720 Characterisation of Recent Trends in Cardiovascular Risk Factors in Young Patients With Ischaemic Stroke

2020 ◽  
Vol 29 ◽  
pp. S360
Author(s):  
A. Bhat ◽  
D. Makarious ◽  
V. Mahajan ◽  
Y. Husen ◽  
E. Tan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Ischaemic Stroke ◽  
Cardiovascular Risk Factors ◽  
Young Patients ◽  
Recent Trends

Association of plaque echostructure and cardiovascular risk factors with symptomatic carotid artery disease

VASA ◽  
2009 ◽  
Vol 38 (4) ◽  
pp. 357-364 ◽  
Author(s):  
Giannoukas ◽  
Sfyroeras ◽  
Griffin ◽  
Saleptsis ◽  
Antoniou ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Carotid Artery ◽  
Cardiovascular Risk Factors ◽  
Carotid Plaque ◽  
Young Patients ◽  
Symptomatic Disease ◽  
Age Related ◽  
Ica Stenosis

Background: Severity of stenosis remains the main factor for assessing risk of stroke in patients with internal carotid artery (ICA) disease. This study was conducted to investigate the association of plaque echostructure and other established and emerging cardiovascular risk factors with symptomatic ICA disease. Design: Cross-sectional study of consecutive patients with significant (> 50 %) ICA stenosis. Patients and methods: Carotid plaque echostructure, smoking, hypertension, diabetes mellitus, serum lipoprotein (a), homocysteine, vitamin B12, folate, cholesterol to high-density lipoprotein ratio, triglycerides, C-reactive protein, and the Framingham risk score were assessed in 124 consecutive patients (70 asymptomatic; 54 symptomatic) with significant (> 50 %) ICA stenosis. Results: The asymptomatic and symptomatic groups did not differ in terms of gender distribution (p = 0.76) and severity of stenosis (p = 0.62). Echolucent plaques (type 1 and 2) were more predominant in patients with symptomatic disease (p = 0.004, OR = 2.13, 95 % CI = 1.26-3.6). Patients with plaques type 1 were relatively younger than those with type 4 (p = 0.02). None of the other factors assessed had any significant association with symptomatic disease and any type of carotid plaque. Conclusions: Besides the severity of carotid stenosis, the presence of an echolucent plaque appears as an important factor associated with symptomatic ICA disease. Also, young patients are more likely to have an echolucent plaque suggesting an age-related association with plaque maturation.

scholarly journals Cannabis-induced recurrent myocardial infarction in a 21-year-old man: a case report

2020 ◽  
Vol 4 (3) ◽  
pp. 1-5 ◽  
Author(s):  
Dennis Lawin ◽  
Thorsten Lawrenz ◽  
Andi Tego ◽  
Christoph Stellbrink
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Young Patients ◽  
Potential Hazard ◽  
Thrombotic Occlusion ◽  
Diagonal Branch ◽  
Coronary Syndrome ◽  
Cannabis Consumption

Abstract Background Acute coronary syndrome (ACS) is rarely caused by coronary artery disease in young patients unless cardiovascular risk factors are present. Although non-atherosclerotic causes of ACS are rare, they need to be considered in young patients. Case summary We report on a 21-year-old patient referred to our institution with ACS. Electrocardiogram showed ST-segment elevation and coronary angiography revealed thrombotic occlusion of the left anterior descending artery. Reperfusion was achieved by thrombus aspiration, glycoprotein IIb/IIIa inhibitors (GPI), and drug-eluting stent (DES). The patient had no cardiovascular risk factors but reported cannabis consumption before symptom onset. Although he was put on dual antiplatelet therapy and strictly advised to avoid consumption, he continued to abuse cannabis and suffered three further ACS events within 18 months: the first 8 months later caused by thrombotic occlusion of a diagonal branch treated by GPI and DES, the second after 17 months due to thrombotic re-occlusion of the diagonal branch, and the third after 18 months by thrombotic occlusion of the circumflex artery, both events treated by GPI alone (all while still using cannabis). Since then, he stopped cannabis consumption and has been symptom-free for 8 months. Discussion This case highlights that cannabis-induced ACS must be considered as a cause of myocardial infarction in young adults. In contrast to ACS in the elderly population, this unusual ACS cause requires specific treatment. The risk of ACS relapse may substantial if cannabis abuse is continued. This potential hazard needs to be taken into consideration when legalization of cannabis is discussed.

scholarly journals Antibodies against HDL Components in Ischaemic Stroke and Coronary Artery Disease

2018 ◽  
Vol 118 (06) ◽  
pp. 1088-1100 ◽  
Author(s):  
Joana Batuca ◽  
Marta Amaral ◽  
Catarina Favas ◽  
Gonçalo Justino ◽  
Ana Papoila ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Artery Disease ◽  
Cardiovascular Risk ◽  
Coronary Artery ◽  
Protective Effect ◽  
Ischaemic Stroke ◽  
Cardiovascular Risk Factors ◽  
Healthy Controls ◽  
Artery Disease

AbstractQuantitative and qualitative defects of high-density lipoprotein (HDL) are important in atherogenesis. In this study, we investigated whether antibodies against HDL components had additional value to conventional cardiovascular risk factors for the diagnosis of ischaemic stroke (IS) and coronary artery disease (CAD). Cross-sectional study was conducted on 53 patients with IS, 51 with CAD and 55 healthy controls, and in vitro studies to validate findings of the clinical study. We determined serum immunoglobulin G (IgG) antibodies against HDL (aHDL), apolipoproteins (aApoA-I, aApoA-II and aApoC-I) and paraoxonase-1 (aPON1) as well as PON1 activity (PON1a), total antioxidant capacity and biomarkers of endothelial activation (serum nitric oxide metabolites, 3-nitrotyrosine, VCAM-1 and ICAM-1); in vitro assays tested the capacity of IgG aHDL purified from high titer patients to inhibit PON1a and to reverse protective effect of HDL on endothelial cells. IgG aHDL, aApoA-I and aPON1 were higher in IS and CAD than controls (p < 0.001), predicted negatively PON1a and positively VCAM-1 and ICAM-1. By adding IgG aHDL and aApoA-I to a traditional cardiovascular risk factors model for IS and by adding IgG aHDL in a similar model for CAD, we obtained better discrimination of IS and CAD from healthy controls. IgG aHDL purified from IS and CAD inhibited PON1a by 38% (p < 0.01) and abrogated the protective effect of HDL on VCAM-1 expression by 126% compared with non-specific human IgG (p < 0.001). IgG against HDL components interfere with the antioxidant and anti-inflammatory properties of HDL and may represent novel biomarkers for vascular disease that need to be investigated in prospective studies.

Role of von Willebrand factor in vascular disease

2009 ◽  
Vol 29 (01) ◽  
pp. 32-38 ◽  
Author(s):  
P. Paulinska ◽  
A. Spiel ◽  
B. Jilma
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Ischaemic Stroke ◽  
Cardiovascular Risk Factors ◽  
Von Willebrand Factor ◽  
Cardiovascular Events ◽  
Peripheral Arterial ◽  
Von Willebrand ◽  
Willebrand Factor

SummaryPlasma levels of von Willebrand factor (VWF) are increased in patients with cardiovascular risk factors. Various studies aimed to elucidate the relation of VWF with thrombo - embolic cardiovascular events, ischaemic stroke as well as with peripheral arterial occlusive disease. In the general population, there is only a weak association between VWF levels and future cardiovascular events or stroke. In contrast, VWF levels are predictive in patients with documented vascular disease. Those patients with increased VWF suffer a higher incidence of major adverse cardiac events including death. The extent of the VWF release and its levels independently predict clinical outcome in patients with acute coronary syndromes. Elevated VWF levels have also been observed in patients with atrial fibrillation compared to controls and predict outcome. This may at least in part be attributable to the association of VWF with underlying cardiovascular risk factors. Hence, VWF correlates with Framingham and CHADS stroke risk stratification score and can be used as a marker in patients with AF. However, VWF is not only a predictor; it also plays a crucial role in thrombogenesis. This fact has made VWF a promising target for research into new antiplatelet therapies that specifically inhibit VWF.This review focuses on the role of VWF in ACS, ischaemic stroke and peripheral arterial disease and the relevance of therapeutic interventions targeting VWF for ACS patients.

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