Effect of intensive statin therapy on regression of carotid intima-media thickness in patients with subclinical carotid atherosclerosis (a prospective, randomized trial: PEACE (Pitavastatin Evaluation of Atherosclerosis Regression by Intensive Cholesterol-lowering Therapy) study)

2012 ◽  
Vol 20 (6) ◽  
pp. 1069-1079 ◽  
Author(s):  
Koji Ikeda ◽  
Tomosaburo Takahashi ◽  
Hiroyuki Yamada ◽  
Kiyoaki Matsui ◽  
Takahisa Sawada ◽  
...  
2020 ◽  
Vol 16 ◽  
Author(s):  
Harish A Rao ◽  
Prakash Harischandra ◽  
Srikanth Yadav

Introduction: Diabetes mellitus is a well-known risk factor for cardiovascular disease, because of the accelerated process of atherosclerosis. Obesity is an established risk factor and has gained immense importance in recent studies as an important risk factor for clinical cardiovascular disease, yet the fundamental component stays unclear. Calf circumference is another form for lean mass and peripheral subcutaneous fat and is inversely associated with occurrence of carotid plaques (CP). Multiplicative and opposite effects of both Calf Circumference (CC) and Waist Circumference (WC) in event of CP suggest that the two measures should be taken into account commonly while assessing vascular risk profile. Aim & Objective: To ascertain if waist to calf circumference ratio (WCR) is a marker of Carotid atherosclerosis in patients with type 2 diabetes mellitus. To asses s the correlation between waist to calf circumference ratio and carotid intima media thickness (CIMT ) in patients with Type 2 diabetes. Materials and methods: A cross sectional study at Hospital affiliated to Kasturba Medical college Mangalore from Sept 2016 to Sept 2018 . Method of study: Patients with type 2 DM as per ADA criteria, age >18years are recruited for the study. Results and discussion: In our study with 150 population 25 patients had carotid atherosclerosis and 20 patients had CIMT>1.1. The waist circumference in patients with CA is in the range of 93.07 and 99.85 & the CC in patients with CA is in the range of 29.49 to 31.25. The WCR in patients with CA is in the range of 3.12 to 3.26. The difference was statistically significant with a p value of <0.05. In our study it was found that WC and WCR correlated well with carotid atherosclerosis, and surprisingly calf circumference also correlated with carotid atherosclerosis but not as significant as both WC and WCR. Conclusion: To conclude, in our population based study of 150 subjects we found that carotid atherosclerosis is significantly more in people with increased waist calf circumference ratio. WCR may be a new, useful and practical anthropometric index that facilitates the early identification of diabetic subjects with high risk for cardiovascular disease. Validation of this finding in individual populations is required. Future studies should test the association of calf circumference with carotid intima media thickness and carotid plaques using better measures than ultrasound such as magnetic resonance imaging. Further research focusing on underlying mechanisms in the role of lean mass and peripheral fat mass is required.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 367-368
Author(s):  
Desiree Bygrave ◽  
Regina Wright

Abstract Carotid atherosclerosis has emerged as an early predictor of reduced cognitive function. Underlying this association are risk factors, such as overweight and obesity, that promote carotid atherosclerosis and poor cognitive outcomes. Given the prevalence of overweight and obesity among older adults, there is a critical need to better understand how atherosclerosis influences cognitive function in the context of elevated weight. To address this gap, the current study examined relations between carotid atherosclerosis (carotid intima-media thickness [IMT]), and attention (Trailmaking Test) and executive function (Verbal Fluency Test) performance, and whether they varied as a function of weight status (body mass index [BMI] classification). Data were analyzed from 162 older adults (mean age = 68.43y, 34% male, 41% African American), free of major disease. Mutliple regression and analysis of variance analyses, adjusted for age, sex, education and mean arterial pressure, showed a statistically significant IMT x BMI interaction for Verbal Fluency performance (p=.04) and a trending IMT x BMI interaction for Trailmaking A performance (p=.05). Simple effects analysis of IMT and Verbal Fluency performance showed that this association was most pronounced among those who are obese. Findings suggest atherosclerosis may influence executive function in the context of obesity among older adults. As the development of carotid atherosclerosis is strongly related to aging, our findings suggest that maintaining a healthy weight may reduce its impact on executive function in older adulthood.


2012 ◽  
Vol 9 (4) ◽  
pp. 549-553 ◽  
Author(s):  
Sae Young Jae ◽  
Kevin Heffernan ◽  
Bo Fernhall ◽  
Yoon-Ho Choi

Background:We tested the hypothesis that higher levels of cardiorespiratory fitness are inversely associated with carotid artery intima media thickness in 746 (age 53 ± 7 yrs) men with type 2 diabetes.Methods:We measured common carotid intima media thickness and defined carotid atherosclerosis as a carotid intima media thickness > 1.0 mm. Cardiorespiratory fitness was directly measured by peak oxygen uptake using expired gases analysis during a standard treadmill test.Results:Cardiorespiratory fitness was independently associated with common carotid intima media thickness in multivariable regression (β = –0.15, P < .05). After adjusting for established risk factors, high and moderate cardiorespiratory fitness were associated with lower odds ratios for having carotid atherosclerosis—0.49 (95% CI, 0.30–0.81), and 0.59 (95% CI, 0.38–0.92), respectively—as compared with low cardiorespiratory fitness. Each 1 metabolic equivalent increment higher cardiorespiratory fitness was associated with 27% (OR = 0.73; 95% CI, 0.61–0.87) lower prevalence of carotid atherosclerosis.Conclusions:These results suggest that high cardiorespiratory fitness is inversely associated with common carotid intima media thickness in men with type 2 diabetes.


2020 ◽  
Vol 30 (6) ◽  
pp. 840-851 ◽  
Author(s):  
Hugo A. Gomes ◽  
Paula Garcia ◽  
Luísa Diogo ◽  
António Pires ◽  
Paula Martins

AbstractBackground:The use of statins in children, although not frequent, is recommended in specific clinical contexts, namely, familial hypercholesterolaemia, conditions carrying a moderate-high cardiovascular risk and sub-optimal cholesterol levels after implementation of lifestyle modifications. The aim of this study is to characterise children with dyslipidaemia managed with statins, followed at a tertiary referral centre in central Portugal.Methods and results:The authors carried out a retrospective and descriptive study made up of 66 patients (50% males, mean age of therapy onset 11.9 years) followed up at the Cardiovascular Clinic of a tertiary referral centre between January, 2012, and May, 2018. Clinical, analytical, and echocardiographic parameters were analysed. About 60.6% had clinical and/or molecular diagnosis of familial hypercholesterolaemia. On average, each patient had three cardiovascular risk factors, obesity (31%) being most prevalent, followed by arterial hypertension (14%). Statin therapy showed a statistically significant reduction in the lipid profile, particularly in the total cholesterol (23%) and low-density lipoprotein cholesterol (30%) levels, as well as in the carotid intima-media thickness (p = 0.015). Hepatic and muscle integrity markers were within normal range.Conclusions:Statins are safe and efficient in the management of children with hypercholesterolaemia. Our study showed that apart from its lipid-lowering properties, it also reduced significantly the carotid intima-media thickness and, implicitly, the cardiovascular risk of these patients.


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