scholarly journals Carotid Atherosclerosis Evolution When Targeting a Low-Density Lipoprotein Cholesterol Concentration <70 mg/dL After an Ischemic Stroke of Atherosclerotic Origin

Circulation ◽  
2020 ◽  
Vol 142 (8) ◽  
pp. 748-757 ◽  
Author(s):  
Pierre Amarenco ◽  
Cristina Hobeanu ◽  
Julien Labreuche ◽  
Hugo Charles ◽  
Maurice Giroud ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Carotid Arteries ◽  
Carotid Atherosclerosis ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Intima Media Thickness ◽  
Target Group ◽  
Low Density Lipoprotein Cholesterol ◽  
Media Thickness ◽  
Common Carotid Arteries

Background: The TST trial (Treat Stroke to Target) showed the benefit of targeting a low-density lipoprotein cholesterol (LDL-C) concentration of <70 mg/dL in terms of reducing the risk of major cardiovascular events in 2860 patients with ischemic stroke with atherosclerotic stenosis of cerebral vasculature. The impact on carotid atherosclerosis evolution is not known. Methods: TST-PLUS (Treat Stroke to Target–Plaque Ultrasound Study) included 201 patients assigned to an LDL-C concentration of <70 mg/dL and 212 patients assigned to a target of 100±10 mg/dL. To achieve these goals, investigators used the statin and dosage of their choice and added ezetimibe as needed. Ultrasonographers were certified and carotid ultrasound examinations were performed using M′Ath software at baseline and at 2, 3, and 5 years. All images were uploaded to the Intelligence in Medical Technologies database directly from the carotid ultrasound device. The central core laboratory performed all offline measurements of the intima–media thickness of both common carotid arteries blinded from the randomization arm. The main outcomes were newly diagnosed atherosclerotic plaque on carotid bifurcation or internal carotid artery using the Mannheim consensus definition and between-group comparison of common carotid arteries intima–media thickness change. Results: After a median follow-up of 3.1 years, the achieved LDL-C concentrations were 64 mg/dL (1.64 mmol/L) in the lower-target group and 106 mg/dL (2.72 mmol/L) in the higher-target group. Compared with the higher-target group, patients in the lower-target group had a similar incidence of newly diagnosed carotid plaque: 46/201 (5-year rate, 26.1%) versus 45/212 (5-year rate, 29.7%). The change in common carotid arteries intima–media thickness was −2.69 µm (95% CI, −6.55 to 1.18) in the higher-target group and −10.53 µm (95% CI, −14.21 to −6.85) in the lower-target group, resulting in an absolute between-group difference of −7.84 µm (95% CI, −13.18 to −2.51; P =0.004). Conclusions: In patients with ischemic stroke and atherosclerosis, an LDL-C target of <70 mg/dL (1.8 mmol/L) did not reduce the incidence of new carotid plaques but produced significantly greater regression of carotid atherosclerosis than an LDL-C target of 90 to 110 mg/dL. Registration: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT01252875.

scholarly journals Lipid profile and carotid artery intima-media thickness in diabetic and non-diabetic ischaemic stroke

2017 ◽  
Vol 4 (2) ◽  
pp. 471
Author(s):  
Preetha R. Pillai ◽  
Dharmendra Tiwari ◽  
O. P. Jatav ◽  
Hindeshwari Rai
Keyword(s):  
Ischemic Stroke ◽  
Lipid Profile ◽  
Blood Sugar ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Intima Media Thickness ◽  
Low Density ◽  
Stroke Patients ◽  
Media Thickness ◽  
Lipid Parameters

Background: Stroke is one of the leading reasons for mortality throughout the world. Measurement of carotid intima media thickness (CIMT) is a reliable marker for the development of atherosclerosis and ischemic stroke (IS). The aim was to study and correlate lipid profile and CIMT in diabetic and non-diabetic IS patients.Methods: An observational study was done including 120 IS patients divided into two groups- diabetes (n=60, diabetic stroke patients) and non-diabetes (n=60, non-diabetic stroke patients) having age >18 years, admitted in Medicine and Neurology wards of G. R. Medical College, Gwalior, Madhya Pradesh, India between August 2015 to August 2016. Detailed history along with investigations such as fasting blood sugar (FBS), post prandial blood sugar (PPBS) and fasting lipid profile including triglycerides (TG), high density lipoprotein (HDL), low density lipoprotein (LDL), very low density lipoprotein (VLDL) and total cholesterol (TC) was done. The common and the internal carotid arteries of both sides were evaluated ultrasonographically using a high frequency linear probe. All the data were analysed using IBM SPSS- ver.20 software. Data was expressed as percentage. Analysis was performed using two-way ANOVA and independent sample student t test. Pearson correlation was used to establish the relation between the data. P values <0.05 was considered to be significant.Results: Most common age group among diabetes and non-diabetes IS patients were 51-60 years (26.66%) and 61-70 years (28.33%) respectively with male predominance (75% and 66.67% respectively). Most of the diabetic IS patients had FBS >200 mg/dl (41.66%) and PPBS >250 mg/dl, (50%). Out of 120 IS patients, 55 (45.83%) had CIMT ≤0.8 mm and 65 (54.16%) patients had CIMT >0.8 mm. Lipid parameters including TC (p=0.034), TG (p=0.022), HDL (p=0.039), VLDL (p=0.043) and LDL (p=0.017) were significantly different between groups (p<0.05). Mean CIMT in patients with diabetes and non-diabetes was 1.03±0.255 mm and 0.83±0.54 mm respectively (p=0.006). A significant positive correlation was recorded between CIMT and TC (r=0.36, p=0.006), TG (r=0.48, p=0.0001) and VLDL (r=0.46, p=0.0001) among diabetes stroke patients. Among non-diabetes stroke patients, TC (r=-0.25, p=0.042), TG (r=-0.44, p=0.0003), HDL (r=-0.33, p=0.016) and LDL (r=-0.58, p=<0.001) were negatively correlated and VLDL (r=0.92, p=<0.0001) was positively correlated with CIMT.Conclusions: Lipid parameters including TC, TG, LDL and VLDL were significantly raised in diabetic stroke patients and had a positive correlation with the risk of stroke.  CIMT was significantly high in diabetic stroke patients. Correlation of lipid parameters (TC, TG and VLDL) with CIMT in diabetic stroke patients were significantly positively correlated, in non-diabetic ischemic stroke patients’ lipid parameters (TC, TG, HDL and LDL) were negatively correlated.

scholarly journals Effect of a six-month treatment with lanreotide on cardiovascular risk factors and arterial intima-media thickness in patients with acromegaly

2002 ◽  
pp. 303-309 ◽  
Author(s):  
A Colao ◽  
P Marzullo ◽  
G Lombardi
Keyword(s):  
Cardiovascular Risk ◽  
Disease Control ◽  
Carotid Arteries ◽  
Glycosylated Hemoglobin ◽  
Hdl Cholesterol ◽  
Intima Media Thickness ◽  
Media Thickness ◽  
Igf I ◽  
The Right ◽  
Common Carotid Arteries

OBJECTIVE: To evaluate the effect of a 6-month treatment with slow-release lanreotide (LAN) on cardiovascular risk and atherosclerosis in 24 normotensive patients with active acromegaly (GH=67.4 +/- 12.6 mU/l, IGF--I=866.0 +/- 55.8 microg/l) and 24 healthy subjects sex-, age- and body mass index-matched with the patients (as controls). DESIGN: Open, prospective, multicenter. METHODS: The following were measured before and after 6 months of LAN treatment (dose 60-90 mg/month): fasting GH, IGF-I, LDL, HDL and total cholesterol, triglyceride, glucose, glycosylated hemoglobin, insulin and fibrinogen levels, intima-media thickness (IMT) and blood systolic and diastolic peak velocity (SPV and DPV respectively) in both common carotids. RESULTS: At study entry, insulin, total and LDL cholesterol, triglyceride and fibrinogen levels were higher while HDL cholesterol levels were lower in patients than in controls. At the right (0.88 +/- 0.04 vs 0.77 +/- 0.03 mm, P=0.05) and left (0.93 +/- 0.03 vs 0.78 +/- 0.02 mm, P=0.01) common carotid IMT was significantly higher in patients than in controls; 12 patients and two controls showed an IMT of > or = 1 mm (chi(2)=8.2, P=0.004). After 6 months of LAN treatment, disease control was achieved in 15 patients (62.5%). Insulin, triglyceride and fibrinogen levels were significantly decreased, and a trend toward a decrease of IMT in the right (from 0.90 +/- 0.05 to 0.78 +/- 0.04 mm, P=0.06) and left (from 0.95 +/- 0.04 to 0.84 +/- 0.04 mm, P=0.06) common carotid arteries was observed only in patients with disease control, while SPV and DPV did not change. CONCLUSIONS: LAN treatment for 6 months significantly lowered GH, IGF-I, insulin and fibrinogen levels and reduced IMT of both common carotid arteries in normotensive patients with acromegaly.

Low-Density Lipoprotein Levels and Not Mutation Status Predict Intima-Media Thickness in Familial Hypercholesterolemia

2014 ◽  
Vol 28 (2) ◽  
pp. 421-426 ◽  
Author(s):  
Akl C. Fahed ◽  
Robert H. Habib ◽  
Georges M. Nemer ◽  
Sami T. Azar ◽  
Rabih R. Andary ◽  
...  
Keyword(s):  
Familial Hypercholesterolemia ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Intima Media Thickness ◽  
Low Density ◽  
Mutation Status ◽  
Media Thickness

scholarly journals Plasma lipoprotein(a) levels: a comparison between diabetic and non-diabetic patients with acute ischemic stroke

2004 ◽  
Vol 62 (2a) ◽  
pp. 233-236 ◽  
Author(s):  
Maurus Marques de Almeida Holanda ◽  
Rosália Gouveia Filizola ◽  
Maria José de Carvalho Costa ◽  
Rodrigo Vasconcelos C.L. de Andrade ◽  
José Alberto Gonçalves da Silva
Keyword(s):  
Ischemic Stroke ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Lipoprotein Cholesterol ◽  
Diabetic Patients ◽  
Low Density ◽  
Low Density Lipoprotein Cholesterol ◽  
Type 2 Diabetic Patients ◽  
Type 2 Diabetic

OBJECTIVE: The aim of this study was to evaluate lipoprotein(a) (Lp(a)), total cholesterol, high density lipoprotein cholesterol (HDL), low density lipoprotein cholesterol (LDL), very low density lipoprotein cholesterol (VLDL ), triglycerides , apolipoprotein A (apo A) and B100 (apo B100), uric acid, glycaemic and insulin plasmatic concentrations in patients affected by acute stroke. In this group of patients, we have compared the variables between type 2 diabetic patients and non-diabetic patients. METHOD: We evaluate a total of 34 non-diabetic patients (22 males and 12 females; mean age 66.71 ± 10.83 years) and a group of 26 type 2 diabetic patients (15 males and 11 females; mean age 66.35 ± 9.92 years) in a cross-sectional study. RESULTS: Mean Lp(a) concentration did not significantly differ between type 2 diabetic patients and non-diabetic subjects (29.49 ± 23.09 vs 44.81 ± 44.34 mg/dl). The distribution of Lp(a)levels was highly skewed towards the higher levels in both groups, being over 30 mg/dl in 50%. Lp(a) concentration was positively correlated with abdominal adiposity, using waist-hip ratio(WHR)(p< 0.05). No association was found between Lp(a) and others risk factors like sex, age, other lipidic parameters and the presence of stroke. CONCLUSIONS: Our results showed that there were no significant differences between diabetic and non-diabetic patients' serum Lp(a) levels, which indicates that elevated Lp(a) levels were associated with ischemic stroke, irrespective of the presence of type 2 diabetes mellitus (type 2 DM).

Sign in / Sign up

Export Citation Format

Share Document