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Carotid Artery Atherosclerosis (carotid + artery_atherosclerosis)
Selected AbstractsCombined Effects of Glycated Hemoglobin A1c and Blood Pressure on Carotid Artery Atherosclerosis in Nondiabetic PatientsCLINICAL CARDIOLOGY, Issue 9 2010Wen Zhu MD Background The relationship between HbA1c, blood pressure, and carotid atherosclerosis in nondiabetic patients is not clear. Hypothesis HbA1c and blood pressure can affect carotid-artery atherosclerosis in nondiabetic patients. Methods This retrospective cross-sectional study included 216 patients without diabetes mellitus. A positive carotid ultrasonographic result was defined as intima-media thickness of the common carotid artery , 0.9 mm, or presence of carotid plaque. Results Compared with patients without carotid atherosclerosis, patients with carotid atherosclerosis had significantly higher levels of HbA1c and systolic blood pressure (SBP). Higher levels of HbA1c and SBP were found to be associated with increased carotid atherosclerosis. Given similar SBP levels, higher HbA1c (>5.6%) was also related to increased carotid atherosclerosis. In multiple logistic regression analysis, HbA1c (odds ratio: 4.1, P = 0.009) emerged as the only statistically significant modifiable factor that was associated with carotid atherosclerosis, independent of smoking, body mass index, fasting plasma glucose, 2-hour plasma glucose, SBP, diastolic blood pressure, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol. Conclusions Our study shows that a slight increase of HbA1c may associate with carotid atherosclerosis in nondiabetic patients. Moreover, the coexistence of an elevated SBP level and a slightly increased HbA1c level may have a more significant effect on carotid atherosclerosis. Copyright © 2010 Wiley Periodicals, Inc. Dr. Zhu and Dr. Sun contributed equally to this work. The authors of this manuscript have certified that they comply with the Principles of Ethical Publishing in the International Journal of Cardiology (Coats AJ. Ethical authorship and publishing. Int J Cardiol. 2009;131:149,150). This work was supported by a Chinese National Science Grant to Dr. Yong Li (Grant No. 30873350). The authors have no other funding, financial relationships, or conflicts of interest to disclose. [source] Prevalence of diabetes and/or ischaemic heart disease in classes of increasing carotid artery atherosclerosis: an ultrasonographic studyDIABETIC MEDICINE, Issue 8 2003S. Inchiostro Abstract Aims To evaluate the prevalence of non-diabetic subjects and diabetic patients, with or without ischaemic heart disease (IHD), in different classes of increasing carotid atherosclerotic damage. Methods Using high-resolution B-mode ultrasound, we studied 598 subjects without known cardiovascular disease (CVD) or diabetes, 74 diabetic patients without CVD, 74 non-diabetic subjects with IHD and 36 patients with both diabetes and IHD. Carotid atherosclerosis was classified as: normal; thickened intima-media; non-stenotic plaque; stenotic plaque. Results Compared with subjects without diabetes or CVD, the frequency of patients with diabetes without known CVD increased significantly from ,normal' to ,stenotic plaque' (4.1%, 6.4%, 13%, 14.8% for normal, thickened intima-media, non-stenotic plaque and stenotic plaque, respectively; P = 0.0057). The same figures were 6%, 7.6%, 10.2%, 23.3% (P = 0.0007) for non-diabetic subjects with IHD, and 0%, 2%, 5.6%, 15.9% (P < 0.0001) for diabetic patients with IHD. No difference was found comparing subjects with diabetes without CVD with non-diabetic patients with IHD (P = 0.56). Using polychotomous logistic regression analysis, diabetic patients without CVD and non-diabetic subjects with IHD showed a similar association with the increasing degree of carotid atherosclerosis (P = 0.59), but significantly stronger compared with subjects without diabetes or CVD (P < 0.03 for both). Conclusions Diabetic patients without known CVD show an advanced degree of carotid atherosclerotic damage similar to non-diabetic subjects with IHD and significantly higher compared with non-diabetic subjects without CVD. Our data support the need for an aggressive early prevention of CVD in diabetic subjects. [source] Role of hyperlipidemia in atherosclerotic plaque formation in the internal carotid arteryJOURNAL OF CLINICAL ULTRASOUND, Issue 6 2006Levente Kerenyi MD Abstract Purpose. The role of hyperlipidemia in atherosclerotic changes of the carotid artery is controversial. The aims of this retrospective study were to assess (1) the relationship between total serum cholesterol and triglyceride and the grade of internal carotid artery stenosis and (2) whether total serum cholesterol and triglyceride levels are independent risk factors for internal carotid artery atherosclerosis. Methods. The files of 1,934 acute ischemic stroke patients were investigated retrospectively. The atherosclerotic involvement of the internal carotid artery was assessed via duplex sonography as percent of stenosis and was graded as follows: group 1, no plaque; group 2, <30% stenosis; group 3, 30,99% stenosis; and group 4, occlusion. Results. The mean age of the patients was 66.9 ± 12.8 years. Patients without any plaque had significantly lower cholesterol levels compared with those with any degree of internal carotid artery stenosis. Univariate analysis revealed that age (p < 0.001), sex (p < 0.001), hypertension (p < 0.05), cholesterol (p < 0.01), triglycerides(p < 0.05), and smoking (p < 0.001) were significant contributors to atherosclerosis. In the ordinal logistic regression model, age (p < 0.001), sex (p < 0.001), smoking(p < 0.001), and cholesterol (p < 0.05) remained independent predictors of internal carotid artery atherosclerosis. Conclusions. Total serum cholesterol level seems to be an independent risk factor of atherosclerosis in the carotid artery. © 2006 Wiley Periodicals, Inc. J Clin Ultrasound 34:283,288, 2006 [source] The GH,IGF-I axis and the cardiovascular system: clinical implicationsCLINICAL ENDOCRINOLOGY, Issue 3 2008Annamaria Colao Summary Background, GH and IGF-I affect cardiac structure and performance. In the general population, low IGF-I has been associated with higher prevalence of ischaemic heart disease and mortality. Both in GH deficiency (GHD) and excess life expectancy has been reported to be reduced because of cardiovascular disease. Objective, To review the role of the GH,IGF-I system on the cardiovascular system. Results, Recent epidemiological evidence suggests that serum IGF-I levels in the low-normal range are associated with increased risk of acute myocardial infarction, ischaemic heart disease, coronary and carotid artery atherosclerosis and stroke. This confirms previous findings in patients with acromegaly or with GH-deficiency showing cardiovascular impairment. Patients with either childhood- or adulthood-onset GHD have cardiovascular abnormalities such as reduced cardiac mass, diastolic filling and left ventricular response at peak exercise, increased intima-media thickness and endothelial dysfunction. These abnormalities can be reversed, at least partially, after GH replacement therapy. In contrast, in acromegaly chronic GH and IGF-I excess causes a specific cardiomyopathy: concentric cardiac hypertrophy (in more than two-thirds of the patients at diagnosis) associated to diastolic dysfunction is the most common finding. In later stages, impaired systolic function ending in heart failure can occur, if GH/IGF-I excess is not controlled. Abnormalities of cardiac rhythm and of cardiac valves can also occur. Successful control of acromegaly is accompanied by decrease of the left ventricular mass and improvement of cardiac function. Conclusion, The cardiovascular system is a target organ for GH and IGF-I. Subtle dysfunction in the GH,IGF-I axis are correlated with increased prevalence of ischaemic heart disease. Acromegaly and GHD are associated with several abnormalities of the cardiovascular system and control of GH/IGF-I secretion reverses (or at least stops) cardiovascular abnormalities. [source] | ||||||||||