Risk Factor Analysis for Development of Asymptomatic Carotid Stenosis in Koreans

Many risk factors for atherosclerosis have been proposed to identify high risk individuals. We conducted a retrospective study to determine the risk factors for development of carotid stenosis (CS) in Koreans. Database of 2,805 subjects who underwent a check up of carotid artery for health examination were analyzed. Stenosis (%) of common carotid artery or proximal internal carotid artery was examined with ultrasonography. Subjects were divided into 2 groups (Group I; CS or =30%). We compared demographic, laboratory and clinical data between 2 groups to determine the risk factors of CS. One hundred ninety seven subjects (7.0%) were categorized as Group II. At age- and sex-adjusted multivariate analysis, diabetes mellitus, hypertension, cerebrovascular disease, ischemic heart disease, hyperlipidemia, aspirin medication, current smoking, fasting glucose, total cholesterol, low density lipoprotein-cholesterol (LDL-C) and leukocyte count were significant risk factors of CS. At stepwise logistic regression analysis, age, hypertension, hyperlipidemia, LDL-C and leukocyte count were independent risk factors. At subgroup analysis by smoking, age and leukocyte count were independent risk factors in smoker and age and hypertension in nonsmoker.

Circulating levels of interleukin-8 and vascular endothelial growth factor in patients with carotid stenosis

Interleukin (IL)-8 and vascular endothelial growth factor (VEGF) are important factors that induce the migration and proliferation of endothelial cells, increase the vascular permeability, and the modulate chemotaxis of monocytes. These molecules have been found in human atherosclerotic plaques. However, it is not clear whether the circulating levels of IL-8 and VEGF correlate with the extents of carotid stenosis. In this study, we investigated the relationship between circulating levels of IL-8 as well as VEGF and the extents of carotid stenosis. Sera from 41 patients with carotid stenosis were assessed for concentrations of IL-8 and VEGF by enzyme-linked immunosorbent assay. The degree of stenosis of extracranial carotid artery was calibrated by carotid B- mode ultrasonography. The serum concentration of IL-8 (r=-0.04733, p>0.05) was not correlated with the degree of stenosis. However, the serum concentration of VEGF (r=0.4974, p<0.01) was significantly correlated with the degree of carotid stenosis. These findings suggest that increased serum level of VEGF might be a marker for higher degree of stenosis of extracranial carotid artery.

Comparaçäo das fraçöes HDL e LDL colesterol como fatores de risco para a aterosclerose carotídea / Comparison between HDL and LDL cholesterol fractions as risk factors for carotid atherosclerosis

Estudo prospectivo com o objetivo de verificar qual das fraçoes do colesterol sanguíneo, HDL ou LDL, é mais significativa para o desenvolvimento da aterosclerose das artérias carótidas (AC). Constou de 125 indivíduos de ambos os sexos, com idade enttre 45 a 75 anos, incluídos aleatoriamente. Em todos foi procedida a dosagem sanguínea do colesterol total e das fraçoes HDL e LDL e estudo ultrassonográfico (através de ultrasonografia modo B) das AC. Os resultados mostraram que a presença de placa de ateroma, com ou sem estenose nas AC, é inversamente proporcional aos níveis de HDL. Estes achados forma estatísticamente significantes (x2=6,57 e x2=9,24), respectivamente para placa sem estenose e com estenose; x2 crítico = 5,99 para alfa=5 por cento). Foi também constatada associaçao entre a presença de placa aterosclerótica na AC e níveis sanguíneos elevados de LDL: quanto maiores os níveis de LDL, maior a proporçao de indivíduos com placas, porém este achado nao foi estatisticamente significante (x2=0,97, x2 crítico 5,99 para alfa=5 por cento) Nao foi encontrada nesta casuística relaçao entre níveis elevados de LDL a presença de estenose nas AC. Estes resultados, ainda que iniciais, sugerem níveis baixos de HDL sao mais aterogênicos para as AC comparativamente a níveis elevados de LDL.

The effect of aspirin on neurodeficit and platelet aggregability in acute ischemic cerebral strokes.

We examined the role of aspirin in modifying platelet aggregability (PA) and neurodeficit (ND) in patients presenting within 48 hours of acute ischemic cerebral strokes of the carotid territory. 28 adult patients were studied at baseline and after 7 days of treatment with a single daily dose of aspirin 325mg (group A, n = 12) and 160 mg (Group B, n = 16). We also evaluated the neurologic outcome at the beginning and at the end of 7 days using a scoring system. There was no significant difference in the ND scores and in vitro PA between these two groups. PA, as measured in vitro, does not appear to have any significant role as a predictor of neurologic outcome in acute ischemic strokes. The change in ND scores of patients with ischemic cerebral strokes treated acutely with aspirin was not significant upto first 7 days therapy.