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https://www.readbyqxmd.com/read/28329380/subclinical-thyroid-dysfunction-and-cardiovascular-diseases-2016-update
#1
Carmen Floriani, Baris Gencer, Tinh-Hai Collet, Nicolas Rodondi
Subclinical thyroid dysfunction comprises subclinical hypothyroidism (SHypo), defined as elevated thyroid-stimulating hormone (TSH) by normal free thyroxine (FT4), and subclinical hyperthyroidism (SHyper) with decreased or undetectable TSH and normal FT4. Up to 10% of the elderly have SHypo, which is usually asymptomatic. Individual participant data (IPD) analyses of prospective cohort studies from the international Thyroid Studies Collaboration show that SHypo is associated with increased coronary heart disease (CHD) mortality [hazard ratio (HR) 1,58 for TSH ≥ 10 mIU/L, 95% CI 1...
February 27, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28323231/carotid-endarterectomy-in-the-southern-california-vascular-outcomes-improvement-collaborative
#2
Kaelan Chan, Ahmed Abouzamzam, Karen Woo
OBJECTIVE: The objective of this study is to examine the variation in practice patterns and associated outcomes for carotid endarterectomy (CEA) within the Southern California Vascular Outcomes Improvement Collaborative (So Cal VOICe), a regional quality group of the Vascular Quality Initiative (VQI). METHODS: All cases entered in the CEA registry by the So Cal VOICe were included in the study. RESULTS: From September 2010 through September 2015, 1110 CEA cases were entered by nine centers in the So Cal VOICe...
March 17, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28319050/extracellular-matrix-proteomics-identifies-molecular-signature-of-symptomatic-carotid-plaques
#3
Sarah R Langley, Karin Willeit, Athanasios Didangelos, Ljubica Perisic Matic, Philipp Skroblin, Javier Barallobre-Barreiro, Mariette Lengquist, Gregor Rungger, Alexander Kapustin, Ludmilla Kedenko, Chris Molenaar, Ruifang Lu, Temo Barwari, Gonca Suna, Xiaoke Yin, Bernhard Iglseder, Bernhard Paulweber, Peter Willeit, Joseph Shalhoub, Gerard Pasterkamp, Alun H Davies, Claudia Monaco, Ulf Hedin, Catherine M Shanahan, Johann Willeit, Stefan Kiechl, Manuel Mayr
BACKGROUND: The identification of patients with high-risk atherosclerotic plaques prior to the manifestation of clinical events remains challenging. Recent findings question histology- and imaging-based definitions of the "vulnerable plaque," necessitating an improved approach for predicting onset of symptoms. METHODS: We performed a proteomics comparison of the vascular extracellular matrix and associated molecules in human carotid endarterectomy specimens from 6 symptomatic versus 6 asymptomatic patients to identify a protein signature for high-risk atherosclerotic plaques...
March 20, 2017: Journal of Clinical Investigation
https://www.readbyqxmd.com/read/28318997/diastolic-blood-pressure-is-a-risk-factor-for-peri-procedural-stroke-following-carotid-endarterectomy-in-asymptomatic-patients
#4
D D de Waard, G J de Borst, R Bulbulia, A Huibers, A Halliday
OBJECTIVE/BACKGROUND: Carotid endarterectomy (CEA) prevents future stroke, but this benefit depends on detection and control of high peri-operative risk factors. In symptomatic patients, diastolic hypertension has been causally related to procedural stroke following CEA. The aim was to identify risk factors causing peri-procedural stroke in asymptomatic patients and to relate these to timing of surgery and mechanism of stroke. METHODS: In the first Asymptomatic Carotid Surgery Trial (ACST-1), 3,120 patients with severe asymptomatic carotid stenosis were randomly assigned to CEA plus medical therapy or to medical therapy alone...
March 16, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28317160/contrast-enhanced-ultrasonography-vs-b-mode-ultrasound-for-visualization-of-intima-media-thickness-and-detection-of-plaques-in-human-carotid-arteries
#5
Benoy N Shah, Navtej S Chahal, Jaspal S Kooner, Roxy Senior
BACKGROUND: Carotid intima-media thickness (IMT) and plaque are recognized markers of increased risk for cerebrovascular events. Accurate visualization of the IMT and plaques is dependent upon image quality. Ultrasound contrast agents improve image quality during echocardiography-this study assessed whether contrast-enhanced ultrasound (CEUS) improves carotid IMT visualization and plaque detection in an asymptomatic population. METHODS & RESULTS: Individuals free from known cardiovascular disease, enrolled in a community study, underwent B-mode and CEUS carotid imaging...
March 19, 2017: Echocardiography
https://www.readbyqxmd.com/read/28306696/n-terminal-fragment-of-b-type-natriuretic-peptide-predicts-coexisting-subclinical-heart-and-vessel-disease
#6
Luigi E Pastormerlo, Stefano Maffei, Daniele Della Latta, Vladislav Chubuchny, Carla Susini, Sergio Berti, Concetta Prontera, Simona Storti, Claudio Passino, Emilio Pasanisi, Michele Emdin, Dante Chiappino
BACKGROUND: Identification of preclinical cardiovascular disease represents a challenge. We evaluate N-terminal proB-type natriuretic peptides (NT-proBNP) as markers of both cardiac and vascular subclinical disease in a community-based study including asymptomatic middle- aged study participants. METHODS AND RESULTS: In total, 807 study participants without previous cardiovascular disease were recruited. They underwent thorough laboratory assessment (including NT-proBNP), ultrasound examination of heart and evaluation of coronary calcium score and carotid intima-media thickness, by computed tomography and ultrasound, respectively...
March 16, 2017: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/28300680/evaluation-by-mri-of-silent-brain-infarcts-in-pre-and-post-operative-asymptomatic-carotid-surgery
#7
Remy Pascot, Anne Daoudal, Alain Cardon, Gilles Godet, Antoine Lucas, Elodie Clochard, Jean-Yves Gauvrit, Yann Le Teurnier, Adrien Kaladji
OBJECTIVE: To report the prevalence of Silent Brain Infarcts (SBI) at MRI before and after surgery for asymptomatic high grade carotid stenosis. DESIGN: Single-center retrospective observational study METHODS: Asymptomatic patients who underwent carotid endarterectomy between October 2012 and October 2014 were included. The preoperative assessment included a Doppler and a CT scan dating less than 3 months. A neurological examination was performed during the anesthesia consultation and in the 15 days before surgery...
March 11, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28298139/emergent-carotid-stenting-and-intra-arterial-abciximab-in-acute-ischemic-stroke-due-to-tandem-occlusion
#8
Fawaz Al-Mufti, Krishna Amuluru, Nathan W Manning, Imad Khan, Lissa Peeling, Chirag D Gandhi, Charles J Prestigiacomo, Galyna Pushchinska, David Fiorella, Henry H Woo
OBJECTIVE: Acute occlusions of the extracranial internal carotid artery (ICA) and a major intracranial artery respond poorly to intravenous tissue plasminogen activator (tPA) and present an endovascular challenge. The aim of our study was to retrospectively delineate the feasibility of the combined use of emergent carotid stenting and intra-arterial (IA) Abciximab with intracranial revascularization in the setting of acute ischemic stroke and carotid occlusions at our institution. METHODS: Eleven patients with complete cervical carotid occlusion with or without concomitant intracranial ICA and/or MCA occlusion were identified from a single center, retrospective review of patients admitted to the Stroke unit...
March 15, 2017: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/28298048/carotid-atherosclerotic-plaque-instability-and-cognition-determined-by-ultrasound-measured-plaque-strain-in-asymptomatic-patients-with-significant-stenosis
#9
Robert J Dempsey, Tomy Varghese, Daren C Jackson, Xiao Wang, Nirvedh H Meshram, Carol C Mitchell, Bruce P Hermann, Sterling C Johnson, Sara E Berman, Stephanie M Wilbrand
OBJECTIVE This article describes the use of ultrasound measurements of physical strain within carotid atherosclerotic plaques as a measure of instability and the potential for vascular cognitive decline, microemboli, and white matter changes. METHODS Asymptomatic patients with significant (> 60%) carotid artery stenosis were studied for dynamic measures of plaque instability, presence of microemboli, white matter changes, and vascular cognitive decline in comparison with normative controls and premorbid state...
March 10, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28296733/clinical-usefulness-of-metabolic-risk-factors-to-identify-young-asymptomatic-women-adults-with-subclinical-atherosclerosis-a-cross-sectional-study
#10
Guangming Qin, Zhihao Chen, Weiwei Su, Xiaoge Geng, Xiaojun Chen, Xiang Xu, Wensheng Pan
Interventions of cardiovascular disease should be implemented in early ages. But most studies were performed in middle aged or elderly adults because of the low prevalence in young, especially for women. We investigate the association between metabolic risk factors and subclinical atherosclerosis in young asymptomatic women adults, using carotid intima-media thickness (CIMT) as a marker of the atherosclerotic process.We performed a cross-sectional study of 950 Chinese young asymptomatic women adults (37.28 ± 5...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28292859/-18-f-fluoride-and-18-f-fluorodeoxyglucose-positron-emission-tomography-after-transient-ischemic-attack-or-minor-ischemic-stroke-case-control-study
#11
Alex T Vesey, William S A Jenkins, Agnese Irkle, Alastair Moss, Greg Sng, Rachael O Forsythe, Tim Clark, Gemma Roberts, Alison Fletcher, Christophe Lucatelli, James H F Rudd, Anthony P Davenport, Nicholas L Mills, Rustam Al-Shahi Salman, Martin Dennis, William N Whiteley, Edwin J R van Beek, Marc R Dweck, David E Newby
BACKGROUND: Combined positron emission tomography (PET) and computed tomography (CT) can assess both anatomy and biology of carotid atherosclerosis. We sought to assess whether (18)F-fluoride or (18)F-fluorodeoxyglucose can identify culprit and high-risk carotid plaque. METHODS AND RESULTS: We performed (18)F-fluoride and (18)F-fluorodeoxyglucose PET/CT in 26 patients after recent transient ischemic attack or minor ischemic stroke: 18 patients with culprit carotid stenosis awaiting carotid endarterectomy and 8 controls without culprit carotid atheroma...
March 2017: Circulation. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28291675/choices-of-stent-and-cerebral-protection-in-the-ongoing-acst-2-trial-a-descriptive-study
#12
D D de Waard, A Halliday, G J de Borst, R Bulbulia, A Huibers, R Casana, L H Bonati, V Tolva
OBJECTIVE/BACKGROUND: Several plaque and lesion characteristics have been associated with an increased risk for procedural stroke during or shortly after carotid artery stenting (CAS). While technical advancements in stent design and cerebral protection devices (CPD) may help reduce the procedural stroke risk, and anatomy remains important, tailoring stenting procedures according to plaque and lesion characteristics might be a useful strategy in reducing stroke associated with CAS. In this descriptive report of the ongoing Asymptomatic Carotid Surgery Trial-2 (ACST-2), it was assessed whether choice for stent and use or type of CPD was influenced by plaque and lesion characteristics...
March 11, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28290390/prevalence-and-risk-factors-of-asymptomatic-carotid-artery-stenosis-in-indian-population-an-8-year-follow-up-study
#13
Subhash Kaul, Suvarna Alladi, K Rukmini Mridula, V C S Srinivasarao Bandaru, Matapathi Umamashesh, Darapureddy Anjanikumar, Palli Lalitha, R Chandrasekhar
BACKGROUND: Asymptomatic carotid artery stenosis (ACAS) is a marker for cerebrovascular disease, coronary atherosclerosis, and death. AIM: To investigate the prevalence of ACAS in the Indian population, and to correlate ACAS with other vascular risk factors. MATERIALS AND METHODS: We prospectively recruited 1500 individuals who were older than 40 years and asymptomatic for cerebrovascular disease between June 2003 and December 2014. Evaluation of vascular risk factors was done for all the participants...
March 2017: Neurology India
https://www.readbyqxmd.com/read/28289534/dysphagia-after-arteria-lusoria-dextra-surgery-anatomical-considerations-before-redo-surgery
#14
Judith Mayer, Natascha van der Werf-Grohmann, Johannes Kroll, Ute Spiekerkoetter, Brigitte Stiller, Jochen Grohmann
Aberrant right subclavian artery (arteria lusoria) is the most common congenital root anomaly, remaining asymptomatic in most cases. Nevertheless, some of the 20%-40% of those affected present tracheo-esophageal symptoms. We report on a 6-year-old previously healthy girl presenting with progressive dysphagia over 4 wk. Diagnostics including barium swallow, echocardiography and magnetic resonance angiography (MRA) revealed a retro-esophageal compression by an aberrant right subclavian artery. Despite the successful, uneventful transposition of this arteria lusoria to the right common carotid via right-sided thoracotomy, the girl was suffering from persisting dysphagia...
February 26, 2017: World Journal of Cardiology
https://www.readbyqxmd.com/read/28288976/risk-of-inhospital-stroke-or-death-is-associated-with-age-but-not-sex-in-patients-treated-with-carotid-endarterectomy-for-asymptomatic-or-symptomatic-stenosis-in-routine-practice-secondary-data-analysis-of-the-nationwide-german-statutory-quality-assurance-database
#15
Sofie Schmid, Pavlos Tsantilas, Christoph Knappich, Michael Kallmayer, Thomas König, Thorben Breitkreuz, Alexander Zimmermann, Andreas Kuehnl, Hans-Henning Eckstein
BACKGROUND: Guideline recommendations on carotid endarterectomy are based predominantly on randomized, controlled trials, in which women or elderly patients are often under-represented. This study analyzed the association of age and sex with the risk of in-hospital stroke or death following carotid endarterectomy under routine conditions in Germany. METHODS AND RESULTS: Secondary data analysis using the Statutory German Quality Assurance Database on all carotid endarterectomy procedures (n=142 074) performed between 2009 and 2014...
March 13, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28283609/intraoperative-completion-studies-local-anesthesia-and-antiplatelet-medication-are-associated-with-lower-risk-in-carotid-endarterectomy
#16
Christoph Knappich, Andreas Kuehnl, Pavlos Tsantilas, Sofie Schmid, Thorben Breitkreuz, Michael Kallmayer, Alexander Zimmermann, Hans-Henning Eckstein
BACKGROUND AND PURPOSE: In Germany, all surgical and endovascular procedures on the carotid bifurcation must be documented in a statutory nationwide quality assurance database. We aimed to analyze the association between procedural and perioperative variables and in-hospital stroke or death rates after carotid endarterectomy. METHODS: Between 2009 and 2014, overall 142 074 elective carotid endarterectomy procedures for asymptomatic or symptomatic carotid artery stenosis were documented in the database...
March 10, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28275231/the-ratio-of-monocyte-frequency-to-hdl-cholesterol-level-as-a-predictor-of-asymptomatic-organ-damage-in-patients-with-primary-hypertension
#17
Emel Aydin, Ihsan Ates, Mehmet Fettah Arikan, Nisbet Yilmaz, Fatih Dede
This study aimed to examine the relationship between the ratio of monocyte frequency to high-density lipoprotein (HDL) cholesterol level (the monocyte/HDL ratio (MHR)) and asymptomatic organ damage (AOD) in primary hypertension (PHT). A total of 366 participants were enrolled in the study, including 275 cases currently being followed up after a diagnosis of PHT in our clinic and 91 healthy volunteers. The MHR was higher in patients with PHT than in individuals in the control group. In the PHT group, the MHR was higher in patients with AOD (AOD+) than in patients without AOD (AOD-)...
March 9, 2017: Hypertension Research: Official Journal of the Japanese Society of Hypertension
https://www.readbyqxmd.com/read/28274755/semiautomatic-quantification-of-carotid-plaque-volume-with-three-dimensional-ultrasound-imaging
#18
Amir A Khan, Christian Koudelka, Carly Goldstein, Limin Zhao, John Yokemick, Moira Dux, Siddhartha Sikdar, Brajesh K Lal
OBJECTIVE: Vessel wall volume (VWV) assessed by three-dimensional duplex ultrasound (3DUS) imaging provides a more comprehensive measure of plaque burden than conventional two-dimensional measures of diameter stenosis. We previously demonstrated that manual outlining of the arterial lumen-intima boundary and outer wall boundary can be performed reliably on images obtained with a commercially available 3D-DUS transducer. Manual segmentation, however, is time consuming (∼45 minutes), limiting its clinical translation...
March 5, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28274754/noninvasive-characterization-of-carotid-plaque-strain
#19
Amir A Khan, Siddhartha Sikdar, Thomas Hatsukami, Juan Cebral, Michael Jones, John Huston, George Howard, Brajesh K Lal
OBJECTIVE: Current risk stratification of internal carotid artery plaques based on diameter-reducing percentage stenosis may be unreliable because ischemic stroke results from plaque disruption with atheroembolization. Biomechanical forces acting on the plaque may render it vulnerable to rupture. The feasibility of ultrasound-based quantification of plaque displacement and strain induced by hemodynamic forces and their relationship to high-risk plaques have not been determined. We studied the feasibility and reliability of carotid plaque strain measurement from clinical B-mode ultrasound images and the relationship of strain to high-risk plaque morphology...
March 5, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28274551/carotid-stenosis-treatment-variation-in-international-practice-patterns
#20
M Venermo, G Wang, A Sedrakyan, J Mao, N Eldrup, R DeMartino, K Mani, M Altreuther, B Beiles, G Menyhei, G Danielsson, I Thomson, G Heller, C Setacci, M Björck, J Cronenwett
OBJECTIVES: The aim was to determine current practice for the treatment of carotid stenosis among 12 countries participating in the International Consortium of Vascular Registries (ICVR). METHODS: Data from the United States Vascular Quality Initiative (VQI) and the Vascunet registry collaboration (including 10 registries in Europe and Australasia) were used. Variation in treatment modality of asymptomatic versus symptomatic patients was analysed between countries and among centres within each country...
March 5, 2017: European Journal of Vascular and Endovascular Surgery
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