC or cIMT/plaque among various regions and ethnic groups may in fact be associated with significantly different levels of absolute risk of ASCVD. Therefore, it remains to be determined whether measures of subclinical atherosclerosis improve risk prediction in non-US/European populations. Although CAC and cIMT/plaque are promising surrogates of ASCVD in research, we conclude that their use in clinical practice, especially as screening tools for primary prevention in asymptomatic adults, is premature due to many vagaries that remain to be clarified.
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Affiliation(s)
- Maryam Zaid
- Center for Epidemiologic Research in Asia, Shiga University of Medical Science
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136
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Sturlaugsdottir R, Aspelund T, Bjornsdottir G, Sigurdsson S, Thorsson B, Eiriksdottir G, Gudnason V. Prevalence and determinants of carotid plaque in the cross-sectional REFINE-Reykjavik study. BMJ Open 2016; 6:e012457. [PMID: 27884845 PMCID: PMC5168519 DOI: 10.1136/bmjopen-2016-012457] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVE Carotid plaque and intima-media thickness are non-invasive arterial markers that are used as surrogate end points for cardiovascular disease. The aim was to assess the prevalence and severity of carotid plaque, and examine its determinant risk factors and their association to the common carotid artery intima-media thickness (CCA-IMT) in a general population. METHODS We examined 6524 participants aged 25-69 years in the population-based REFINE (Risk Evaluation For INfarct Estimates)-Reykjavik study. Plaques at the bifurcation and internal carotid arteries were evaluated. Mean CCA-IMT was measured in the near and far walls of the common carotid arteries. RESULTS The prevalence of minimal, moderate and severe plaque was 35.0%, 8.9% and 1.1%, respectively, and the mean CCA-IMT was 0.73 (SD 0.14) mm. Age, sex, smoking and type 2 diabetes mellitus (T2DM) were the strongest risk factors associated with plaque, followed by systolic blood pressure, total cholesterol, body mass index and family history of myocardial infarct. Low educational level was also strongly and independently associated with plaque. CCA-IMT shared the same risk factors except for a non-significant association with T2DM and family history of myocardial infarction (MI). Participants with T2DM had greater plaque prevalence, 2-fold higher in those <50 years and 17-30% greater in age groups 50-54 to 60-64, and more significant plaques (moderate or severe) were the difference in prevalence was 24% in age group 50-54 and ≥60% in older age groups, compared with non-T2DM. CONCLUSIONS Carotid plaque and CCA-IMT have mostly common determinants. However, T2DM and family history of MI were associated with plaque but not with CCA-IMT. Greater prevalence and more severe plaques in individuals with T2DM raise the concern that with increasing prevalence of T2DM we may expect an increase in atherosclerosis and its consequences.
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Affiliation(s)
- Ran Sturlaugsdottir
- Icelandic Heart Association, Kopavogur, Iceland
- University of Iceland, Reykjavik, Iceland
| | - Thor Aspelund
- Icelandic Heart Association, Kopavogur, Iceland
- University of Iceland, Reykjavik, Iceland
| | - Gudlaug Bjornsdottir
- Icelandic Heart Association, Kopavogur, Iceland
- University of Iceland, Reykjavik, Iceland
| | | | | | | | - Vilmundur Gudnason
- Icelandic Heart Association, Kopavogur, Iceland
- University of Iceland, Reykjavik, Iceland
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137
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Plaque surface irregularity and calcification length within carotid plaque predict secondary events in patients with coronary artery disease. Atherosclerosis 2016; 256:29-34. [PMID: 27998824 DOI: 10.1016/j.atherosclerosis.2016.11.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Revised: 10/13/2016] [Accepted: 11/08/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND AND AIMS Although comprehensive risk factor modification is recommended, a uniform management strategy does not necessarily prevent secondary events in patients with coronary artery disease (CAD). Therefore, identification of high-risk patients who may benefit from more intensive interventions may improve prognosis. Carotid ultrasound can reliably identify systemic atherosclerosis, and carotid plaque and intima-media thickness (IMT) are known independent risk factors for CAD. However, it is unclear whether findings on carotid ultrasound can improve prediction of secondary CAD events. METHODS The study population comprised 146 consecutive patients with CAD (mean age, 66 ± 9 years; 126 with angina pectoris, 20 with acute myocardial infarction). IMT, plaque score, plaque area, plaque surface irregularity, and calcification length (calculated by summing the calcified lesions within each plaque accompanied by acoustic shadow) were measured at baseline. Patients were followed for 10 years to ascertain secondary CAD events defined as hard major adverse cardiovascular events (MACE; cardiac death and acute myocardial infarction) and as total MACE (hard MACE and angina pectoris with coronary revascularization). RESULTS Multiple regression analysis demonstrated that calcification length (p < 0.05) and plaque surface irregularity (p < 0.01) remained independently associated with total MACE after adjustment for age, sex, diabetes mellitus, dyslipidemia, hypertension, chronic kidney disease, smoking, and multivessel CAD. CONCLUSIONS These findings suggest that the combination of calcification length and plaque surface irregularity has additional value beyond traditional risk classification. Intensive intervention for these high-risk patients may avoid or delay progression of atherosclerosis towards secondary CAD events.
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138
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Pelisek J, Wendorff H, Wendorff C, Kuehnl A, Eckstein HH. Age-associated changes in human carotid atherosclerotic plaques. Ann Med 2016; 48:541-551. [PMID: 27595161 DOI: 10.1080/07853890.2016.1204468] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Little is known about changes in carotid plaque morphology during aging and the possible impact on cardiovascular events. Only few studies addressed so far age-related modifications within atherosclerotic lesions. Therefore, in this work we endeavored to summarize the current knowledge about changing of plaque composition in elderly. The data from hitherto existing studies confirm that atherosclerotic plaques undergo distinct alternations with advanced age. However, the results are often ambiguous and the changes do not seem to be as disastrous as expected. Interestingly, none of the studies could definitely evidence increased plaque vulnerability with advanced age. Nevertheless, based on the previous work showing decrease in elastin fibers, fibroatheroma, SMCs, overall cellularity and increase in the area of lipid core, hemorrhage, and calcification, the plaque morphology appears to transform toward unstable plaques. Otherwise, even if inflammatory cells often accumulate in plaques of younger patients, their amount is reduced in the older age and so far no clear association has been observed between thin fibrous cap and aging. Thus, the accurate contribution of age-related changes in plaque morphology to cardiovascular events has yet to be elucidated. KEY MESSAGES Composition of carotid atherosclerotic lesions changes during aging. These alternations are however, just moderate and depend upon additional variables, such as life style, accompanying disease, genetics, and other factors that have yet to be determined. Based on the current data, the age-associated plaque morphology seems to transform toward vulnerable plaques. However, the changes do not seem to be as disastrous as expected.
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Affiliation(s)
- Jaroslav Pelisek
- a Department of Vascular and Endovascular Surgery , Klinikum rechts der Isar der Technischen Universitaet Muenchen , Munich , Germany
| | - Heiko Wendorff
- a Department of Vascular and Endovascular Surgery , Klinikum rechts der Isar der Technischen Universitaet Muenchen , Munich , Germany
| | - Carina Wendorff
- a Department of Vascular and Endovascular Surgery , Klinikum rechts der Isar der Technischen Universitaet Muenchen , Munich , Germany
| | - Andreas Kuehnl
- a Department of Vascular and Endovascular Surgery , Klinikum rechts der Isar der Technischen Universitaet Muenchen , Munich , Germany
| | - Hans-Henning Eckstein
- a Department of Vascular and Endovascular Surgery , Klinikum rechts der Isar der Technischen Universitaet Muenchen , Munich , Germany
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139
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Mazlan SA, bin Mohamed Said MS, Hussein H, binti Shamsuddin K, Shah SA, Basri H. A Study of Intima Media Thickness and Their Cardiovascular Risk Factors in Patients with Psoriatic Arthritis. ACTA MEDICA (HRADEC KRÁLOVÉ) 2016; 52:107-16. [DOI: 10.14712/18059694.2016.114] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Introduction: Psoriatic Arthritis (PsA) is an inflammatory arthritis associated with Psoriasis. Its recognition as an inflammatory disease distinct from Rheumatoid Arthritis has put forward for consideration several questions regarding its specific CVS mortality and morbidity (9, 11, 16, 26). Carotid intima media thickness is a useful surrogate and sensitive marker to determine atherosclerosis even in its subclinical stages (6, 14, 22, 27, 32). Objective: Prevalence of carotid intima media thickness in patients with Psoriatic arthritis is unknown in Asian population. We aim to identify the presence of subclinical atherosclerosis in patients with psoriatic arthritis and disease activity association and its predictors in a series of patients with PsA attended to the rheumatology clinic, tertiary hospitals. Methods: A total of 63 patients with PsA who fulfilled the CASPAR criteria were recruited from UKM Medical Centre and Hospital Putrajaya. Common carotid intima media thickness (IMT) was measured in both right and left carotid artery by using high resolution B-mode ultrasound. This was a cross sectional study first done in Malaysia for PsA patients. Results: The positive IMT (IMT >1.00 mm) among PsA was observed in 10 out of 63 patients (15.9 %) regardless of background cardiovascular risk. The mean±SD of IMT was 0.725 ±0.260 mm for this study. Variables significantly associated with positive IMT (p<0.05) included age at the time of study (p=0.005), waist circumference (p=0.001), Hypertension (p=0.007), Diabetes (p=0.002) and Metabolic syndrome (p=0.001) and not associated with gender, ethnicity, duration of PsA disease, pattern of PsA, disease activity and severity. Above all, only age had positive IMT independent predictor (p=0.032), with OR 1.116; 95 % CI (1.010–1.234). Conclusions: There was a significant association between CVS risk and positive Intima Media Thickness in Psoriatic Arthritis patients. Otherwise, there was no association in disease activity, disease severity and DMARDS therapy with positive Intima Media Thickness in Psoriatic Arthritis patients. The study was approved by Research and Ethics Committee of the faculty of medicine, Universiti Kebangsaan Malaysia with project code FF-114-2008 and by Community Research Center (CRC) of National Institutes of Health (NIH) for the case study in Hospital Putrajaya with the project code NMRR-08- 970-2125.
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140
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Schmidt C, Bergström G. Carotid Artery Intima-Media Thickness Predicts Major Cardiovascular Events During 7-Year Follow-Up in 64-Year-Old Women Irrespective of Other Glucometabolic Factors. Angiology 2016; 68:553-558. [PMID: 27729556 DOI: 10.1177/0003319716672526] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Cardiovascular (CV) disease (CVD) is a leading cause of morbidity and mortality worldwide. Most CV events are caused by atherosclerosis. Diabetes and impaired glucose tolerance are associated with greater carotid intima-media thickness (IMT) and increased risk for CVD. The present study examined if common carotid artery IMT (CCAIMT) is predictive of CVD irrespective of glucose tolerance category and glycated hemoglobin (HbA1c) in a sample of 639 women with different glucose tolerance categories. During 7-year follow-up, 30 events in the cardiac and 32 events in the cerebral territory were documented. Unadjusted Cox hazard models showed that CCAIMT, glucose tolerance category, and HbA1c were associated with increased risk. An adjusted and extended model, including CCAIMT, glucose tolerance category, and HbA1c, showed that CCAIMT was still associated with events with an almost unchanged hazard ratio. In conclusion, this study suggests that CCAIMT is predictive of major CV events during 7-year follow-up, irrespective of glucose tolerance category, HbA1c, and other established risk factors in a cohort of 64-year-old women.
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Affiliation(s)
- Caroline Schmidt
- 1 Department of Molecular and Clinical Medicine, Wallenberg Laboratory for Cardiovascular and Metabolic Research, University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Göran Bergström
- 1 Department of Molecular and Clinical Medicine, Wallenberg Laboratory for Cardiovascular and Metabolic Research, University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden
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141
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Wyman RA, Mays ME, McBride PE, Stein JH. Ultrasound-detected carotid plaque as a predictor of cardiovascular events. Vasc Med 2016; 11:123-30. [PMID: 16886843 DOI: 10.1191/1358863x06vm666ra] [Citation(s) in RCA: 67] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Ultrasound detection of carotid plaque can be performed with equipment that is available in many clinical settings and can identify patients at increased risk of cardiovascular (CV) disease. We reviewed the literature to determine the CV risk factors associated with the presence of carotid plaque and whether its presence is associated with the presence and extent of coronary artery disease. A MEDLINE search subsequently was performed to determine whether carotid plaque burden predicts future CV events. Studies that had more than 300 subjects and reported hazard ratios or relative risk estimates for CV events, or data from which these values could be calculated, were included. References from identified studies also were examined for inclusion in the review. Nine studies met these criteria. Although there was not a uniform definition of carotid plaque, eight studies found that the presence of carotid plaque predicted incident CV death and/or myocardial infarction. In several studies, this relationship persisted after adjustments for risk factors. Ultrasound detection of carotid plaque is a straightforward, inexpensive, and safe tool that has the potential to be used in an office setting to help clarify a patient’s CV risk.
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Affiliation(s)
- Rachael A Wyman
- Cardiovascular Medicine Division, University of Wisconsin Medical School, Madison, Wisconsin, USA
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142
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Wierzbowska-Drabik K, Cygulska K, Cieślik-Guerra U, Uznańska-Loch B, Rechciński T, Trzos E, Kurpesa M, Kasprzak JD. Circumferential strain of carotid arteries does not differ between patients with advanced coronary artery disease and group without coronary stenoses. Adv Med Sci 2016; 61:203-206. [PMID: 26890558 DOI: 10.1016/j.advms.2015.12.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Revised: 10/24/2015] [Accepted: 12/28/2015] [Indexed: 10/22/2022]
Abstract
PURPOSE Speckle tracking echocardiography is widely used for the analysis of myocardial function. Recently, circumferential strain (CS) of carotid arteries was postulated as novel indicator of vascular function. Our aim was to characterize and compare CS of carotid arteries in patients with advanced coronary artery disease and controls without significant coronary stenoses. PATIENTS/METHODS We compared CS of both common carotid arteries (CCA) in the 25 patients with three-vessel coronary artery disease (3VD) (mean age 69±9 years, 9 male) and in 16 age-matched subjects without significant coronary lesions (C) (69±8 years, 7 male). Additionally in 11 patients we estimated pulse wave velocity (PWV) and assessed the correlation between PWV and CS. Short-axis images of arteries were acquired for strain analysis with linear probe of echocardiograph. The assessment of CS was performed off-line by two observers. RESULTS The intraobserver variability for the CS (coefficient of variation) were 4.9 and 5.4% for left and right CCA and interobserver variability were 11.7% and 12.5%, respectively. The mean CS for left and right CCA did not differ between compared groups. We did not find correlation between CS strain and PWV. The only difference was related to the more prevalent plaque presence and thicker intima-media complex (IMT) in 3VD (p=0.0039 for IMT of left CCA and p=0.016 for IMT of right CCA). CONCLUSIONS The global CS of CCA, contrary to IMT, did not allow for differentiation between 3VD and C subjects. Despite good feasibility and concordance of CS measurements its clinical significance remains to be established.
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143
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Carotid intima–media thickness, nonalcoholic fatty liver disease, and hemoglobin A1c are independently associated with the severity of psoriasis. DERMATOL SIN 2016. [DOI: 10.1016/j.dsi.2016.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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144
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Cohen-Manheim I, Pinchas-Mizrachi R, Doniger GM, Simon ES, Sinnreich R, Kark JD. Measures of carotid atherosclerosis and cognitive function in midlife: The Jerusalem LRC longitudinal study. INTELLIGENCE 2016. [DOI: 10.1016/j.intell.2016.05.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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145
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McAllister DA, Newby DE. Association between Impaired Lung Function and Cardiovascular Disease. Cause, Effect, or Force of Circumstance? Am J Respir Crit Care Med 2016; 194:3-5. [DOI: 10.1164/rccm.201601-0167ed] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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146
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Chen Z, Wang F, Zheng Y, Zeng Q, Liu H. H-type hypertension is an important risk factor of carotid atherosclerotic plaques. Clin Exp Hypertens 2016; 38:424-8. [PMID: 27359263 DOI: 10.3109/10641963.2015.1116547] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Affiliation(s)
- Zhilai Chen
- Health Management Institute, The General Hospital of Chinese People’s Liberation Army, Beijing, China
| | - Fan Wang
- Department of Geriatric Cardiology, The General Hospital of Chinese People’s Liberation Army, Beijing, China
| | - Yansong Zheng
- Health Management Institute, The General Hospital of Chinese People’s Liberation Army, Beijing, China
| | - Qiang Zeng
- Health Management Institute, The General Hospital of Chinese People’s Liberation Army, Beijing, China
| | - Huijun Liu
- Health Management Institute, The General Hospital of Chinese People’s Liberation Army, Beijing, China
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147
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Roman MJ, Naqvi TZ, Gardin JM, Gerhard-Herman M, Jaff M, Mohler E. American Society of Echocardiography Report. Vasc Med 2016; 11:201-11. [PMID: 17288128 DOI: 10.1177/1358863x06070511] [Citation(s) in RCA: 82] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Noninvasive measures of atherosclerosis have emerged as adjuncts to standard cardiovascular disease (CVD) risk factors in an attempt to refine risk stratification and the need for more aggressive preventive strategies. Two such approaches, carotid artery imaging and brachial artery reactivity testing (BART), are ultrasound based. Numerous carotid artery imaging protocols have been used, and methodologic aspects are described in detail in this review. The panel recommends that protocols: (1) use end-diastolic (minimum dimension) images for intimal-medial thickness (IMT) measurements; (2) provide separate categorization of plaque presence and IMT; (3) avoid use of a single upper limit of normal for IMT because the measure varies with age, sex, and race; and (4) incorporate lumen measurement, particularly when serial measurements are performed to account for changes in distending pressure. Protocols may vary in the number of segments wherein IMT is measured, whether near wall is measured in addition to far wall, and whether IMT measurements are derived from B-mode or M-mode images, depending on the application. BART is a technique that requires meticulous attention to patient preparation and methodologic detail. Its application is substantially more challenging than is carotid imaging and remains largely a research technique that is not readily translated into routine clinical practice.
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Affiliation(s)
- Mary J Roman
- Weill Medical College of Cornell University, New York, NY, USA.
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Kim DS, Li YK, Bell GA, Burt AA, Vaisar T, Hutchins PM, Furlong CE, Otvos JD, Polak JF, Arnan MK, Kaufman JD, McClelland RL, Longstreth WT, Jarvik GP. Concentration of Smaller High-Density Lipoprotein Particle (HDL-P) Is Inversely Correlated With Carotid Intima Media Thickening After Confounder Adjustment: The Multi Ethnic Study of Atherosclerosis (MESA). J Am Heart Assoc 2016; 5:e002977. [PMID: 27207961 PMCID: PMC4889175 DOI: 10.1161/jaha.115.002977] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Accepted: 04/12/2016] [Indexed: 12/17/2022]
Abstract
BACKGROUND Recent studies have failed to establish a causal relationship between high-density lipoprotein cholesterol levels (HDL-C) and cardiovascular disease (CVD), shifting focus to other HDL measures. We previously reported that smaller/denser HDL levels are protective against cerebrovascular disease. This study sought to determine which of small+medium HDL particle concentration (HDL-P) or large HDL-P was more strongly associated with carotid intima-media thickening (cIMT) in an ethnically diverse cohort. METHODS AND RESULTS In cross-sectional analyses of participants from the Multi Ethnic Study of Atherosclerosis (MESA), we evaluated the associations of nuclear magnetic resonance spectroscopy-measured small+medium versus large HDL-P with cIMT measured in the common and internal carotid arteries, through linear regression. After adjustment for CVD confounders, low-density lipoprotein cholesterol (LDL-C), HDL-C, and small+medium HDL-P remained significantly and inversely associated with common (coefficient=-1.46 μm; P=0.00037; n=6512) and internal cIMT (coefficient=-3.82 μm; P=0.0051; n=6418) after Bonferroni correction for 4 independent tests (threshold for significance=0.0125; α=0.05/4). Large HDL-P was significantly and inversely associated with both cIMT outcomes before HDL-C adjustment; however, after adjustment for HDL-C, the association of large HDL-P with both common (coefficient=1.55 μm; P=0.30; n=6512) and internal cIMT (coefficient=4.84 μm; P=0.33; n=6418) was attenuated. In a separate sample of 126 men, small/medium HDL-P was more strongly correlated with paraoxonase 1 activity (rp=0.32; P=0.00023) as compared to both total HDL-P (rp=0.27; P=0.0024) and large HDL-P (rp=0.02; P=0.41) measures. CONCLUSIONS Small+medium HDL-P is significantly and inversely correlated with cIMT measurements. Correlation of small+medium HDL-P with cardioprotective paraoxonase 1 activity may reflect a functional aspect of HDL responsible for this finding.
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Affiliation(s)
- Daniel Seung Kim
- Division of Medical Genetics, Department of Medicine, University of Washington School of Medicine, Seattle, WA Department of Genome Sciences, University of Washington School of Medicine, Seattle, WA Department of Biostatistics, University of Washington School of Public Health, Seattle, WA
| | - Yatong K Li
- Department of Biostatistics, University of Washington School of Public Health, Seattle, WA
| | - Griffith A Bell
- Department of Epidemiology, University of Washington School of Public Health, Seattle, WA
| | - Amber A Burt
- Division of Medical Genetics, Department of Medicine, University of Washington School of Medicine, Seattle, WA
| | - Tomas Vaisar
- Division of Metabolism, Endocrinology, and Nutrition, Department of Medicine, University of Washington School of Medicine, Seattle, WA
| | - Patrick M Hutchins
- Division of Metabolism, Endocrinology, and Nutrition, Department of Medicine, University of Washington School of Medicine, Seattle, WA TSI Incorporated, Shoreview, MN
| | - Clement E Furlong
- Division of Medical Genetics, Department of Medicine, University of Washington School of Medicine, Seattle, WA Department of Genome Sciences, University of Washington School of Medicine, Seattle, WA
| | | | - Joseph F Polak
- Department of Radiology, Tufts University School of Medicine, Boston, MA
| | | | - Joel D Kaufman
- Division of General Medicine, Department of Medicine, University of Washington School of Medicine, Seattle, WA Department of Epidemiology, University of Washington School of Public Health, Seattle, WA Department of Environmental and Occupational Health Sciences, University of Washington School of Public Health, Seattle, WA
| | - Robyn L McClelland
- Department of Biostatistics, University of Washington School of Public Health, Seattle, WA
| | - W T Longstreth
- Department of Neurology, Wake Forest School of Medicine, Winston-Salem, NC Department of Epidemiology, University of Washington School of Public Health, Seattle, WA
| | - Gail P Jarvik
- Division of Medical Genetics, Department of Medicine, University of Washington School of Medicine, Seattle, WA Department of Genome Sciences, University of Washington School of Medicine, Seattle, WA
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149
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Aizawa K, Elyas S, Adingupu DD, Casanova F, Gooding KM, Shore AC, Strain WD, Gates PE. Echogenicity of the Common Carotid Artery Intima-Media Complex in Stroke. ULTRASOUND IN MEDICINE & BIOLOGY 2016; 42:1130-1137. [PMID: 26944528 DOI: 10.1016/j.ultrasmedbio.2016.01.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Revised: 12/18/2015] [Accepted: 01/12/2016] [Indexed: 06/05/2023]
Abstract
The grey-scale median of the common carotid artery intima-media complex (IM-GSM) characterizes arterial wall composition, and a low IM-GSM is associated with increased cardiovascular mortality in the elderly. We aimed to determine differences in the IM-GSM between a cohort with cerebrovascular disease and a healthy cohort. Eighty-two healthy individuals (control group: 63.2 ± 8.7 y) and 96 patients with either stroke or transient ischemic attacks (CRVD group: 68.6 ± 9.8 y) were studied. Common carotid artery intima-media thickness and IM-GSM obtained by ultrasound were analyzed using semi-automated edge-detection software. The IM-GSM was significantly lower in the CRVD group than in the control group (106 ± 24 vs. 124 ± 27 au, p < 0.001). The IM-GSM was similar for the infarct and non-infarct sides in CRVD. In the pooled cohort of all participants, the lower the quartile of IM-GSM, the greater were the carotid artery intima-media thickness and carotid artery remodeling. These results suggest the presence of an altered atherosclerotic phenotype in the intima-media complex of CRVD patients that can be detected by ultrasound.
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Affiliation(s)
- Kunihiko Aizawa
- Diabetes and Vascular Medicine Research Centre, University of Exeter Medical School, Exeter, UK; NIHR Exeter Clinical Research Facility, Exeter, UK.
| | - Salim Elyas
- Diabetes and Vascular Medicine Research Centre, University of Exeter Medical School, Exeter, UK; NIHR Exeter Clinical Research Facility, Exeter, UK; Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
| | - Damilola D Adingupu
- Diabetes and Vascular Medicine Research Centre, University of Exeter Medical School, Exeter, UK; NIHR Exeter Clinical Research Facility, Exeter, UK
| | - Francesco Casanova
- Diabetes and Vascular Medicine Research Centre, University of Exeter Medical School, Exeter, UK; NIHR Exeter Clinical Research Facility, Exeter, UK
| | - Kim M Gooding
- Diabetes and Vascular Medicine Research Centre, University of Exeter Medical School, Exeter, UK; NIHR Exeter Clinical Research Facility, Exeter, UK
| | - Angela C Shore
- Diabetes and Vascular Medicine Research Centre, University of Exeter Medical School, Exeter, UK; NIHR Exeter Clinical Research Facility, Exeter, UK
| | - W David Strain
- Diabetes and Vascular Medicine Research Centre, University of Exeter Medical School, Exeter, UK; NIHR Exeter Clinical Research Facility, Exeter, UK; Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
| | - Phillip E Gates
- Diabetes and Vascular Medicine Research Centre, University of Exeter Medical School, Exeter, UK; NIHR Exeter Clinical Research Facility, Exeter, UK
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150
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McLeod O, Silveira A, Valdes-Marquez E, Björkbacka H, Almgren P, Gertow K, Gådin JR, Bäcklund A, Sennblad B, Baldassarre D, Veglia F, Humphries SE, Tremoli E, de Faire U, Nilsson J, Melander O, Hopewell JC, Clarke R, Björck HM, Hamsten A, Öhrvik J, Strawbridge RJ. Genetic loci on chromosome 5 are associated with circulating levels of interleukin-5 and eosinophil count in a European population with high risk for cardiovascular disease. Cytokine 2016; 81:1-9. [PMID: 26821299 PMCID: PMC4837217 DOI: 10.1016/j.cyto.2016.01.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Revised: 12/18/2015] [Accepted: 01/18/2016] [Indexed: 12/30/2022]
Abstract
IL-5 is a Th2 cytokine which activates eosinophils and is suggested to have an atheroprotective role. Genetic variants in the IL5 locus have been associated with increased risk of CAD and ischemic stroke. In this study we aimed to identify genetic variants associated with IL-5 concentrations and apply a Mendelian randomisation approach to assess IL-5 levels for causal effect on intima-media thickness in a European population at high risk of coronary artery disease. We analysed SNPs within robustly associated candidate loci for immune, inflammatory, metabolic and cardiovascular traits. We identified 2 genetic loci for IL-5 levels (chromosome 5, rs56183820, BETA=0.11, P=6.73E(-5) and chromosome 14, rs4902762, BETA=0.12, P=5.76E(-6)) and one for eosinophil count (rs72797327, BETA=-0.10, P=1.41E(-6)). Both chromosome 5 loci were in the vicinity of the IL5 gene, however the association with IL-5 levels failed to replicate in a meta-analysis of 2 independent cohorts (rs56183820, BETA=0.04, P=0.2763, I(2)=24, I(2)-P=0.2516). No significant associations were observed between SNPs associated with IL-5 levels or eosinophil count and IMT measures. Expression quantitative trait analyses indicate effects of the IL-5 and eosinophil-associated SNPs on RAD50 mRNA expression levels (rs12652920 (r2=0.93 with rs56183820) BETA=-0.10, P=8.64E(-6) and rs11739623 (r2=0.96 with rs72797327) BETA=-0.23, P=1.74E(-29), respectively). Our data do not support a role for IL-5 levels and eosinophil count in intima-media thickness, however SNPs associated with IL-5 and eosinophils might influence stability of the atherosclerotic plaque via modulation of RAD50 levels.
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Affiliation(s)
- Olga McLeod
- Cardiovascular Medicine Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Angela Silveira
- Cardiovascular Medicine Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Elsa Valdes-Marquez
- CTSU - Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Harry Björkbacka
- Experimental Cardiovascular Research Unit, Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden
| | - Peter Almgren
- Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden
| | - Karl Gertow
- Cardiovascular Medicine Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Jesper R Gådin
- Cardiovascular Medicine Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Alexandra Bäcklund
- Cardiovascular Medicine Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Bengt Sennblad
- Cardiovascular Medicine Unit, Department of Medicine, Science for Life Laboratory, Karolinska Institutet, Stockholm, Sweden
| | - Damiano Baldassarre
- Dipartimento di Scienze Farmacologiche e Biomolecolari, Università di Milano, Italy; Centro Cardiologico Monzino, IRCCS, Milan, Italy
| | | | | | - Elena Tremoli
- Dipartimento di Scienze Farmacologiche e Biomolecolari, Università di Milano, Italy; Centro Cardiologico Monzino, IRCCS, Milan, Italy
| | - Ulf de Faire
- Division of Cardiovascular Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Jan Nilsson
- Experimental Cardiovascular Research Unit, Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden
| | - Olle Melander
- Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden
| | - Jemma C Hopewell
- CTSU - Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Robert Clarke
- CTSU - Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Hanna M Björck
- Cardiovascular Medicine Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Anders Hamsten
- Cardiovascular Medicine Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - John Öhrvik
- Cardiovascular Medicine Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden; Centre for Clinical Research Västerås, Uppsala University, SE-72189 Västerås, Sweden
| | - Rona J Strawbridge
- Cardiovascular Medicine Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
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