Relationship between lipoprotein (a) and subclinical carotid atherosclerosis in asymptomatic individuals

Abstract Background: This study aimed to evaluate the associations between Lipoprotein (a) ‒ Lp(a) levels and carotid Intima-Media Thickness (cIMT) and with carotid plaques in healthy subjects because of previous contradictory data. Methods: A total of 317 healthy normolipidemic subjects (20‒77 years old) were selected. The cIMT and atherosclerotic plaques were determined by B-mode ultrasonography. Mann-Whitney tests were performed to compare the groups according to Lp(a) levels and to explore the associations between Lp(a), carotid plaques, and cIMT, logistic and linear regression analyses were performed. Results: Studied population (51% females, median age 43 years old) presented carotid plaques and cIMT ≥ 0.9 mm in 23% and 18% of the participants, respectively. The group with Lp(a) levels > 30 mg/dL presented significantly higher age and atherosclerotic plaques. Indeed, multivariate linear regression analysis showed a significant association between Lp(a), age, and race. On the other hand, logistic regression analysis demonstrated that the subjects with Lp(a) > 30 mg/dL have a significantly high risk of carotid plaques. Conclusion: The data from the present study indicate that Lp(a) levels above 30 mg/dL contribute to the development of carotid plaques even in apparently healthy participants.

Clinical Study of LP-PLA2 in Carotid Plaques Cerebral Infarction Patients / 现代检验医学杂志

Objective To study the relationship between the lipoprotein associated phospholipase A2 (LP-PLA2) with the carotid plaques cerebral infarction,and study the predictive value of LP-PLA2 in carotid artery plaque stability.Methods According to the results of color doppler ultrasound examination of carotid artery,169 patients with cerebral infarction were random divided into cerebral infarction with carotid plaques group (101 patients) and cerebral infarction without carotid plaques group(68 patients) groups.According to the nature of plaque stability of carotid plaques.101 cases of cerebral infarction with carotid plaques group was divided into plaques group 30 cases and 71 cases of unstable plaque group.Set healthy control groups at the same time.Then detected level of LP-PLA2 for each patient by the method of double antibody sandwich enzyme-linked immunosorbent (ELISA).To evaluate the predictive value of LP-PLA2 in carotid artery plaque stability by mapping the receiver-operating characteristic (ROC) curve.Results The level of LP-PLA2 (212.90± 117.69 ng/ml) in carotid plaques group were significantly higher than those without plaque group (127.70 ± 57.96 ng/ml,t=3.016,P ＜0.01).It was not show significantly difference between no plaque group and healthy control group (108.34 ± 42.58 ng/ml,t=0.779,P＞0.05).But it showed significantly different between the unstable plaque group (236.24 ± 128.33 ng/ml)and stability plaques group (157.65±59.27 ng/ml,t=3.442,P＜0.01).Conclusion The LP-PLA2 of plasma could be involved in the development of atherosclerosis plaques.The LP-PLA2 can certain correlation with cerebral infarction of carotid plaques,can well evaluate the stability of carotid plaques.

Effect of different blood glucose levels on the new carotid plaque / 中国综合临床

Objective To explore the relationship between different blood glucose levels and new carotid artery plaques.Methods A total of 5 440 participants met the inclusion criteria were selected stratified randomly from the 101,510 serving and retired workers of Tangshan Kailuan Company who participated the health examination from 2006 to 2007.The follow-up health examination were respectively preformed from 2010 to 2011 and from 2012 to 2013 which included carotid ultrasound for these 5 440 participants.The 5 440 participants were divided into three groups (ideal blood glucose group,impaired fasting glucose group and diabetic group) according to their fasting glucose levels in 2010-2011 examination.Multivariate Logistic regression analysis was used to analyze the risk factors of new carotid artery plaques.Results Among 5 440 subjects,participants whose FPG,ultrasound data incomplete and ultrasound detection of carotid plaques during the 2010-2011 health examination were excluded,then 3 084 participants were included in this study,among them,175 participants who did not participate the 2012-2013 health examination and 561 participants whose carotid plaque ultrasound data incomplete were excluded.Thus,a total of 2 348 participants were included in the present analysis.The total detection of new carotid artery plaque rate was 15.0％ (352/2 348) after 2 years of follow-up.The detection of new carotid artery plaque rate in normal glucose group(n =1724),impaired fasting glucose group(n=464) and diabetic group(n=160) were 14.2％(245/1 724),14.9％(69/464) and 23.8％(38/160),respectively.The diabetic group was higher than that of the ideal blood glucose group and the impaired fasting glucose group,the difference was statistically significant(P＜0.05).Impaired fasting glucose group and diabetic group had an increased risk of new carotid artery plaque compared with those in ideal glucose group(OR =0.924,95％CI 0.691-1.235 and OR =1.733,95％CI 1.107-2.713,respectively),the difference was statistically significant(P＜0.05).After adjusted for the other risk factors,with the risk-adjusted ratio (OR =1.117,95％CI 0.824-1.513 and OR =1.393,95％CI 0.872-2.226).Conclusion The detection of new carotid artery plaque increase in the diabetic group.However,after adjustment for other risk factors associate with emerging danger of new carotid artery plaque is no significant difference.This requires more long-term follow-up study of a large sample to be further confirmed.

Analysis on carotid artery colour to exceed examination and its manifestations of cerebral infarction / 中国医学装备

Objective: To observe the discussion colour to exceed to check the correlation of carotid atherosclerosis and cerebral infarction. Methods: Choose 144 cases of cerebral infarction patients as observation group;And there is no history of high blood pressure, to select 138 cases of cardiovascular disease and diabetes in old people as control group, the two groups do colour to exceed carotid check, observation analysis of the plaques and hemodynamic index. Results:the observation group of patients with carotid artery plaque detection rate was 76.4%;Peak systolic velocity(PSV), end-diastolic velocity(EDV), significantly lower than the control group, the difference was statistically significant (t=5.32, t=5.64, P<0.05);Vascular resistance index(RI), blood vessels, pulsation index (PI) is significantly higher than the control group, the difference was statistically significant(t=6.23, t=3.56, P<0.05). Conclusion:the incidence of cerebral infarction is associated with carotid atherosclerosis, unstable plaque is the main risk factors.

Coronary artery plaque burden and calcium scores in healthy men adhering to long-term wine drinking or alcohol abstinence

Observational studies suggest there are clinical benefits to moderate red wine (RW) consumption. However, the effects on coronary vasculature and overall lifestyle are unclear. We investigated whether a lifestyle of regular long-term RW consumption is associated with changes in coronary plaque burden, calcium score, carotid intima/media thickness, endothelial function, and metabolic variables, compared with alcohol abstinence. Healthy volunteers were evaluated by coronary computed tomography angiography (CTA) as well as carotid and brachial artery ultrasound. Nutritional status, psychological status, and metabolic variables were assessed. The study included 101 drinkers [aged 58.9±7.3 years (means±SD)], from wine brotherhoods, and 104 abstainers, from Anglican, Evangelical and Catholic churches both in the city of São Paulo, Brazil. No significant differences in demographics were noted. Lesion prevalence per patient assessed by coronary CTA and classified as absent (0), 1-25, 26-49, and ≥50% stenosis was similar between groups. When analyzed by individual arteries, i.e., left anterior descending, circumflex, and right coronary, prevalence was also not different. On the other hand, calcium scores were higher among drinkers than abstainers (144.4±362.2 vs 122.0±370.3; P<0.01). However, drinkers reported less history of diabetes and exercised more. RW drinkers consumed 2127.9±387.7 kcal/day while abstainers consumed 1836.0±305.0 (P<0.0001). HDL cholesterol was significantly higher among drinkers compared to abstainers (46.9±10.9 vs 39.5±9.0 mg/dL; P<0.001), while fasting plasma glucose was lower (97.6±18.2 vs 118.4±29.6 mg/dL; P<0.02). Liver enzymes were normal in both groups. In conclusion, long-term wine drinkers displayed a similar plaque burden but greater calcium score than abstainers, despite a more atherogenic diet, and the mechanisms for the increased calcium scores in the former remain speculative.

Control study of Beraprost Sodium and atorvastatin in treatment with TIA combined carotid plaques / 中国生化药物杂志

Objective To investigate the effect of Beraprost Sodium and atorvastatin in the treatment of TIA combined carotid plaques. Method 60 cases in our hospital with TIA and carotid artery plaques were randomly divided into observation group and control group, 30 cases in each group. The observation group was received beraprost natriuretic peptide and atorvastatin calcium therapy, the control group was treated with atorvastatin calcium. 12 months later,two groups were compared with carotid plaque area change and coagulation conditions. Results Carotid plaque area in observed group was significantly less than the control group (P<0.05). The differences of platelet agglutination test(PAgT), fibrinogen(Fg) , hypersensieive 3 C-reaction protein, total cholesterol(TC), high density lipoprotein cholesterol (HDL), low density lipoprotein cholesterol (LDL), TIA recurrence rate and incidence of ischemic stroke between two groups after treatment were statistically significant (P<0.05). Conclusion Beraprost Sodium and atorvastatin has a good effect in reducing carotid plaques area, adjusting blood fat and preventing TIA and ischemic stroke, It is worthy to clinical popularization and application.

Correlation between carotid atherosclerosis and coronary artery atherosclerosis, and their relationship with peripheral blood macrophage colony stimulatory factor, C-reactive protein and plaque stability / 中国医师进修杂志

Objective To explore the correlation between carotid atherosclerosis and coronary artery atherosclerosis, and their relationship with macrophage colony stimulatory factor (M-SCF), C-reactive protein(CRP) and plaque stability.Methods A total of 400 patients having underwent a selective coronary angiography were divided into no coronary heart disease (NCHD) group (93 cases), acute coronary artery syndrome(ACS) group (202 cases) and stable angina pectoris(SAP) group ( 105 cases).Based on coronary angiography plaque morphology, the patch was typed as Ⅰ, Ⅱ and Ⅲ and based on ultrasound for the carotid artery, plaque was typed as stable and unstable plaques.The plaque type, the levels of peripheral blood M-SCF, CRP was compared among ACS group,SAP group and NCHD group.Results Coronary artery atherosclerosis was mainly type Ⅱ in ACS group[78.7%(159/202)], and carotid atherosclerosis was mainly unstable[69.3%(140/202)].Coronary artery atherosclerosis of type Ⅰ , Ⅱ , Ⅲ was 40.0%(42/105), 30.5% (32/105) and 29.5%(31/105) in SAP group,and carotid atherosclerosis was mainly stable.The levels of peripheral blood M-SCF, CRP in ACS group were higher than those in SAP group and NCHD group (P＜ 0.05 ) ,and there was no significant difference between SAP group and NCHD group (P＞ 0.05 ).The levels of peripheral blood M-SCF, CRP in coronary artery atherosclerosis with type Ⅱ were higher than those with type Ⅰ , Ⅲ (p＜ 0.05).The levels of peripheral blood M-SCF, CRP in carotid atherosclerosis with unstable plaque were higher than those with stable (P ＜ 0.05 ).Conclusion Coronary arteriosclerosis is closely related with carotid arteriosclerosis.The levels of M-SCF and CRP are related to plaque structural characteristics and plaque stability.

Idade e tempo em diálise são associações maiores com placas de carótida em pacientes não diabéticos em HD / Age and time on dialysis are major associations with carotid plaques in non-diabetic HD patients

Introdução: Aterosclerose acelerada é uma característica bem reconhecida da doença renal avançada, sendo um dos fatores predominantes associados com a alta morbidade e mortalidade nesta população de pacientes. Vários estudos correlacionaram a presença de placas ateroscleróticas com o estado nutricional e a inflamação nestes pacientes. Entretanto, fatores de risco tradicionais como hipertensão, tabagismo e dislipidemia devem sempre ser considerados no contexto de aspectos étnicos, geográficos e culturais de uma dada população de pacientes renais. Objetivo: Este estudo teve por objetivo a descrição da prevalência da aterosclerose avançada, segundo avaliação através da presença de placas carotídeas, e sua correlação com dados epidemiológicos, fatores de risco tradicionais e não-tradicionais em pacientes não diabéticos em hemodiálise (HD). Métodos: Trinta e nove pacientes em um programa regular de HD foram avaliados (idade média: 47,0 ± 12,8 anos, 20 homens, tempo médio em diálise: 5,2 ± 2,9 anos). A presença de aterosclerose foi investigada por Doppler de carótida e a inflamação pela proteína C-reativa (PCR). Dados acerca do estado nutricional, pressão arterial e parâmetros bioquímicos foram igualmente analisados. Resultados: A presença de placa em carótida foi um achado prevalente, observada em 64,1% dos pacientes. A idade (50,8 ± 10,6 anos) e o tempo em diálise (6 [1-15] anos) foram significativamente maiores no grupo de pacientes com placas, comparado ao grupo de pacientes sem placas (41,3 ± 14,5 e 4 [1-11], respectivamente, p < 0,05). Não houve diferença estatística entre os grupos no que diz respeito à PCR, estado nutricional e parâmetros bioquímicos. Placas de carótida foram associadas com a idade acima de 38 anos (O.R.: 28.29; C.I.: 2.68-712.8; p < 0,001), e tempo em diálise acima de 4 anos (O.R.: 5.5; C.I.: 1.02-33.37; p < 0.05).Além disso, 70% dos pacientes com pressão diastólica pós HD menor do que 90 mmHg apresentaram placas de carótida.

Introduction: Accelerated atherosclerosis is a well-recognized characteristic of end stage renal disease (ESRD), as one of the leading factors associated with the high cardiovascular morbidity and mortality in this patient population. Several studies have been done correlating the presence of atherosclerotic carotid plaques with nutritional status and inflammation in this setting. Nevertheless, traditional risk factors like hypertension, smoking and dyslipidemia must always be taken into account in the context of the specific ethnic, geographic and cultural aspects of a given renal population. Aim: The present study was designed to describe the prevalence of advanced atherosclerosis, as detected by the presence of carotid plaques, and its correlation with epidemiological data, traditional and non-traditional risk factors in non-diabetic hemodialysis (HD) patients. Methods: Thirty-nine patients on a regular HD program were evaluated (mean age: 47.0±12.8 years, 20 men, mean time on dialysis: 5.2±2.9 years). Atherosclerosis was assessed by carotid Doppler and inflammation by serum C reactive protein (CRP). Data on nutritional status, biochemical parameters, and arterial pressure (AP) were also analyzed. Results: Carotid plaque was a prevalent finding, observed in 64.1% of the patients. The age (50.8±10.6 years) and time on dialysis (6 [1-15] years) were significantly higher in the group of patients with plaques, compared to the group of patients without plaques (41.3±14.5 and 4 [1-11], respectively, P<0.05). There was no statistical difference between the groups regarding CRP, nutritional status, biochemistry parameters, and mean pre and post HD arterial, diastolic and systolic pressure. Carotid plaques were associated with age higher than 38 (OR.: 28.29; 95% CI.: 2.68-712.8; p<0.001), and time on dialysis higher than 4 years (OR.: 5.5; 95% CI.: 1.02-33.37; p<0.05). In addition, 70% of patients with post HD diastolic AP lower than 90 mmHg presented carotid plaques.