scholarly journals The role of monocyte to HDL ratio in predicting clinically significant carotid stenosis in patients with asymptomatic carotid artery disease

2020 ◽  
Vol 66 (8) ◽  
pp. 1043-1048
Author(s):  
Mustafa Yurtdaş ◽  
Yalin Tolga Yaylali ◽  
Mahmut Özdemir
Keyword(s):  
Carotid Artery ◽  
Carotid Stenosis ◽  
Carotid Artery Disease ◽  
Monocyte Count ◽  
Asymptomatic Carotid ◽  
Markers Of Inflammation ◽  
Group 2 ◽  
Clinically Significant ◽  
Artery Disease ◽  
Group 1

SUMMARY OBJECTIVE Monocyte count to HDL-C Ratio (MHR) and Fibrinogen to Albumin Ratio (FAR) have recently emerged as markers of inflammation in atherosclerotic diseases. Our goal was to investigate the relationships of MHR and FAR with the severity of carotid artery stenosis (CAS) in patients with asymptomatic carotid artery disease. METHODS This retrospective study consisted of 300 patients with asymptomatic CAS. Pre-angiographic MHR, FAR, and high-sensitive C-reactive protein (hsCRP) were measured. Carotid angiography was performed in patients with ≥50% stenosis on carotid ultrasonography. Patients were first split into 2 groups based on the degree of CAS and then tertiles (T) of MHR. RESULTS 96 patients had clinically insignificant CAS (<50%) (Group-1), and 204 patients had clinically significant CAS (≥50%) (Group-2). Group-2 had higher MHR, FAR, and hsCRP than group-1. Patients in T3 had higher MHR, FAR, and hsCRP than in T1 and T2. MHR, FAR, and hsCRP were correlated with each other (p<0.001, for all). MHR, FAR, and hsCRP were independent predictors of significant CAS. MHR better predicted a significant CAS than FAR and hsCRP (p<0.05). CONCLUSION Pre-angiographic MHR may be a better predictor than FAR and hsCRP in identifying a clinically significant carotid stenosis in patients with asymptomatic CAS. Patients with asymptomatic CAS and a high level of MHR should be followed-up closely to supervise risk-factor control and intensify treatment.

Asymptomatic Carotid Artery Disease in Valvular Heart Surgery

Angiology ◽  
2011 ◽  
Vol 63 (3) ◽  
pp. 171-177 ◽  
Author(s):  
Amedeo Anselmi ◽  
Mario Gaudino ◽  
Nicola Risalvato ◽  
Giuseppe Lauria ◽  
Franco Glieca
Keyword(s):  
Cardiac Surgery ◽  
Carotid Artery ◽  
Carotid Stenosis ◽  
Heart Surgery ◽  
Carotid Artery Disease ◽  
Asymptomatic Carotid ◽  
Valvular Surgery ◽  
Artery Disease ◽  
Ischemic Attack

We evaluated the prevalence of asymptomatic carotid artery disease in patients scheduled for valvular cardiac surgery. Preoperative screening of the carotid arteries was performed. Among 1012 patients scheduled for valvular cardiac surgery, 267 (26.4%) had carotid stenosis graded >50%; 37 had carotid stenosis >70% and underwent combined valvular surgery and carotid endarterectomy (CEA); and 230 (86%) had carotid stenosis >50% to ≤69% and received valvular cardiac surgery under hypothermic cardiopulmonary bypass. Operative mortality and the rate of perioperative adverse neurological events were comparable among the groups. During 6.8 years of follow-up, patients with carotid stenosis not exceeding 69% at the time of surgery had CEA more frequently ( P < .05) and stroke/transient ischemic attack ([TIA] P < .05) versus patients treated with combined surgery. The prevalence of asymptomatic carotid stenosis is not negligible in patients undergoing isolated valvular surgery. Combined valvular and carotid surgery is safe and reduces the incidence of CEA and stroke/TIA during follow-up.

Asymptomatic Cervical Carotid Stenosis

2019 ◽  
pp. 145-154
Author(s):  
Kunal Vakharia ◽  
Sabareesh K. Natarajan ◽  
Hussain Shallwani ◽  
Elad I. Levy
Keyword(s):  
Carotid Artery ◽  
Carotid Stenosis ◽  
Stroke Risk ◽  
Surgical Intervention ◽  
Carotid Artery Disease ◽  
Endovascular Management ◽  
Lifestyle Modifications ◽  
Asymptomatic Carotid ◽  
Artery Disease ◽  
Angioplasty And Stenting

Abstract: This chapter discusses the evaluation and management of asymptomatic carotid stenosis. Surgical and endovascular management of carotid artery disease continues to progress. With lifestyle modifications and medical management, the stroke risk without surgical intervention has been decreased; however, in patients with significant carotid stenosis, surgical intervention has still been shown to decrease the stroke risk by nearly half. A thorough understanding of the arterial and venous anatomy is essential for surgical planning. Carotid endarterectomy for asymptomatic carotid artery disease has been validated through prospective clinical trials to help dramatically reduce the risk of stroke. Endovascular management through carotid artery angioplasty and stenting is another option that continues to undergo evaluation in the asymptomatic patient population.

29 ASYMPTOMATIC CAROTID ARTERY DISEASE IN VALVULAR HEART SURGERY

2011 ◽  
Vol 12 (1) ◽  
pp. 7
Author(s):  
A. Anselmi ◽  
M. Morelli ◽  
C. Pragliola ◽  
N. Pavone ◽  
V. Tsiopoulos ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Heart Surgery ◽  
Carotid Artery Disease ◽  
Asymptomatic Carotid ◽  
Artery Disease

Advances in Management of Carotid Atherosclerosis

1997 ◽  
Vol 12 (2) ◽  
pp. 55-65
Author(s):  
Marc D. Malkoff ◽  
Linda S. Williams ◽  
Jose Biller
Keyword(s):  
Magnetic Resonance Angiography ◽  
Carotid Artery ◽  
Carotid Stenosis ◽  
Carotid Atherosclerosis ◽  
Stroke Risk ◽  
Carotid Artery Disease ◽  
Carotid Angioplasty ◽  
Conventional Angiography ◽  
Artery Disease ◽  
Experimental Treatments

Carotid artery stenosis is a common and potentially treatable cause of stroke. Stroke risk is increased as the degree of carotid stenosis increases, as well as in patients with neurological symptoms referable to the stenosed carotid artery. Carotid stenosis can be quantified by ultrasound imaging, magnetic resonance angiography, or conventional angiography. Medical treatment with platelet antiaggregants reduces stroke risk in some patients; other patients are best treated with carotid endarterectomy. Experimental treatments for carotid stenosis, including carotid angioplasty with or without stenting, are under investigation. We summarize the current literature and provide treatment recommendations for patients with atherosclerotic carotid artery disease.

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