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Texakalidis P, Giannopoulos S, Jonnalagadda AK, Chitale RV, Jabbour P, Armstrong EJ, Schwartz GG, Kokkinidis DG. Preoperative Use of Statins in Carotid Artery Stenting: A Systematic Review and Meta-analysis. J Endovasc Ther 2018; 25:624-631. [PMID: 30101624 DOI: 10.1177/1526602818794030] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
PURPOSE To determine through meta-analysis whether administration of statins before carotid artery stenting (CAS) is associated with fewer periprocedural adverse events. METHODS All randomized and observational English-language studies of periprocedural statin administration prior to CAS that reported the outcomes of interest (stroke, transient ischemic attack, myocardial infarction, and death at 30 days) were included in a random-effects meta-analysis. The I2 statistic was used to assess heterogeneity. Meta-regression analysis was performed to determine whether an association of statin treatment with risk of outcome events was influenced by other trial-level baseline characteristics of statin-treated and untreated patients. RESULTS Eleven studies comprising 4088 patients were included. Patients who received statins prior to CAS had a significantly lower risk of stroke (OR 0.39, 95% CI 0.27 to 0.58, p<0.01; I2=0%) and death (OR 0.30, 95% CI 0.10 to 0.96, p=0.042; I2=0%). Statin use was not associated with a reduced risk of transient ischemic attack or myocardial infarction. In meta-regression analysis, other trial-level baseline characteristics had no significant influence on the association of statin treatment with death or stroke. CONCLUSION Statin therapy prior to CAS is associated with decreased risk of perioperative stroke and death without any effect on the rates of transient ischemic attack or myocardial infarction.
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Affiliation(s)
| | | | - Anil K Jonnalagadda
- 3 Division of Cardiology, Medstar Washington Hospital Center, Washington, DC, USA
| | - Rohan V Chitale
- 4 Department of Neurosurgery, Vanderbilt University Hospital, Nashville, TN, USA
| | - Pascal Jabbour
- 5 Department of Neurosurgery, Thomas Jefferson University, Philadelphia, PA, USA
| | - Ehrin J Armstrong
- 6 Division of Cardiology, Denver VA Medical Center, University of Colorado, Denver, CO, USA
| | - Gregory G Schwartz
- 6 Division of Cardiology, Denver VA Medical Center, University of Colorado, Denver, CO, USA
| | - Damianos G Kokkinidis
- 7 Department of Medicine, Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
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Eto A, Sakata N, Nagai R, Shirakawa JI, Inoue R, Kiyomi F, Nii K, Aikawa H, Iko M, Tsutsumi M, Sakamoto K, Hiraoka F, Mitsutake T, Hanada H, Kazekawa K. N ε-(carboxymethyl)lysine Concentration in Debris from Carotid Artery Stenting Correlates Independently with Signal Intensity on T1-Weighted Black-Blood Magnetic Resonance Images. J Stroke Cerebrovasc Dis 2017; 26:1341-1348. [PMID: 28314627 DOI: 10.1016/j.jstrokecerebrovasdis.2017.02.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Revised: 01/27/2017] [Accepted: 02/02/2017] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND AND PURPOSE Because magnetic resonance imaging (MRI) focuses on the morphological characteristics of carotid artery plaques, its diagnostic value with respect to plaque vulnerability is limited. We examined the correlation between Nε-(carboxymethyl)lysine (CML), a main chemical structure of advanced glycation end-products, and the vulnerability of plaques visualized on MRI scans. MATERIALS AND METHODS We enrolled 43 patients who had undergone carotid artery stenting (CAS) for carotid artery stenosis; all underwent MRI studies, including black-blood MRI and diffusion-weighted imaging (DWI). The signal intensity ratio (SIR) of plaques to adjacent sternocleidomastoid muscle (P/M) on T1- and T2-weighted images (T1WI, T2WI) was calculated. Protein samples were extracted from debris trapped by a filter device. The concentrations of CML and myeloperoxidase (MPO) were measured by solid-phase enzyme-linked immunosorbent assay. RESULTS The patients were classified into 2 groups based on their SIR-P/M on T1WI and T2WI scans. We observed a higher incidence of post-CAS DWI lesions in patients with a higher than a lower SIR-P/M on T1WI; the CML and MPO concentrations in their CAS debris were also higher. No such differences were seen in patients with a higher or lower SIR-P/M on T2WI scans. The concentration of CML in CAS debris correlated independently with the SIR-P/M on T1WI of the carotid plaques, and was related to the concentration of MPO in CAS debris. CONCLUSIONS Our findings suggest CML as a candidate molecular imaging probe for the identification of vulnerable plaques.
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Affiliation(s)
- Ayumu Eto
- Department of Neurosurgery, Fukuoka University Chikushi Hospital, Fukuoka, Japan
| | - Noriyuki Sakata
- General Medical Research Center, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Ryoji Nagai
- Laboratory of Food and Regulation Biology, Department of Bioscience, School of Agriculture, Tokai University, Kumamoto, Japan
| | - Jun-Ichi Shirakawa
- Laboratory of Food and Regulation Biology, Department of Bioscience, School of Agriculture, Tokai University, Kumamoto, Japan
| | - Ritsurou Inoue
- Department of Neurosurgery, Fukuoka University Chikushi Hospital, Fukuoka, Japan
| | - Fumiaki Kiyomi
- Academia, Industry and Government Collaborative Research Institute of Translational Medicine for Life Innovation, Fukuoka University, Fukuoka, Japan
| | - Kouhei Nii
- Department of Neurosurgery, Fukuoka University Chikushi Hospital, Fukuoka, Japan.
| | - Hiroshi Aikawa
- Department of Neurosurgery, Fukuoka University Chikushi Hospital, Fukuoka, Japan
| | - Minoru Iko
- Department of Neurosurgery, Fukuoka University Chikushi Hospital, Fukuoka, Japan
| | - Masanori Tsutsumi
- Department of Neurosurgery, Fukuoka University Chikushi Hospital, Fukuoka, Japan
| | - Kimiya Sakamoto
- Department of Neurosurgery, Fukuoka University Chikushi Hospital, Fukuoka, Japan
| | - Fumihiro Hiraoka
- Department of Neurosurgery, Fukuoka University Chikushi Hospital, Fukuoka, Japan
| | - Takahumi Mitsutake
- Department of Neurosurgery, Fukuoka University Chikushi Hospital, Fukuoka, Japan
| | - Hayatsura Hanada
- Department of Neurosurgery, Fukuoka University Chikushi Hospital, Fukuoka, Japan
| | - Kiyoshi Kazekawa
- Department of Neurosurgery, Fukuoka University Chikushi Hospital, Fukuoka, Japan
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Ito K, Sakata N, Nagai R, Shirakawa JI, Watanabe M, Mimata A, Abe Y, Yasuno T, Sasatomi Y, Miyake K, Ueki N, Hamauchi A, Nakashima H. High serum level of methylglyoxal-derived AGE, Nδ-(5-hydro-5-methyl-4-imidazolone-2-yl)-ornithine, independently relates to renal dysfunction. Clin Exp Nephrol 2016; 21:398-406. [PMID: 27344336 DOI: 10.1007/s10157-016-1301-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Accepted: 06/21/2016] [Indexed: 12/31/2022]
Abstract
BACKGROUND The dicarbonyl methylglyoxal reacts primarily with arginine residues to form advanced glycation end products, including Nδ-(5-hydro-5-methyl-4 -imidazolone-2-yl)-ornithine (MG-H1), which are risk factors for not only diabetic complications but also lifestyle-related disease including renal dysfunction. However, the data on serum level and clinical significance of this substance in chronic kidney disease are limited. METHODS Serum levels of MG-H1 and Nε-(carboxymethyl) lysine (CML) in 50 patients with renal dysfunction were measured by liquid chromatography/triple-quadruple mass spectrometry. RESULTS The median serum MG-H1 levels in patients with estimated glomerular filtration rate (eGFR) of ≥30, 15-30, and <15 ml/min/1.73 m2 was 4.16, 12.58, and 14.66 mmol/mol Lys, respectively (p > 0.05). On the other hand, MG-H1 levels in patients with HbA1c of <6 and ≥6 % was 12.85 and 10.45 mmol/mol Lys, respectively, the difference between which is not significant. In logistic regression analysis, decreased renal function (eGFR <15 ml/min/1.73 m2) significantly associated with high serum levels of MG-H1 [odds ratio: 9.39 (95 % confidence interval 1.528-57.76), p = 0.015; Spearman rank correlation: MG-H1 vs. eGFR, r = -0.691, p < 0.01]. In contrast, the serum level of CML did not correlate with eGFR, but correlated with systolic blood pressure [odds ratio 16.17 (95 % confidence interval 1.973-132.5), p = 0.010; Spearman rank correlation coefficient: CML vs. eGFR, r = 0.454, p < 0.01]. CONCLUSION These results showed that the serum concentration of MG-H1 was strongly related to renal function rather than to DM.
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Affiliation(s)
- Kenji Ito
- Division of Nephrology and Rheumatology, Faculty of Medicine, Fukuoka University, 7-45-1, Nanakuma, Jonan-ku, Fukuoka, 814-0180, Japan.
| | - Noriyuki Sakata
- Division of Pathology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Ryoji Nagai
- Laboratory of Food and Regulation Biology Department of Bioscience, School of Agriculture, Tokai University, Kumamoto, Japan
| | - Jun-Ichi Shirakawa
- Laboratory of Food and Regulation Biology Department of Bioscience, School of Agriculture, Tokai University, Kumamoto, Japan
| | - Maho Watanabe
- Division of Nephrology and Rheumatology, Faculty of Medicine, Fukuoka University, 7-45-1, Nanakuma, Jonan-ku, Fukuoka, 814-0180, Japan
| | - Ayako Mimata
- Division of Nephrology and Rheumatology, Faculty of Medicine, Fukuoka University, 7-45-1, Nanakuma, Jonan-ku, Fukuoka, 814-0180, Japan
| | - Yasuhiro Abe
- Division of Nephrology and Rheumatology, Faculty of Medicine, Fukuoka University, 7-45-1, Nanakuma, Jonan-ku, Fukuoka, 814-0180, Japan
| | - Tetsuhiko Yasuno
- Division of Nephrology and Rheumatology, Faculty of Medicine, Fukuoka University, 7-45-1, Nanakuma, Jonan-ku, Fukuoka, 814-0180, Japan
| | - Yoshie Sasatomi
- Division of Nephrology and Rheumatology, Faculty of Medicine, Fukuoka University, 7-45-1, Nanakuma, Jonan-ku, Fukuoka, 814-0180, Japan
| | - Katsuhisa Miyake
- Division of Nephrology and Rheumatology, Faculty of Medicine, Fukuoka University, 7-45-1, Nanakuma, Jonan-ku, Fukuoka, 814-0180, Japan
| | - Naoko Ueki
- Division of Nephrology and Rheumatology, Faculty of Medicine, Fukuoka University, 7-45-1, Nanakuma, Jonan-ku, Fukuoka, 814-0180, Japan
| | - Aki Hamauchi
- Division of Nephrology and Rheumatology, Faculty of Medicine, Fukuoka University, 7-45-1, Nanakuma, Jonan-ku, Fukuoka, 814-0180, Japan
| | - Hitoshi Nakashima
- Division of Nephrology and Rheumatology, Faculty of Medicine, Fukuoka University, 7-45-1, Nanakuma, Jonan-ku, Fukuoka, 814-0180, Japan
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