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Li L, Dai F, Xu J, Dong J, Wu B, He S, Liu H. Geometric consistency among atherosclerotic plaques in carotid arteries evaluated by multidimensional parameters. Heliyon 2024; 10:e37419. [PMID: 39309847 PMCID: PMC11414503 DOI: 10.1016/j.heliyon.2024.e37419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2024] [Accepted: 09/03/2024] [Indexed: 09/25/2024] Open
Abstract
The three-dimensional (3D) geometry of carotid atherosclerotic plaques is associated with multiple cardiovascular diseases. However, it is unknown if carotid plaques of different sizes are consistent in 3D geometry, with a lack of quantitative observation. We aim to evaluate the geometric consistency of carotid plaques using the correlations between multidimensional parameters. 42 cases with asymptomatic stenosis caused by atherosclerotic plaque in the carotid artery were included. Carotid plaques and calcifications were identified on computed tomography angiography images and 3D reconstructed. Multidimensional geometric parameters (length, surface area, volume, etc.) were measured on the reconstructed 3D structures. Linear and non-linear (power function) fittings were used to investigate the relationships between multidimensional parameters. The analysis was performed based on cases and plaques, respectively. Spearman rank correlation analysis, R-squared, and p-values were used to evaluate the significance of the relationship. Significant relationship was defined as R-squared >0.25 and p < 0.05. In total, 112 atherosclerotic plaques and 74 calcifications were extracted. In plaque-based analysis, significant correlations were widely observed between paired multidimensional parameters of carotid plaques, where non-linear fitting showed higher R-squared values. Plaque volume and surface area were significantly correlated with total volume and total surface area of intra-plaque calcifications. In subject-based analysis, triglycerides and total cholesterol were significantly correlated with carotid plaque size. There is a consistency in geometry among carotid atherosclerotic plaques of different sizes. The size of a carotid plaque is associated with the patient's lipid profile.
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Affiliation(s)
- Ling Li
- Department of Neurology, Zhoushan Hospital, Wenzhou Medical University, Zhoushan, 316000, Zhejiang Province, China
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, Hong Kong Special Administrative Region of China
| | - Fangyu Dai
- Department of Neurology, Zhoushan Hospital, Wenzhou Medical University, Zhoushan, 316000, Zhejiang Province, China
| | - Jie Xu
- Department of Neurology, Zhoushan Hospital, Wenzhou Medical University, Zhoushan, 316000, Zhejiang Province, China
| | - Jiaoxuan Dong
- Department of Neurology, Zhoushan Hospital, Wenzhou Medical University, Zhoushan, 316000, Zhejiang Province, China
| | - Bin Wu
- Department of Neurology, People's Hospital of Quzhou, Quzhou, 324002, Zhejiang Province, China
| | - Songbin He
- Department of Neurology, Zhoushan Hospital, Wenzhou Medical University, Zhoushan, 316000, Zhejiang Province, China
- Department of Neurology, Zhoushan Hospital, Zhejiang University, School of Medicine, Zhoushan, 316000, Zhejiang Province, China
| | - Haipeng Liu
- Centre for Intelligent Healthcare, Coventry University, Coventry, CV1 5RW, UK
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Lu KC, Hung KC, Liao MT, Shih LJ, Chao CT. Vascular Calcification Heterogeneity from Bench to Bedside: Implications for Manifestations, Pathogenesis, and Treatment Considerations. Aging Dis 2024:AD.2024.0289. [PMID: 38739930 DOI: 10.14336/ad.2024.0289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Accepted: 04/20/2024] [Indexed: 05/16/2024] Open
Abstract
Vascular calcification (VC) is the ectopic deposition of calcium-containing apatite within vascular walls, exhibiting a high prevalence in older adults, and those with diabetes or chronic kidney disease. VC is a subclinical cardiovascular risk trait that increases mortality and functional deterioration. However, effective treatments for VC remain largely unavailable despite multiple attempts. Part of this therapeutic nihilism results from the failure to appreciate the diversity of VC as a pathological complex, with unforeseeable variations in morphology, risk associates, and anatomical and molecular pathogenesis, affecting clinical management strategies. VC should not be considered a homogeneous pathology because accumulating evidence refutes its conceptual and content uniformity. Here, we summarize the pathophysiological sources of VC heterogeneity from the intersecting pathways and networks of cellular, subcellular, and molecular crosstalk. Part of these pathological connections are synergistic or mutually antagonistic. We then introduce clinical implications related to the VC heterogeneity concept. Even within the same individual, a specific artery may exhibit the strongest tendency for calcification compared with other arteries. The prognostic value of VC may only be detectable with a detailed characterization of calcification morphology and features. VC heterogeneity is also evident, as VC risk factors vary between different arterial segments and layers. Therefore, diagnostic and screening strategies for VC may be improved based on VC heterogeneity, including the use of radiomics. Finally, pursuing a homogeneous treatment strategy is discouraged and we suggest a more rational approach by diversifying the treatment spectrum. This may greatly benefit subsequent efforts to identify effective VC therapeutics.
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Affiliation(s)
- Kuo-Cheng Lu
- Division of Nephrology, Department of Internal Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei, Taiwan
- Division of Nephrology, Department of Internal Medicine, Fu Jen Catholic University Hospital, School of Medicine, Fu Jen Catholic University, New Taipei, Taiwan
| | - Kuo-Chin Hung
- Division of Nephrology, Department of Internal Medicine, Min-Sheng General Hospital, Taoyuan, Taiwan
- Department of Pharmacy, Tajen University, Pingtung, Taiwan
| | - Min-Tser Liao
- Department of Pediatrics, Taoyuan Armed Forces General Hospital, Hsinchu Branch, Hsinchu, Taiwan
- Department of Pediatrics, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Li-Jane Shih
- Department of Medical Laboratory, Taoyuan Armed Forces General Hospital, Taoyuan, Taiwan
- Graduate Institute of Medical Science, National Defense Medical Center, Taipei, Taiwan
| | - Chia-Ter Chao
- Division of Nephrology, Department of Internal Medicine, National Taiwan University College of Medicine, Taipei, Taiwan
- Graduate Institute of Toxicology, National Taiwan University College of Medicine, Taipei, Taiwan
- Center of Faculty Development, National Taiwan University College of Medicine, Taipei, Taiwan
- Division of Nephrology, Department of Internal Medicine, Min-Sheng General Hospital, Taoyuan, Taiwan
- Division of Nephrology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
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Sinharoy A, Reddy N, Lin JK, Nambi V, Yang EY, Kougias P, Taylor AA, Lumsden AB, Ballantyne CM, Morrisett JD, Brunner G. Magnetic resonance imaging based superficial femoral artery velocity measurements in peripheral artery disease. Magn Reson Imaging 2022; 93:128-134. [DOI: 10.1016/j.mri.2022.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 07/07/2022] [Accepted: 08/02/2022] [Indexed: 11/27/2022]
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4
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Han RI, Hu CW, Loose DS, Yang L, Li L, Connell JP, Reardon MJ, Lawrie GM, Qutub AA, Morrisett JD, Grande-Allen KJ. Differential proteome profile, biological pathways, and network relationships of osteogenic proteins in calcified human aortic valves. Heart Vessels 2022; 37:347-358. [PMID: 34727208 PMCID: PMC10960607 DOI: 10.1007/s00380-021-01975-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 10/22/2021] [Indexed: 11/30/2022]
Abstract
Calcific aortic valve disease (CAVD) is the most common heart valve disease requiring intervention. Most research on CAVD has focused on inflammation, ossification, and cellular phenotype transformation. To gain a broader picture into the wide range of cellular and molecular mechanisms involved in this disease, we compared the total protein profiles between calcified and non-calcified areas from 5 human valves resected during surgery. The 1413 positively identified proteins were filtered down to 248 proteins present in both calcified and non-calcified segments of at least 3 of the 5 valves, which were then analyzed using Ingenuity Pathway Analysis. Concurrently, the top 40 differentially abundant proteins were grouped according to their biological functions and shown in interactive networks. Finally, the abundance of selected osteogenic proteins (osteopontin, osteonectin, osteocalcin, osteoprotegerin, and RANK) was quantified using ELISA and/or immunohistochemistry. The top pathways identified were complement system, acute phase response signaling, metabolism, LXR/RXR and FXR/RXR activation, actin cytoskeleton, mineral binding, nucleic acid interaction, structural extracellular matrix (ECM), and angiogenesis. There was a greater abundance of osteopontin, osteonectin, osteocalcin, osteoprotegerin, and RANK in the calcified regions than the non-calcified ones. The osteogenic proteins also formed key connections between the biological signaling pathways in the network model. In conclusion, this proteomic analysis demonstrated the involvement of multiple signaling pathways in CAVD. The interconnectedness of these pathways provides new insights for the treatment of this disease.
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Affiliation(s)
- Richard I Han
- Department of Bioengineering, Rice University, 6100 Main Street, MS-142, Houston, TX, 77030, USA
- Division of Atherosclerosis and Vascular Medicine, Departments of Medicine, Baylor College of Medicine, Houston, TX, USA
| | - Chenyue W Hu
- Department of Bioengineering, Rice University, 6100 Main Street, MS-142, Houston, TX, 77030, USA
| | - David S Loose
- Department of Integrative Biology and Pharmacology, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Li Yang
- Department of Pathology, University of Washington, Seattle, WA, USA
| | - Li Li
- Clinical and Translational Proteomics Service Center, University of Texas Health Sciences at Houston, Houston, TX, USA
| | - Jennifer P Connell
- Department of Bioengineering, Rice University, 6100 Main Street, MS-142, Houston, TX, 77030, USA
| | - Michael J Reardon
- Methodist DeBakey Heart and Vascular Center, Houston Methodist Hospital, Houston, TX, USA
| | - Gerald M Lawrie
- Methodist DeBakey Heart and Vascular Center, Houston Methodist Hospital, Houston, TX, USA
| | - Amina A Qutub
- Department of Biomedical Engineering, University of Texas at San Antonio, San Antonio, TX, USA
| | - Joel D Morrisett
- Division of Atherosclerosis and Vascular Medicine, Departments of Medicine, Baylor College of Medicine, Houston, TX, USA
| | - K Jane Grande-Allen
- Department of Bioengineering, Rice University, 6100 Main Street, MS-142, Houston, TX, 77030, USA.
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Gimnich OA, Zil-E-Ali A, Brunner G. Imaging Approaches to the Diagnosis of Vascular Diseases. Curr Atheroscler Rep 2022; 24:85-96. [PMID: 35080717 DOI: 10.1007/s11883-022-00988-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/13/2021] [Indexed: 12/12/2022]
Abstract
PURPOSE OF REVIEW Vascular imaging is a complex field including numerous modalities and imaging markers. This review is focused on important and recent findings in atherosclerotic carotid artery plaque imaging with an emphasis on developments in magnetic resonance imaging (MRI) and computed tomography (CT). RECENT FINDINGS Recent evidence shows that carotid plaque characteristics and not only established measures of carotid plaque burden and stenosis are associated independently with cardiovascular outcomes. On carotid MRI, the presence of a lipid-rich necrotic core (LRNC) has been associated with incident cardiovascular disease (CVD) events independent of wall thickness, a traditional measure of plaque burden. On carotid MRI, intraplaque hemorrhage (IPH) presence has been identified as an independent predictor of stroke. The presence of a fissured carotid fibrous cap has been associated with contrast enhancement on CT angiography imaging. Carotid artery plaque characteristics have been associated with incident CVD events, and advanced plaque imaging techniques may gain additional prominence in the clinical treatment decision process.
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Affiliation(s)
- Olga A Gimnich
- Penn State Heart and Vascular Institute, Pennsylvania State University College of Medicine, Hershey, PA, USA
| | - Ahsan Zil-E-Ali
- Penn State Heart and Vascular Institute, Pennsylvania State University College of Medicine, Hershey, PA, USA
| | - Gerd Brunner
- Penn State Heart and Vascular Institute, Pennsylvania State University College of Medicine, Hershey, PA, USA.
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Cosarca MC, Horváth E, Molnar C, Molnár GB, Russu E, Mureșan VA. Calcification patterns in femoral and carotid atheromatous plaques: A comparative morphometric study. Exp Ther Med 2021; 22:865. [PMID: 34178138 PMCID: PMC8220650 DOI: 10.3892/etm.2021.10297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 05/05/2021] [Indexed: 11/05/2022] Open
Abstract
This comparative study was designed to focus on the mineral patterns in human atherosclerotic plaques based on quantitative measurements of calcium deposits through the morphometric method. A total of 101 atherosclerotic plaques were harvested by conventional transluminal angioplasty from the carotid artery (CA) and different segments of the femoral-popliteal axis (FPA), fixed in formalin and sent for histological processing. The histological grade of the atherosclerotic plaque and the calcification pattern were evaluated, followed by a morphometric analysis of the mineral deposits. Regarding the localization, the advanced plaques (VII and VIII types) developed predominantly at the level of the superficial femoral artery (SFA) compared to the CA (P<0.001). This significant difference was maintained even if they were divided into low grade (IV and V) and high grade categories (VI, VII and VIII) (P<0.05). Compared with that in the carotid plaques, in the FPA plaques the mineralized surface increased in parallel with the narrowing of the vascular lumen diameter. The image analysis of the total pathological calcification score (pCS) showed a significant difference between the CA plaques and distal SFA (dSFA) plaques (P=0.038) and between the proximal SFA (pSFA) and dSFA plaques (P=0.013). In the case of the simple nodular pattern, calcification occupied significantly larger areas in the plaques developed in the dSFA and popliteal artery (PA) in comparison with the CA plaques (P=0.0007 and P=0.0009). pCSs calculated in plaques with extensive calcification pattern showed a lower value in the CA vs. the pSFA plaques (P=0.004). A less pronounced, but significant difference was observed between the pCS of pSFA and dSFA plaques (P=0.017). Femoral and carotid plaques exhibited different morphology and tendency for calcification. In parallel with the narrowing of the vascular lumen diameter, the mineralized surface increased at the level of different FPA segments. These results suggest that the mechanism is site-specific, and wall structure-dependent.
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Affiliation(s)
- Mircea Catalin Cosarca
- Doctoral School, ‘George Emil Palade’ University of Medicine, Pharmacy, Science and Technology, 540142 Târgu-Mureș, Romania
| | - Emőke Horváth
- Department of Pathology, ‘George Emil Palade’ University of Medicine, Pharmacy, Science and Technology, 540142 Târgu-Mureș, Romania
| | - Calin Molnar
- Department of General Surgery, ‘George Emil Palade’ University of Medicine, Pharmacy, Science and Technology, 540142 Târgu-Mureș, Romania
| | - Gyopár-Beáta Molnár
- Pathological Anatomy Service, Târgu Mureș County Emergency Clinical Hospital (SCJU Târgu Mureș), 540136 Târgu Mureș, Romania
| | - Eliza Russu
- Department of Vascular Surgery, ‘George Emil Palade’ University of Medicine, Pharmacy, Science and Technology, 540142 Târgu Mureș, Romania
| | - Vasile Adrian Mureșan
- Department of Vascular Surgery, ‘George Emil Palade’ University of Medicine, Pharmacy, Science and Technology, 540142 Târgu Mureș, Romania
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7
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Ishiyama H, Okazaki S, Saito K, Yamagami H, Ihara M. Rolling stones sign as hard and fast evidence of calcified cerebral emboli. Neurology 2018; 91:41-43. [DOI: 10.1212/wnl.0000000000005731] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Accepted: 03/20/2018] [Indexed: 11/15/2022] Open
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8
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Kopanja L, Kovacevic Z, Tadic M, Žužek MC, Vrecl M, Frangež R. Confocal micrographs: automated segmentation and quantitative shape analysis of neuronal cells treated with ostreolysin A/pleurotolysin B pore-forming complex. Histochem Cell Biol 2018; 150:93-102. [DOI: 10.1007/s00418-018-1670-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/17/2018] [Indexed: 01/27/2023]
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Bischetti S, Scimeca M, Bonanno E, Federici M, Anemona L, Menghini R, Casella S, Cardellini M, Ippoliti A, Mauriello A. Carotid plaque instability is not related to quantity but to elemental composition of calcification. Nutr Metab Cardiovasc Dis 2017; 27:768-774. [PMID: 28739184 DOI: 10.1016/j.numecd.2017.05.006] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Revised: 05/10/2017] [Accepted: 05/22/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND AIMS Recent studies highlighted the role of calcification processes in the clinical progression of chronic cardiovascular diseases. In this study we investigated the relationship between the chemical composition of calcification and atherosclerotic plaque stability in carotid arteries. METHODS AND RESULTS To this end, we characterized the calcification on 229 carotid plaques, by morphology, immunohistochemistry, transmission electron microscopy and energy dispersive X-ray microanalysis. Plaques were classified into two categories: unstable and stable. No significant differences were found in the incidence of the various risk factors between patients with and without carotid calcification, with the exception of diabetes. The energy dispersive X-ray microanalysis allowed us to identify two types of calcium salts in the atheromatous plaques, hydroxyapatite (HA) and calcium oxalate (CO). Our results showed that calcification is a common finding in carotid plaques, being present in 77.3% of cases, and the amount of calcium is not a factor of vulnerability. Noteworthy, we observed an association between HA calcification and unstable plaques. On the contrary, CO calcifications were mainly detected in stable plaques. CONCLUSIONS The presence of different types of calcification in atheromatous plaques may open new perspectives in understanding the molecular mechanisms of atheroma formation and plaque instability.
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Affiliation(s)
- S Bischetti
- Department of Experimental Medicine and Surgery, University of Rome "Tor Vergata", Rome, Italy.
| | - M Scimeca
- Department of Experimental Medicine and Surgery, University of Rome "Tor Vergata", Rome, Italy; OrchideaLab S.r.l., Via del Grecale 6, Morlupo, Rome, Italy; IRCCS San Raffaele Pisana, 00166 Rome, Italy.
| | - E Bonanno
- Department of Experimental Medicine and Surgery, University of Rome "Tor Vergata", Rome, Italy.
| | - M Federici
- Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy; Center for Atherosclerosis, Department of Medicine, Policlinico Tor Vergata, 00133 Rome, Italy.
| | - L Anemona
- Department of Experimental Medicine and Surgery, University of Rome "Tor Vergata", Rome, Italy.
| | - R Menghini
- Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy; Center for Atherosclerosis, Department of Medicine, Policlinico Tor Vergata, 00133 Rome, Italy.
| | - S Casella
- Department of Experimental Medicine and Surgery, University of Rome "Tor Vergata", Rome, Italy.
| | - M Cardellini
- Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy; Center for Atherosclerosis, Department of Medicine, Policlinico Tor Vergata, 00133 Rome, Italy.
| | - A Ippoliti
- Vascular Surgery, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy.
| | - A Mauriello
- Department of Experimental Medicine and Surgery, University of Rome "Tor Vergata", Rome, Italy.
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Rosenthal PA, Lundy KC, Massoglia DP, Payne EH, Gilbert G, Gebregziabher M. Incidental paranasal sinusitis on routine brain magnetic resonance scans: association with atherosclerosis. Int Forum Allergy Rhinol 2016; 6:1253-1263. [PMID: 27509266 DOI: 10.1002/alr.21824] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2016] [Revised: 05/17/2016] [Accepted: 06/19/2016] [Indexed: 11/09/2022]
Abstract
BACKGROUND Incidental paranasal sinusitis (IPS) is common on imaging for non-sinusitis disorders, usually without symptoms or obstructive features, and possibly arising from periodontitis (PD). PD associations with atherosclerosis have been widely reported. We test if IPS may also be associated with atherosclerosis. METHODS IPS was scored retrospectively in a random sample of 180 magnetic resonance (MR) brain scans and compared with chart review for atherosclerosis (all subtypes), rhinosinusitis, and related factors (smoking, asthma, and relevant surgery). IPS was scored out of 30, from all sinuses, with maxillary sinuses weighted double volumetrically. Significant IPS (Sig IPS) was designated as 6 or more out of 30. Bivariate logistic regression was used to test for associations of Sig IPS to the clinical data, with multivariate analysis then testing for potential confounders. RESULTS A total of 173 subjects were analyzed (7 exclusions). MR indications included suspected acute/prior stroke (22.0%). Sig IPS found in 20 (11.6%). Positive histories for atherosclerosis were cerebral, 57 (32.9%); coronary, 48 (27.7%); and peripheral arterial disease, 14 (8.1%). IPS ≥6 was strongly associated with cerebrovascular disease (odds ratio [OR] 6.0, p < 0.001), and less robustly to smoking (OR 2.9, p = 0.07) and rhinosinusitis (OR 2.4, p = 0.09). No associations with coronary or peripheral artery diseases were found. After controlling for smoking and rhinosinusitis, yielding significant subclinical sinusitis, the link of Sig IPS to cerebrovascular disease persisted (modified OR 5.2, p = 0.002). CONCLUSION Significant incidental sinusitis, which is mostly subclinical sinusitis, is associated with cerebrovascular disease but not other atheroscleroses. This suggests possible common causation of both by PD.
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Affiliation(s)
| | | | | | - Elizabeth H Payne
- Ralph H. Johnson VA Medical Center, Bee Street, Charleston, SC.,Medical University of South Carolina, Charleston, SC.,The Emmes Corporation in Rockville, MD
| | - Gregory Gilbert
- Ralph H. Johnson VA Medical Center, Bee Street, Charleston, SC
| | - Mulugeta Gebregziabher
- Ralph H. Johnson VA Medical Center, Bee Street, Charleston, SC.,Medical University of South Carolina, Charleston, SC
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