scholarly journals Nontraditional Risk Factors in Carotid Artery Disease

2010 ◽  
Vol 16 (5) ◽  
pp. 554-558 ◽  
Author(s):  
Zeynep G. Ozturk ◽  
Hakan Ekmekci ◽  
Ozlem B. Ekmekci ◽  
Pinar Atukeren ◽  
Ilknur Butun ◽  
...  
Keyword(s):  
Risk Factors ◽  
Carotid Artery ◽  
Carotid Artery Disease ◽  
Asymptomatic Group ◽  
Carotid Artery Plaque ◽  
Lipoprotein A ◽  
Symptomatic Group ◽  
Tnf Α ◽  
Artery Disease ◽  
Factor Α

Carotid atherosclerosis (AS) is one of the main risk factors for ischemic stroke. Our aim is to evaluate the nontraditional biochemical markers in asymptomatic and symptomatic patients with carotid artery plaque. This study was conducted on 55 patients: 43 with symptomatic and 12 with asymptomatic carotid artery disease. Lipoprotein (a) (Lp(a)), homocysteine, adiponectin, nitric oxide (NO), and tumor necrosis factor α (TNF-α) levels were measured in the plasma. The mean of total cholesterol, triglyceride, and homocysteine levels was significantly elevated in the symptomatic group as compared with the asymptomatic group (P = .03). In the asymptomatic group, adiponectin and NO levels showed elevations as compared with the symptomatic group but this increase was not significant (P > .05). Lipoprotein (a) and TNF-α levels acted inversely with adiponectin and NO. There was an insignificant decline in Lp(a) and TNF-α levels in the asymptomatic group as compared with the symptomatic group (P > .05).

Abstract 13769: Assessing the Risk for Cardiovascular Diseases According to Lipoprotein(a) Levels

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Narek A Tmoyan ◽  
Marat V Ezhov ◽  
Olga I Afanasieva ◽  
Uliana V Chubykina ◽  
Elena A Klesareva ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Cardiovascular Diseases ◽  
Carotid Artery ◽  
Lower Extremity ◽  
Carotid Artery Disease ◽  
Lipoprotein A ◽  
Artery Disease ◽  
Lower Extremity Artery Disease

Introduction: There is no common opinion about threshold lipoprotein(a) [Lp(a)] concentration for atherosclerotic cardiovascular diseases (ASCVD) risk. Different clinical guidelines and consensus documents postulated cut-off Lp(a) level as 30 mg/dL or 50 mg/dL. We assessed the concentration of Lp(a) that associated with ASCVD of different locations. Methods: The study included 1224 patients with ASCVD. Lp(a) concentration was measured by enzyme-linked immunosorbent assay in serum. Patients were divided into 3 groups: group I - Lp(a)<30 mg/dL, group II - 30≤Lp(a)<50 mg/dL, group III - Lp(a)≥50 mg/dL (table). Results: Coronary heart disease, carotid artery disease, lower extremity artery disease, myocardial infarction and ischemic stroke were diagnosed in 61%; 34%; 23%; 42% and 11% patients, respectively. Lower extremity artery disease, carotid artery disease and myocardial infarction were more frequent in patients with Lp(a) concentration from 30 to 50 mg/dL compared to patients with Lp(a) <30 mg/dL: 36%, 41%, 48% vs. 17%, 30%, 36% respectively, p<0.01 for all. Subjects with Lp(a) 30-50 mg/dL (n=182, 15%) had a greater odds ratio of lower extremity artery disease, carotid artery disease and myocardial infarction compared to patients with Lp(a) <30 mg/dL (table). ROC analysis demonstrated that Lp(a) cut-off levels for lower extremity artery disease, carotid artery disease, coronary heart disease and myocardial infarction were 26; 21; 37 and 36 mg/dL, respectively. Conclusions: Our results demonstrate that in case of Lp(a) cut-off level of 50 mg/dL about 15% of patients are underestimated for the risk of ASCVD. Lp(a) cut-off level for ASCVD is between 20 and 40 mg/dL regarding the atherosclerosis location.

Lipoprotein(a) and Asymptomatic Carotid Artery Disease

Stroke ◽  
1995 ◽  
Vol 26 (9) ◽  
pp. 1582-1587 ◽  
Author(s):  
Johann Willeit ◽  
Stefan Kiechl ◽  
Peter Santer ◽  
Friedrich Oberhollenzer ◽  
Georg Egger ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Carotid Artery Disease ◽  
Asymptomatic Carotid ◽  
Lipoprotein A ◽  
Artery Disease

scholarly journals Toll-like receptor 2 and 4 stimulation elicits an enhanced inflammatory response in human obese patients with atherosclerosis

2011 ◽  
Vol 121 (5) ◽  
pp. 205-214 ◽  
Author(s):  
Vincent P.W. Scholtes ◽  
Dik Versteeg ◽  
Jean-Paul P.M. de Vries ◽  
Imo E. Hoefer ◽  
Arjan H. Schoneveld ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Carotid Artery ◽  
Cardiovascular Risk Factors ◽  
Carotid Artery Disease ◽  
Innate Immune ◽  
Obese Patients ◽  
Cd11b Expression ◽  
Activation Marker ◽  
Artery Disease

The innate immune response elicited by activation of TLRs (Toll-like receptors) plays an important role in the pathogenesis of atherosclerosis. We hypothesized that cardiovascular risk factors are associated with the activation status of the innate immune system. We therefore assessed the responsiveness of TLRs on circulating cells in two groups of patients with established atherosclerosis and related this to the presence of cardiovascular risk factors. TNF (tumour necrosis factor)-α release induced by TLR2 and TLR4 activation was measured in patients with established coronary [PCI (percutaneous coronary intervention) study, n=78] or carotid artery disease [CEA (carotid endarterectomy) study, n=104], by stimulating whole blood samples with lipopolysaccharide (TLR4 ligand) and Pam3CSK4 [tripalmitoylcysteinylseryl-(lysyl)4; TLR2 ligand]. As an early activation marker, CD11b expression was measured by flow cytometry on CD14+ cells. Obesity was the ‘only’ risk factor that correlated with the TLR response. In both studies, obese patients had significantly higher TNF-α levels after stimulation of TLR2 compared with non-obese patients [16.9 (7.7–49.4) compared with 7.5 (1.5–19.2) pg/ml (P=0.008) in coronary artery disease and 14.6 (8.1–28.4) compared with 9.5 (6.1–15.7) pg/ml (P=0.015) in carotid artery disease; values are medians (interquartile range)]. Similar results were obtained following TLR4 stimulation. The enhanced inflammatory state in obese patients was also confirmed by a significant increased expression of the activation marker CD11b on circulating monocytes. In conclusion, obesity is associated with an enhanced TLR response in patients suffering from established atherosclerotic disease.

scholarly journals Carotid Artery Disease in Diabetic Patients

PRILOZI ◽  
2014 ◽  
Vol 35 (3) ◽  
pp. 149-161 ◽  
Author(s):  
Marijan Bosevski
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Carotid Artery ◽  
Carotid Artery Disease ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Diabetic Patients ◽  
Symptomatic Carotid ◽  
Main Determinants ◽  
Artery Disease

AbstractThere are two points of view on the interplay between carotid artery disease and diabetes mellitus: Diabetes mellitus has been recognized as one of the main determinants for the presence and progression of asymptomatic and symptomatic carotid artery disease; and carotid intima-media thickness has been defined as a useful tool for risk stratification of this population.Hyperglycaemia, duration of diabetes, arterial hypertension, cholesterol and inflammatory markers have previously been determined as independent factors for carotid atherosclerosis in diabetes, and aging as its predictor in this population by our own results. This paper focuses on the particularities of risk factors in diabetic patients (especially in type 2) and evidence-based guidelines for the management and risk reduction of these patients with stroke and/or carotid artery disease.At present, carotid ultrasound is recommended in diabetic patients with cerebrovascular symptoms. Since the prevalence of diabetes increases constantly, we attempt to address refreshment of criteria for screening of carotid artery disease in the diabetic population. It could be recommended for diabetic patients with at least one more risk factors and for diabetic patients above 60 years of age.

scholarly journals The validity of myocardial perfusion using 99mTc-Tetrofosmin gated single-photon emission tomography (gSPECT) in the detection of coronary artery disease in different stages of chronic kidney disease

2020 ◽  
Vol 5 (8) ◽  
Keyword(s):  
Risk Factors ◽  
Coronary Artery Disease ◽  
Single Photon ◽  
Photon Emission ◽  
Emission Tomography ◽  
Single Photon Emission ◽  
Asymptomatic Group ◽  
Symptomatic Group ◽  
Artery Disease ◽  
Photon Emission Tomography

Background: Patients with advanced chronic kidney disease (CKD), subjected to hemodialysis (H.D.), May not manifest chest pain with severe coronary artery disease (CAD). Aim of the study: Study the value of radionuclide myocardial perfusion using gated single-photon emission tomography (gSPECT) in recognition of the frequency and risk factors of CAD in different stages of CKD patients. Patients and Methods: the current study divided 133 CKD patients (pts) into three groups according to CKD stage: 43 cases in stage 3, 43 in stage 4, and 47 in stage 5. Each stage included asymptomatic and symptomatic subgroups. The present study recorded the clinical evaluation, laboratory data (in the form of complete blood picture, fasting blood glucose and glycosylated hemoglobin (HbA1c), lipid profile, serum calcium and phosphorus, C-reactive protein [CRP]), together with imaging tests (Dipyridamole stress-rest gSPECT/C.T., coronary C.T. angiography and LVM index by echocardiography) for all patients. Results: the study included ninety-nine asymptomatic and 34 symptomatic patients. CKD 3 included 33 asymptomatic and ten symptomatic, CKD 4 included 33, and 10, while CKD5 included 33 and 14, respectively. The asymptomatic group presented forty-eight cases (48.5%) abnormal gSPECT (19 fixed and 29 reversible defects). Eleven of this abnormal gSPECT were in CKD3, thirteen in CKD 4, and twenty-four in CKD 5, with a statistically higher prevalence of abnormality in CKD5 (P<0.0001). On the contrary, thirty cases of the symptomatic group had abnormal gSPECT (12 fixed and 18 reversible defects) seven in CKD 3, nine in CKD 4, and all the fourteen of CKD5. We Compared both groups concerning risk factors, age (senior in asymptomatic), blood pressure (greater in symptomatic), serum creatinine (higher in symptomatic), duration of hemodialysis (longer in symptomatic), cholesterol (more elevated in symptomatic) and HDL (more elevated in asymptomatic). The symptomatic group had a statistically more abundant perfusion defects size compared to the asymptomatic group. Stepwise regression discovered that the abnormal myocardium (SSS score > 4) was dependent first of all on age, which consequently revealed the substantial role of D.M., LVH, and elevated CRP. Conclusion: stress-rest gSPECT is essential in the revealing of CAD in different stages of CKD, even in low-risk patients. High-risk CKD patients for CAD are those with D.M., LVH, and high CRP.

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