Effect of Statin Treatment in Patients With Advanced Carotid Atherosclerosis: An Observational Outcome Study

Abstract Purpose Although preeclampsia (PE) is a well-established cardiovascular risk factor (CVRF) in the general population, its role in type 1 diabetes (T1D) has been scarcely studied. We assessed the association between PE and preclinical atherosclerosis in T1D. Methods We recruited 112 women without cardiovascular disease and last pregnancy ≥5 years before: (1) T1D and previous PE (T1D+/PE+; n = 28); (2) T1D without preeclampsia (T1D+/PE–; n = 28); (3) previous PE without T1D (T1D–/PE+; n = 28); and (4) controls (without T1D or PE; T1D–/PE–; n = 28). Groups were matched by age, several CVRFs, and diabetes duration and retinopathy (in T1D participants). Carotid intima-media thickness (IMT) and the presence of plaque (IMT ≥ 1.5 mm) were assessed by standardized ultrasonography protocol. Results Mean age of the participants was 44.9 ± 7.8 years (14.3% hypertension and 21.4% active smokers). Groups including T1D (T1D+/PE+ and T1D+/PE–) more frequently presented hypertension and statin treatment (23.2% vs 5.4% and 37.5% vs 8.9%; respectively; P < 0.01), without differences in other CVRFs. Carotid plaques were observed in 20.5%. In multivariate models adjusted for age, CVRF, and statins, both T1D and PE showed a similar impact on the presence of plaque, with odds ratios (95% confidence interval), 5.45 (1.36–21.9) and 4.24 (1.04–17.3), respectively. Both entities showed an additive effect when combined, both in common carotid-IMT (T1D+/PE– or T1D–/PE+, β = 0.198; T1D+/PE+, β = 0.297) and in the presence of plaque (8.53 [1.07–68.2] and 28.1 [2.67–296.4], respectively). Conclusions Previous PE was independently associated with preclinical atherosclerosis in T1D. Further studies are needed to ascertain its usefulness for stratifying risk in T1D women.

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NGAL and MMP-9/NGAL as biomarkers of plaque vulnerability and targets of statins in patients with carotid atherosclerosis

Clinical Chemistry and Laboratory Medicine (CCLM) ◽

10.1515/cclm-2017-0156 ◽

2017 ◽

Vol 56 (1) ◽

Cited By ~ 19

Author(s):

Wolf Eilenberg ◽

Stefan Stojkovic ◽

Alexandra Kaider ◽

Nicolas Kozakowski ◽

Christoph M. Domenig ◽

...

Keyword(s):

Carotid Artery ◽

Atherosclerotic Plaque ◽

Carotid Artery Stenosis ◽

Carotid Atherosclerosis ◽

Heart Association ◽

Statin Treatment ◽

Artery Stenosis ◽

Plaque Vulnerability ◽

Symptomatic Carotid ◽

Asymptomatic Patients

AbstractBackground:Neutrophil gelatinase associated lipocalin (NGAL) is expressed in atherosclerotic lesions and was recently implicated in the pathogenesis of cardiovascular pathologies. Statins are known to exert stabilizing effects on atherosclerotic plaque. The aims of our study were (1) to investigate the association of serum NGAL and metalloproteinase (MMP)-9/NGAL complex with the vulnerability of the atherosclerotic plaque, and (2) to reveal the effects of statin treatment on circulating NGAL and MMP-9/NGAL levels in patients with carotid artery stenosis.Methods:We examined the levels of NGAL and MMP-9/NGAL in blood samples from 136 patients with carotid artery stenosis by specific enzyme-linked immunosorbent assays.Results:Patients with vulnerable plaques, as determined by ultrasound (plaques with decreased echogenicity) and histological analysis (type VI according to the classification of American Heart Association [AHA]), displayed the highest levels of NGAL (both p<0.0001) and MMP-9/NGAL complex (p=0.0004 and p=0.004, respectively). Moreover, patients with symptomatic carotid atherosclerosis had significantly higher NGAL levels compared to asymptomatic patients (p=0.0007). The statin-treated group (n=108) demonstrated lower NGAL (73.9 vs. 128.0 μg/L, p<0.0001) and MMP-9/NGAL (28.9 vs. 40.6 μg/L, p=0.046) as compared to the non-statin group (n=28). Furthermore, in multivariate regression analysis NGAL, but not MMP-9/NGAL levels, were independently associated with symptomatic carotid artery stenosis. In addition, statin treatment was independently associated with lower NGAL levels.Conclusions:Circulating NGAL and MMP-9/NGAL are associated with plaque vulnerability in patients with carotid artery stenosis. Statin treatment could contribute to plaque stabilization by reducing circulating NGAL and MMP-9/NGAL levels.

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899: Multi-Institutional Outcome Study of Safety and Efficacy of Closed-Suction Drainage of the Scrotum in Primary 3-Piece Inflatable Penile Prosthesis Surgery

The Journal of Urology ◽

10.1016/s0022-5347(18)38148-5 ◽

2004 ◽

Vol 171 (4S) ◽

pp. 238-238

Author(s):

Pedram Ilbeigi ◽

Steven K. Wilson ◽

John R. Delk ◽

Andrew Siegel ◽

Larry Shannon ◽

...

Keyword(s):

Penile Prosthesis ◽

Outcome Study ◽

Suction Drainage ◽

Safety And Efficacy ◽

Closed Suction ◽

Inflatable Penile Prosthesis ◽

Closed Suction Drainage

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American Society of Maxillofacial Surgeons Outcome Study: Preoperative and Postoperative Neurodevelopmental Findings in Single-Suture Craniosynostosis

Yearbook of Plastic and Aesthetic Surgery ◽

10.1016/s1535-1513(08)70276-5 ◽

2006 ◽

Vol 2006 ◽

pp. 25-26

Author(s):

S.P. Bartlett

Keyword(s):

Outcome Study ◽

American Society ◽

Single Suture

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C-reactive protein as a marker of progression of carotid atherosclerosis in subjects with type 2 diabetes mellitus

VASA ◽

10.1024/0301-1526/a000614 ◽

2017 ◽

Vol 46 (3) ◽

pp. 187-192 ◽

Cited By ~ 7

Author(s):

Aleš Pleskovič ◽

Marija Šantl Letonja ◽

Andreja Cokan Vujkovac ◽

Jovana Nikolajević Starčević ◽

Katarina Gazdikova ◽

...

Keyword(s):

Diabetes Mellitus ◽

Carotid Atherosclerosis ◽

Inflammatory Marker ◽

Progression Rate ◽

C Reactive Protein ◽

Reactive Protein ◽

Hs Crp ◽

Unstable Plaques

Abstract. Background: This prospective study was designed to evaluate the effect of inflammatory markers on the presence and progression of subclinical markers of carotid atherosclerosis in a 3.8-year follow-up period in patients with type 2 diabetes mellitus (T2DM). Patients and methods: A total of 595 subjects with T2DM were enrolled. Subclinical markers of carotid atherosclerosis (carotid intima media thickness (CIMT), plaque thickness, and plaques presence) were assessed with ultrasound at the time of recruitment and again after 3.8 years. Subjects with T2DM were divided into 2 groups according to the plasma high sensitive C-reactive protein (hs-CRP) levels (subjects with hs-CRP ≥ 2 mg/L and subjects with hs-CRP below 2 mg/L). Results: Subjects with T2DM and hs-CRP levels ≥ 2 mg/L had higher CIMT in comparison with subjects with T2DM and hs-CRP levels below 2 mg/L, and higher incidence of plaques/unstable plaques in comparison with subjects with T2DM and hs-CRP levels below 2 mg/L. Multivariate logistic regression analysis found the association between the HDL cholesterol level and presence of plaques, whereas the inflammatory marker hs-CRP was not associated with subclinical markers of progression of carotid atherosclerosis. Multiple linear regression analysis found the association between the hs-CRP levels and either CIMT progression rate or a change in the number of sites with plaques in a 3.8-year follow-up. Conclusions: We demonstrated an association between the inflammatory marker hs-CRP and either CIMT or incidence of plaques/unstable plaques at the time of recruitment in Caucasians with T2DM. Moreover, we found the association between hs-CRP levels and either CIMT progression rate or a change in the number of sites with plaques in a 3.8-year follow-up in subjects with T2DM.

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