ABSTRACT
Objective To evaluate the association between triglyceride(TG) level and newly identified 5-year carotid plaque and to explore the prediction value of TG level on the newlyidentified carotid plaque with risk factors of traditional atherosclerosis.Methods A cohort study was adopted.The baseline survey including CVD risk factors and B-mode ultrasound of carotid artery was performed in 2002,and the second follow-up examination was performed in 2007.We evaluated 1949participants with lipid measurements and B-mode ultrasound of carotid arteries in the two surveys (with mean age as 57.9 ± 8.1 years and 39.2％ were men).The baseline TG levels were divided into four groups:group 1 (TG＜1.13 mmol/L),group 2 (TG=1.13-1.69 mmol/L),group 3 (TG=1.70-2.25 mmol/L) and group 4 (TG≥2.26 mmol/L).Newly identified carotid plaque was regarded as the indicator of progression of carotid atherosclerosis.New relationship between fasting TG levels and newly identified carotid plaque was analysed.Results Compared to newly identified carotid plaque which including different TG level groups,the incidence of newly artery plaque had significantly increased along with the increase of baseline triglyceride level (30.8％,38.8％,41.9％and 44.2％ respectively,with x2=21.22,P＜0.01 ).Compared to individuals (TG＜ 1.13 mmol/L),TG seemed a risk factor of plaque progression (P＜0.01).After adjusted for age,sex,dyslipidemia and other risk factors,high TG group (TG ≥2.26 mmol/L) appeared a significant independent predictor of newly identified carotid plaque (OR=1.37,95％ CI:1.00-1.86).When further stratifying the traditional atherosclerosis risk factors,we found that high TG group with smoking or hypertension was an independent factor of atherosclerosis progression.Conclusion With the increase of triglyceride levels,the rate of newly identified carotid plaque also increased.After adjusting age,sex,dyslipidemia and other risk factors,serum fasting TG ≥2.26 mmol/L appeared to be an independent predictor of newly developed carotid plaque.
ABSTRACT
<p><b>BACKGROUND</b>Percutaneous coronary intervention (PCI) is a well-established method for managing coronary diseases. However, the increasing use of PCI has led to an increased incidence of acute cerebrovascular accidents (CVA) related to PCI. In this study, we investigated the characteristics and risk factors of CVA after PCI in patients with known stroke history.</p><p><b>METHODS</b>Between January 1, 2005 and March 1, 2009, 621 patients with a history of stroke underwent a total of 665 PCI procedures and were included in this retrospective study. Demographic and clinical characteristics, previous medications, procedures, neurologic deficits, location of lesion and in-hospital clinical outcomes of patients who developed a CVA after the cardiac catheterization laboratory visit and before discharge were reviewed.</p><p><b>RESULTS</b>Acute CVA was diagnosed in 53 (8.5%) patients during the operation or the perioperative period. Seventeen patients suffered from transient ischemic attack, thirty-four patients suffered from cerebral infarction and two patients suffered from cerebral hemorrhage. The risk factors for CVA after PCI in stroke patients were: admission with an acute coronary syndrome, use of an intra-aortic balloon pump, urgent or emergency procedures, diabetes mellitus, and poor left ventricular systolic function, arterial fibrillation, previous myocardial infarction, dyslipidemia, tobacco use, and no/irregular use of anti-platelet medications.</p><p><b>CONCLUSIONS</b>The incidence of CVA during and after PCI in patients with history of stroke is much higher than that in patients without history of stroke. Patients with atrial fibrillation, previous myocardial infarction, diabetes mellitus, dyslipidemia, tobacco use, and no or irregular use of anti-platelet medications were at higher risk for recurrent stroke. This study showed a strong association between acute coronary syndromes and in-hospital stroke after PCI.</p>