scholarly journals Sonographic Tophi and Inflammation Are Associated With Carotid Atheroma Plaques in Gout

2021 ◽  
Vol 8 ◽  
Author(s):  
Irene Calabuig ◽  
Agustín Martínez-Sanchis ◽  
Mariano Andrés
Keyword(s):  
Odds Ratio ◽  
Carotid Atherosclerosis ◽  
Power Doppler ◽  
Intima Media Thickness ◽  
Local Inflammation ◽  
Rheumatology Unit ◽  
Urate Crystal ◽  
Ultrasound Assessment ◽  
Urate Lowering Treatment ◽  
Gout Tophi

Objective: Gout and cardiovascular disease are closely related, but the mechanism connecting them remains unknown. This study aims to explore whether urate crystal deposits and inflammation (assessed by ultrasound) are associated with carotid atherosclerosis.Methods: We included consecutive patients with crystal-proven gout newly presenting to a tertiary rheumatology unit. Patients under urate-lowering treatment were excluded. Ultrasound assessment was performed during intercritical periods. Musculoskeletal scans evaluated six joints and four tendons for urate crystal deposits (double contour, aggregates, and tophi), and power Doppler (PD) signal (graded 0–3) as a marker of local inflammation. The sum of locations showing deposits or a positive PD signal (≥1) was registered. Carotids were scanned for increased intima-media thickness (IMT) and atheroma plaques, according to the Mannheim consensus. Associations were analyzed using logistic regression.Results: The study included 103 patients showing sonographic crystal deposits at the examined locations (mean sum 9.9, minimum 2); tophi were the most frequent. Two-thirds of participants presented a positive PD signal (30.1% grade 2–3). In the carotid scans, 59.2% of participants showed atheroma plaques, and 33.0% increased IMT. Tophi (odds ratio [OR] 1.24; 95% confidence interval [CI] 1.03–1.50) and a positive PD signal (OR 1.67; 95% CI 1.09–2.56) were significantly associated with atheroma plaques, while an increased IMT showed no sonographic association.Conclusion: Sonographic crystal deposits and subclinical inflammation were consistently observed in patients with intercritical gout. Tophi and a positive PD signal were linked to carotid atherosclerosis. Our findings may contribute to understanding the complex relationship between gout and atherosclerosis.

THU0418 CAROTID ATHEROSCLEROSIS AND SONOGRAPHIC SIGNS OF URATE CRYSTAL DEPOSITS IN GOUT: AN ASSOCIATION STUDY

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 446.1-447
Author(s):  
I. Calabuig ◽  
A. Martínez-Sanchis ◽  
M. Andrés
Keyword(s):  
Association Analysis ◽  
Carotid Atherosclerosis ◽  
Subclinical Atherosclerosis ◽  
Power Doppler ◽  
Intima Media Thickness ◽  
Serum Urate ◽  
Assessment Tools ◽  
Urate Crystal ◽  
Urate Lowering Treatment ◽  
Double Contour

Background:Carotid subclinical atherosclerosis is prevalent in patients with gout, although poorly predicted by cardiovascular risk assessment tools. Gout itself is deemed to contribute to its development. However, a previous report did not show an association between clinical characteristics of gout and the presence of subclinical atherosclerosis [1].Objectives:To explore the association between sonographic signs of urate crystal deposits and carotid atherosclerosis.Methods:Consecutive new patients with crystal-proven gout attended in a tertiary Rheumatology unit were eligible for the study. It included musculoskeletal and carotid ultrasound assessment, performed by a trained sonographer blinded to clinical data. Patients were examined during intercritical periods; flare prophylaxis with low-dose colchicine or other agents was permitted, but patients under urate-lowering treatment were excluded. The musculoskeletal scans evaluated wrists, 2nd MCPs and 1st MTPs joints, and triceps and patellar tendons, for the presence of signs suggestive of urate crystal deposits (double contour, hyperechoic aggregates, and tophi), following OMERACT definitions. Also, local power-Doppler (PD) signal was registered and graded as 0 to 3. The sum of locations showing crystal deposits or positive PD signal (≥1) was estimated in order to assess crystal and inflammatory burden, respectively. Carotid arteries were scanned for increased intima-media thickness (IMT) and presence of atheroma plaques, according to Mannheim consensus. The association analysis was done by logistic regression, considering increased IMT or atheroma plaques as the dependent variables.Results:Eighty-eight new patients with gout were enrolled, mean aged 62.0 years (SD 14.5), 89.8% males. Mean gout duration was 5.9 years (SD 9.0), clinical tophi were observed in 16.1% of patients and mean serum urate level at diagnosis was 8.4 mg/dl (SD 1.5). All participants showed at least one sonographic sign of crystal deposits at the examined locations, with a mean sum of 9.4 (SD 4.0). Regarding individual signs, their mean (SD) sum was as follows: 4.6 (2.1) for tophi, 3.9 (2.8) for aggregates and 0.9 (1.0) for double contour. The mean sum of locations with positive PD signal was 1.1 (SD 1.0). Regarding carotid scans, increased IMT was seen in 26 patients (30.6%) and atheroma plaques in 51 (58.0%). Table 1 shows the results of the association analysis. Positive PD signal was significantly associated with the presence of atheroma plaques, while tophi showed a trend with both increased IMT and atheroma plaques.Conclusion:Sonographic deposits were consistently observed in new patients with gout. Crystal and inflammatory load, here shown as tophi and positive PD signal, seem associated with carotid atherosclerosis. This new finding may contribute to understanding the complex relationship between gout and atherosclerosis.References:[1]Ann Rheum Dis. 2017;76:1263.Disclosure of Interests: :Irene Calabuig: None declared, Agustín Martínez-Sanchis: None declared, Mariano Andrés Grant/research support from: Grünenthal, Consultant of: Grünenthal, Menarini, Speakers bureau: Grünenthal, Horizon

scholarly journals Plasma Galectin-3 and Sonographic Measures of Carotid Atherosclerosis in the Atherosclerosis Risk in Communities Study

Angiology ◽  
2018 ◽  
Vol 70 (1) ◽  
pp. 47-55 ◽  
Author(s):  
Abayomi Oyenuga ◽  
Aaron R. Folsom ◽  
Oluwaseun Fashanu ◽  
David Aguilar ◽  
Christie M. Ballantyne
Keyword(s):  
Odds Ratio ◽  
Carotid Plaque ◽  
Carotid Atherosclerosis ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Cross Sectional ◽  
Atherosclerosis Risk In Communities ◽  
Atherosclerosis Risk ◽  
Galectin 3 ◽  
Multivariable Adjustment

Galectin-3 is a β-galactoside-binding lectin that plays a role in the regulation of several conditions that are associated with atherosclerosis. The goal of this cross-sectional study was to assess the association of plasma galectin-3 concentrations with sonographic measures of carotid atherosclerosis in the Atherosclerosis Risk in Communities study. Linear regression was used to determine the difference and 95% confidence intervals (CIs) for carotid intima–media thickness (cIMT) by categorical and continuous representations of galectin-3. Logistic regression was used to determine the odds ratio and 95% CI, separately, for dichotomized cIMT (75th percentile = 0.9 mm) and carotid plaque and/or shadowing. Compared to those in the first quintile of galectin-3, those in the fifth quintile of galectin-3 level had higher cIMT (mean difference: 0.020 mm after multivariable adjustment; P trend = .04). Moreover, compared to those in the lowest galectin-3 quintile, those in the highest galectin-3 quintile had higher odds of carotid plaque/and or shadowing (odds ratio 1.13 after multivariable adjustment; P trend = .014). Higher levels of galectin-3 are associated with greater carotid atherosclerosis. Our findings provide support for the role of inflammatory biomarkers in the pathogenesis of atherosclerosis and suggest galectin-3 as a possible target for intervention in the prevention or management of atherosclerotic disease.

Apolipoprotein(a), Fibrinopeptide A and Carotid Atherosclerosis in Middle-Aged Men

1994 ◽  
Vol 72 (04) ◽  
pp. 563-566 ◽  
Author(s):  
Tuomo Rankinen ◽  
Sari Väisänen ◽  
Michele Mercuri ◽  
Rainer Rauramaa
Keyword(s):  
Risk Factors ◽  
Cardiovascular Diseases ◽  
Carotid Atherosclerosis ◽  
Intima Media Thickness ◽  
Carotid Bifurcation ◽  
Carotid Intima Media Thickness ◽  
Fibrinopeptide A ◽  
Carotid Imt ◽  
Apolipoprotein A ◽  
The Difference

SummaryThe association between apolipoprotein(a) [apo(a)], fibrinogen, fibrinopeptide A (FPA) and carotid intima-media thickness (IMT) was analyzed in Eastern Finnish men aged 50 to 60 years. Apo(a) correlated directly with carotid bifurcation (r = 0.26, p = 0.001), but not with common carotid IMT. Men in the lowest quartile of apo(a) had thinner (p = 0.013) IMT in bifurcation [1.59 mm (95% Cl 1.49; 1.68)] compared to the men in the highest [1.91 mm (95% Cl 1.73; 2.09)] apo(a) quartile. The difference remained (p=0.038) after adjusting for confounders. Plasma fibrinogen was not related to carotid IMT, whereas FPA correlated with common carotid (r = 0.21, p = 0.016) and carotid bifurcation (r = 0.21, p = 0.018) IMT. These associations abolished after adjusting for the confounders. The data suggest that apo(a) associate with carotid atherosclerosis independent of other risk factors for ischemic cardiovascular diseases.

Correlation of Waist to Calf Circumference Ratio and Carotid Intima Media Thickness in Diabetes Mellitus

2020 ◽  
Vol 16 ◽  
Author(s):  
Harish A Rao ◽  
Prakash Harischandra ◽  
Srikanth Yadav
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Risk Factor ◽  
Carotid Atherosclerosis ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Calf Circumference ◽  
Media Thickness

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.

scholarly journals Weight Status Influences Carotid Intima-Media Thickness to Executive Function Among Older Adults

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 367-368
Author(s):  
Desiree Bygrave ◽  
Regina Wright
Keyword(s):  
Older Adults ◽  
Executive Function ◽  
Cognitive Function ◽  
Verbal Fluency ◽  
Weight Status ◽  
Carotid Atherosclerosis ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Overweight And Obesity ◽  
Media Thickness

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.

Subclinical atherosclerosis in children and adolescents with congenital heart disease

2020 ◽  
pp. 1-8
Author(s):  
Silvia M. Cardoso ◽  
Michele Honicky ◽  
Yara M. F. Moreno ◽  
Luiz R. A. de Lima ◽  
Matheus A. Pacheco ◽  
...  
Keyword(s):  
Risk Factors ◽  
Congenital Heart Disease ◽  
Confidence Interval ◽  
Odds Ratio ◽  
Clinical Characteristics ◽  
Congenital Heart ◽  
Subclinical Atherosclerosis ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Media Thickness

Abstract Background: Subclinical atherosclerosis in childhood can be evaluated by carotid intima-media thickness, which is considered a surrogate marker for atherosclerotic disease in adulthood. The aims of this study were to evaluate carotid intima-media thickness and, to investigate associated factors. Methods: Cross-sectional study with children and adolescents with congenital heart disease (CHD). Socio-demographic and clinical characteristics were assessed. Subclinical atherosclerosis was evaluated by carotid intima-media thickness. Cardiovascular risk factors, such as physical activity, screen time, passive smoke, systolic and diastolic blood pressure, waist circumference, dietary intake, lipid parameters, glycaemia, and C-reactive protein, were also assessed. Factors associated with carotid intima-media thickness were analysed using multiple logistic regression. Results: The mean carotid intima-media thickness was 0.518 mm and 46.7% had subclinical atherosclerosis (carotid intima-media thickness ≥ 97th percentile). After adjusting for confounding factors, cyanotic CHD (odds ratio: 0.40; 95% confidence interval: 0.20; 0.78), cardiac surgery (odds ratio: 3.17; 95% confidence interval: 1.35; 7.48), and be hospitalised to treat infections (odds ratio: 1.92; 95% confidence interval: 1.04; 3.54) were associated with subclinical atherosclerosis. Conclusion: Clinical characteristics related to CHD were associated with subclinical atherosclerosis. This finding suggests that the presence of CHD itself is a risk factor for subclinical atherosclerosis. Therefore, the screen and control of modifiable cardiovascular risk factors should be made early and intensively to prevent atherosclerosis.

Gánh nặng xơ vữa động mạch cảnh ở người mắc bệnh động mạch vành sớm

2021 ◽  
Author(s):  
Thanh Huong Truong
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Carotid Stenosis ◽  
Odds Ratio ◽  
Carotid Atherosclerosis ◽  
Multivariate Logistic Regression Analysis ◽  
Lipoprotein Cholesterol ◽  
Premature Coronary Artery Disease ◽  
Viet Nam ◽  
Artery Disease

TÓM TẮT Đặt vấn đề: Dữ liệu xơ vữa động mạch (ĐM) cảnh ở người mắc bệnh động mạch vành sớm (BĐMVS) còn hạn chế tại Việt Nam. Do đó, nghiên cứu này nhằm mục tiêu xác định tỉ lệ xơ vữa ĐM cảnh và các yếu tố liên quan đến tình trạng này ở người mắc BĐMVS tại Việt Nam. Đối tượng, phương pháp nghiên cứu: Đây là nghiên cứu mô tả với 94 người mắc BĐMVS được siêu âm ĐM cảnh. Kết quả: Tình trạng hẹp ĐM cảnh không ý nghĩa và có ý nghĩa quan sát thấy ở 16 (17.0%) và 4 bệnh nhân (4.3%), tương ứng. Phân tích hồi quy logistic đa biến thấy nồng độ lipoprotein cholesterol tỷ trọng thấp (LDL-C) trong máu liên quan độc lập với hẹp ĐM cảnh có ý nghĩa (Odds Ratio = 1.504). Kết luận: Tại Việt Nam, người mắc BĐMVS có tỉ lệ cao bị hẹp ĐM cảnh. Sàng lọc hẹp ĐM cảnh nên được thực hiện cho nhóm bệnh nhân này, đặc biệt là khi có kèm tăng LDL-máu. Từ khoá: Xơ vữa, hẹp động mạch cảnh, bệnh động mạch vành, sớm ABSTRACT BURDEN OF CAROTID ATHEROSCLEROSIS IN PATIENTS WITH PREMATURE CORONARY ARTERY DISEASE Background: Data about carotid atherosclerosis in patients with premature coronary artery disease (PCAD) is still limited in Vietnam. Therefore, this study aims to investigate the prevalence of carotid atherosclerosis in patients with PCAD and factors related to carotid stenosis in these patients in Vietnam. Methods: This is a cross-sectional study that enrolled 94 patients with PCAD. All of patients were screened carotid atherosclerosis using ultrasonography. Results: Non-significant andsignificant carotid stenosiswere observed in 16 patients (17.0%) and 4 patients (4.3%), respectively. Multivariate logistic regression analysis showed that serum low density lipoprotein cholesterol (LDL-C) level was independently related to the presence of carotid stenosis with Odds ratio as 1.504. Conclusions: Prevalence of carotid stenosis is high in patients with PCAD in Vietnam. Screening of carotid stenosis should be recommended in these patients, especially in whom with elevated LDL-C. Key words: Atherosclerosis, carotid stenosis,coronary artery disease, premature.

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