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Asymptomatic carotid atherosclerosis

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https://www.readbyqxmd.com/read/28818257/high-risk-carotid-plaque-lessons-learned-from-histopathology
#1
Frank D Kolodgie, Kazuyuki Yahagi, Hiroyoshi Mori, Maria E Romero, Hugh H Trout, Aloke V Finn, Renu Virmani
The pathophysiology and natural history of atherosclerotic carotid disease is predicated on a more extensive knowledge of lesion progression gained in the studies conducted in the coronary arteries, and these will be reviewed. While the precise sequence of lesion progression leading to carotid plaque vulnerability and cerebrovascular events remain less well understood, specific early and more advanced progressive lesion morphologies associated with stroke risk have been characterized. Of late, there has been a conscious effort for stroke prevention in symptomatic and asymptomatic patients to move beyond luminal stenosis as the only guidance to predict future cerebrovascular events...
March 2017: Seminars in Vascular Surgery
https://www.readbyqxmd.com/read/28818255/clinical-need-design-and-goals-for-the-carotid-revascularization-and-medical-management-for-asymptomatic-carotid-stenosis-trial
#2
Brajesh K Lal, James F Meschia, Thomas G Brott
Prior clinical trials produced evidence-based treatment recommendations for patients with asymptomatic carotid stenosis that may not be appropriate for clinical decision-making today. High-quality patient outcomes data to allow informed decision making regarding the optimal management of high-grade asymptomatic internal carotid artery stenosis is lacking. The results of the Asymptomatic Carotid Atherosclerosis Study were published in 1995 based on a randomized patient enrollment in the 1990s. Outcomes after endarterectomy, stenting, and medical treatment for these patients have all improved in the subsequent 2 decades...
March 2017: Seminars in Vascular Surgery
https://www.readbyqxmd.com/read/28794054/cardiovascular-event-prediction-by-machine-learning-the-multi-ethnic-study-of-atherosclerosis
#3
Bharath Ambale-Venkatesh, Xiaoying Yang, Colin O Wu, Kiang Liu, W G Hundley, Robyn L McClelland, Antoinette S Gomes, Aaron R Folsom, Steven Shea, Eliseo Guallar, David A Bluemke, João A Lima
Rationale: Machine learning may be useful to characterize cardiovascular risk, predict outcomes and identify biomarkers in population studies. Objective: To test the ability of random survival forests (RF), a machine learning technique, to predict six cardiovascular outcomes in comparison to standard cardiovascular risk scores. Methods and Results: We included participants from the Multi-Ethnic Study of Atherosclerosis (MESA). Baseline measurements were used to predict cardiovascular outcomes over 12 years of follow-up...
August 9, 2017: Circulation Research
https://www.readbyqxmd.com/read/28734077/integrative-studies-implicate-matrix-metalloproteinase-12-as-a-culprit-gene-for-large-artery-atherosclerotic-stroke
#4
Hovsep Mahdessian, Ljubica Perisic Matic, Mariette Lengquist, Karl Gertow, Bengt Sennblad, Damiano Baldassarre, Fabrizio Veglia, Steve E Humphries, Rainer Rauramaa, Ulf de Faire, Andries J Smit, Philippe Giral, Sudhir Kurl, Elmo Mannarino, Elena Tremoli, Anders Hamsten, Per Eriksson, Ulf Hedin, Anders Mälarstig
BACKGROUND: Ischemic stroke and coronary heart disease are important contributors to the global disease burden and share atherosclerosis as the main underlying cause. Recent evidence from a genome-wide association study (GWAS) suggested that single nucleotide polymorphisms (SNP) near the MMP12 gene at chromosome 11q22.3 were associated with large-vessel ischemic stroke. Here we evaluated and extended these results by examining the relationship between MMP12 and atherosclerosis in clinical and experimental studies...
July 22, 2017: Journal of Internal Medicine
https://www.readbyqxmd.com/read/28727356/-management-of-carotid-artery-stenosis
#5
Francesco Puccinelli, Marco Roffi, Nicolas Murith, Roman Sztajzel
Carotid artery atherosclerosis remains one of the major causes of stroke. The efficacy of carotid artery recanalization has already been established and is considered significant for symptomatic stenosis >70% and moderate for stenosis between 50-69 %. Regarding asymptomatic stenosis, carotid artery recanalization should be reserved for carefully selected patients with a stenosis between 70-90 % and an estimated procedural risk at less than 3 %. Two therapeutic options are currently available : angioplasty with stent placement and endarterectomy...
April 26, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28675704/the-metabolic-syndrome-is-associated-with-carotid-atherosclerosis-and-arterial-stiffness-in-asymptomatic-nondiabetic-postmenopausal-women
#6
Irene Lambrinoudaki, Aikaterini Kazani, Eleni Armeni, Demetrios Rizos, Areti Augoulea, Georgios Kaparos, Andreas Alexandrou, Georgios Georgiopoulos, Ioannis Kanakakis, Kimon Stamatelopoulos
The menopause transition is associated with adverse changes in cardiometabolic risk factors. We aimed to examine the association of the metabolic syndrome (MS) and its features with indices of vascular structure and function in a population of asymptomatic postmenopausal women. A total of 473 informed-consenting, nondiabetic postmenopausal women were included in the study. The MS was defined according to the Joint Definition. We evaluated the association between the presence of MS and indices of vascular structure (carotid artery intima-media thickness (IMT); atherosclerotic plaques) and function (flow-mediated dilatation (FMD); pulse wave velocity (PWV))...
July 4, 2017: Gynecological Endocrinology
https://www.readbyqxmd.com/read/28675103/carotid-artery-plaques-carotid-intima-media-thickness-and-risk-of-cardiovascular-events-and-all-cause-death-in-older-adults-a-5-year-prospective-community-based-study
#7
Yanlei Zhang, Xianghua Fang, Yang Hua, Zhe Tang, Shaochen Guan, Xiaoguang Wu, Hongjun Liu, Beibei Liu, Chunxiu Wang, Zhongying Zhang, Xiang Gu, Chengbei Hou, Chunxiao Liu
We assessed the effect of asymptomatic carotid atherosclerosis (CAS) on the development of cardiovascular diseases (CVDs) in a community-based population aged ≥55 years in China. A total of 1376 residents underwent CAS assessment by ultrasonography in July 2009. New CVD events, including stroke and coronary heart events, were collected at the follow-up survey at the end of 2014. After adjusting for baseline demographic characteristics and traditional CVD risk factors, the risk of CVD in patients with minimal CAS (mean common carotid artery intima-media thickness [CCA-IMT] ≥1 mm and no plaques), nonstenotic plaques (carotid stenosis <50%), and stenotic plaques (carotid stenosis ≥50%) was 0...
January 1, 2017: Angiology
https://www.readbyqxmd.com/read/28672747/ngal-and-mmp-9-ngal-as-biomarkers-of-plaque-vulnerability-and-targets-of-statins-in-patients-with-carotid-atherosclerosis
#8
Wolf Eilenberg, Stefan Stojkovic, Alexandra Kaider, Nicolas Kozakowski, Christoph M Domenig, Christopher Burghuber, Josif Nanobachvili, Kurt Huber, Markus Klinger, Christoph Neumayer, Ihor Huk, Johann Wojta, Svitlana Demyanets
BACKGROUND: Neutrophil gelatinase associated lipocalin (NGAL) is expressed in atherosclerotic lesions and was recently implicated in the pathogenesis of cardiovascular pathologies. Statins are known to exert stabilizing effects on atherosclerotic plaque. The aims of our study were (1) to investigate the association of serum NGAL and metalloproteinase (MMP)-9/NGAL complex with the vulnerability of the atherosclerotic plaque, and (2) to reveal the effects of statin treatment on circulating NGAL and MMP-9/NGAL levels in patients with carotid artery stenosis...
June 26, 2017: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/28659610/upregulation-of-arylsulfatase-b-in-carotid-atherosclerosis-is-associated-with-symptoms-of-cerebral-embolization
#9
Erik Biros, Corey S Moran, Jane Maguire, Elizabeth Holliday, Christopher Levi, Jonathan Golledge
The aim of this study was to identify genes for which the expression within carotid atherosclerosis was reproducibly associated with the symptoms of cerebral embolization. Two publically available microarray datasets E-MEXP-2257 and GSE21545 were analysed using GeneSpring 11.5. The two datasets utilized a total of 22 and 126 carotid atherosclerosis samples, obtained from patients with and without symptoms of cerebral embolization, respectively. To assess whether the findings were reproducible we analysed carotid atherosclerosis samples from another 8 patients with and 7 patients without symptoms of cerebral embolization using real-time PCR...
June 28, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28652715/association-of-arteriosclerosis-and-or-atherosclerosis-with-hypertensive-target-organ-damage-in-the-community-dwelling-elderly-chinese-the-northern-shanghai-study
#10
Ximin Fan, Mengyun Zhu, Chen Chi, Shikai Yu, Jing Xiong, Yuyan Lu, Bin Bai, Yawei Xu, Yi Zhang
OBJECTIVE: Vascular abnormality includes two forms, arteriosclerosis (ARS) and atherosclerosis (ATS), which coexist in patients with cardiovascular (CV) diseases. However, whether their combination may lead to a worsening status in those patients remains unclear. We therefore aimed to investigate the association of ARS and/or ATS with hypertensive target organ damage (TOD). METHODS: From June 2014 to August 2015, a total of 1,599 community-dwelling elderly subjects (aged >65 years) from northern Shanghai were recruited...
2017: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/28648478/imaging-vulnerable-plaques-by-targeting-inflammation-in-atherosclerosis-using-fluorescent-labeled-dual-ligand-microparticles-of-iron-oxide-and-magnetic-resonance-imaging
#11
Joyce M S Chan, Claudia Monaco, Marzena Wylezinska-Arridge, Jordi L Tremoleda, Jennifer E Cole, Michael Goddard, Maggie S H Cheung, Kishore K Bhakoo, Richard G J Gibbs
OBJECTIVE: Identification of patients with high-risk asymptomatic carotid plaques remains an elusive but essential step in stroke prevention. Inflammation is a key process in plaque destabilization and a prelude to clinical sequelae. There are currently no clinical imaging tools to assess the inflammatory activity within plaques. This study characterized inflammation in atherosclerosis using dual-targeted microparticles of iron oxide (DT-MPIO) as a magnetic resonance imaging (MRI) probe...
June 22, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28623250/adamts-7-is-associated-with-a-high-risk-plaque-phenotype-in-human-atherosclerosis
#12
Eva Bengtsson, Karin Hultman, Pontus Dunér, Giuseppe Asciutto, Peter Almgren, Marju Orho-Melander, Olle Melander, Jan Nilsson, Anna Hultgårdh-Nilsson, Isabel Gonçalves
Several large-scale genome-wide association studies have identified single-nucleotide polymorphisms in the genomic region of A Disintegrin And Metalloproteinase with ThromboSpondin type 1 repeats (ADAMTS)-7 and associations to coronary artery disease. Experimental studies have provided evidence for a functional role of ADAMTS-7 in both injury-induced vascular neointima formation and development of atherosclerotic lesions. However, whether ADAMTS-7 is associated with a specific plaque phenotype in humans has not been investigated...
June 16, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28615715/rnaseq-based-transcriptomics-study-of-smcs-from-carotid-atherosclerotic-plaque-bmp2-and-ids-proteins-are-crucial-regulators-of-plaque-stability
#13
Iraide Alloza, Haize Goikuria, Juan Luis Idro, Juan Carlos Triviño, José María Fernández Velasco, Elena Elizagaray, María García-Barcina, Genoveva Montoya-Murillo, Esther Sarasola, Reyes Vega Manrique, Maria Del Mar Freijo, Koen Vandenbroeck
Carotid artery atherosclerosis is a risk factor to develop cerebrovascular disease. Atheroma plaque can become instable and provoke a cerebrovascular event or else remain stable as asymptomatic type. The exact mechanism involved in plaque destabilization is not known but includes among other events smooth muscle cell (SMC) differentiation. The goal of this study was to perform thorough analysis of gene expression differences in SMCs isolated from carotid symptomatic versus asymptomatic plaques. Comparative transcriptomics analysis of SMCs based on RNAseq technology identified 67 significant differentially expressed genes and 143 significant differentially expressed isoforms in symptomatic SMCs compared with asymptomatic...
June 14, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28610589/high-sensitivity-cardiac-troponin-t-is-a-biomarker-for-atherosclerosis-in-systemic-lupus-erythematous-patients-a-cross-sectional-controlled-study
#14
Gillian Divard, Rachid Abbas, Camille Chenevier-Gobeaux, Noémie Chanson, Brigitte Escoubet, Marie-Paule Chauveheid, Antoine Dossier, Thomas Papo, Monique Dehoux, Karim Sacre
BACKGROUND: Cardiovascular disease (CVD) is the main cause of death in systemic lupus erythematous (SLE) patients. The Framingham score underestimates the risk for CVD in this population. Our study aimed to determine whether serum high-sensitivity cardiac troponin T (HS-cTnT) might help to identify SLE patients at risk for CVD. METHODS: The presence of carotid plaques was prospectively assessed by ultrasound in 63 consecutive SLE patients asymptomatic for CVD and 18 controls...
June 13, 2017: Arthritis Research & Therapy
https://www.readbyqxmd.com/read/28577790/impact-of-provider-characteristics-on-outcomes-of-carotid-endarterectomy-for-asymptomatic-carotid-stenosis-in-new-york-state
#15
Andrew J Meltzer, Christopher Agrusa, Peter H Connolly, Darren B Schneider, Art Sedrakyan
OBJECTIVE: (s)The purpose of this study was to explore the impact of surgeon characteristics (including annual volume, specialty, and years in practice) on outcomes of carotid endarterectomy (CEA) for asymptomatic carotid atherosclerosis in New York State. METHODS: The New York Statewide Planning and Cooperation System (SPARCS) database was utilized to identify patients undergoing CEA from 2004-2011. Provider characteristics were determined by linkage to the New York Office of Professions and National Provider Identification databases...
May 31, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28576484/signs-of-subclinical-atherosclerosis-in-asymptomatic-patients-at-increased-risk-of-type-2-diabetes-mellitus
#16
Loretta Zsuzsa Kiss, Zsolt Bagyura, Réka Vadas, Lívia Polgár, Árpád Lux, Eszter Édes, Orsolya Szenczi, Pál Soós, Zsolt Szelid, Dávid Becker, György Jermendy, Béla Merkely
AIMS: We aimed to study carotid intima media thickness (CIMT) in asymptomatic patients with an increased risk of type 2 diabetes mellitus (T2DM) and in a pre-diabetic state. METHODS: Diabetes risk assessment was performed in 2420 participants in a voluntary screening program between 2011 and 2013. The risk of T2DM was estimated by the Findrisc scoring system (FR). A FR≥12 was considered as increased risk. HbA1c% between 5.7 and 6.4% signified a pre-diabetic state...
May 25, 2017: Journal of Diabetes and its Complications
https://www.readbyqxmd.com/read/28575478/the-preservation-of-cognition-1-yr-after-carotid-endarterectomy-in-patients-with-prior-cognitive-decline
#17
Robert J Dempsey, Daren C Jackson, Stephanie M Wilbrand, Carol C Mitchell, Sara E Berman, Sterling C Johnson, Nirvedh H Meshram, Tomy Varghese, Bruce P Hermann
BACKGROUND: Vascular cognitive decline is critically important in the course of atherosclerosis and stroke. OBJECTIVE: To explore the hypothesis that carotid endarterectomy (CEA) by removing an unstable plaque may slow the course of vascular cognitive decline in both symptomatic and asymptomatic patients. METHODS: Patients with clinically significant (>60%) carotid stenosis were studied preop and 1 yr post-CEA for clinical symptoms, vascular cognitive decline, instability of carotid plaque-presence of microemboli, brain white matter changes, and medical risk factors...
June 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28543093/relationship-between-carotid-atherosclerosis-and-coronary-artery-calcification-in-asymptomatic-diabetic-patients-a-prospective-multicenter-study
#18
Anand Jeevarethinam, Shreenidhi Venuraju, Alain Dumo, Sherezade Ruano, Vishal S Mehta, Miranda Rosenthal, Devaki Nair, Mark Cohen, Daniel Darko, Avijit Lahiri, Roby Rakhit
BACKGROUND: The value of screening sub-clinical atherosclerosis in asymptomatic patients with type 2 diabetes mellitus (T2DM) remains controversial. HYPOTHESIS: An integrated model incorporating carotid intima-media thickness (CIMT) and carotid plaque with traditional risk factors can be used to predict prevalence and severity of coronary artery calcification in asymptomatic T2DM patients. METHODS: A cohort of 262 asymptomatic T2DM patients were prospectively studied with carotid ultrasound to evaluate CIMT and carotid plaque and also a computed tomography coronary artery calcium (CT-CAC) scan...
May 25, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28539213/medical-management-of-asymptomatic-carotid-artery-stenosis
#19
REVIEW
Aaron W Aday, Joshua A Beckman
Carotid artery atherosclerosis is a major risk factor for both stroke and cardiovascular disease. Appropriate management of asymptomatic patients with carotid artery stenosis (CAS) remains unclear. Although several randomized clinical trials support revascularization in asymptomatic patients with severe CAS to reduce stroke risk, the participants in these trials did not receive optimal medical therapy (OMT) by today's standards. For many individuals, medical therapy may provide excellent risk reduction without the periprocedural risk of endarterectomy or stenting...
May 2017: Progress in Cardiovascular Diseases
https://www.readbyqxmd.com/read/28537783/association-of-mild-to-moderate-reduction-in-glomerular-filtration-rate-with-subclinical-atherosclerosis-in-postmenopausal-women
#20
Florina Parv, Andrei Beceanu, Rodica Avram, Romulus Zorin Timar, Bogdan Timar, Florica Gadalean
BACKGROUND: Due to loss of hormonal protective effects, postmenopausal women have an increased cardiovascular (CV) risk. Chronic kidney disease (CKD) is a well-established risk factor for CV disease, but little is known whether mild-to-moderate kidney dysfunction is associated with atherosclerosis burden in the postmenopausal asymptomatic women. MATERIALS AND METHODS: Subclinical atherosclerosis was evaluated in 125 postmenopausal women with no clinical form of atherosclerosis, by carotid and femoral ultrasonography, ankle-brachial index (ABI), and flow-mediated dilation (FMD)...
May 24, 2017: Journal of Women's Health
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