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Lainelehto K, Pienimäki J, Savilahti S, Huhtala H, Numminen H, Putaala J. Cervicocerebral Atherosclerosis Burden Increases Long-Term Mortality in Patients With Ischemic Stroke or Transient Ischemic Attack. J Am Heart Assoc 2024; 13:e032938. [PMID: 38842273 PMCID: PMC11255707 DOI: 10.1161/jaha.123.032938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 05/10/2024] [Indexed: 06/07/2024]
Abstract
BACKGROUND The influence of burden of atherosclerosis in the brain supplying arteries on mortality in patients with acute ischemic stroke or transient ischemic attack is poorly known. We assessed whether total burden of atherosclerosis within cervicocerebral arteries is associated with long-term mortality. METHODS AND RESULTS A total of 406 patients (median age, 71.8 years; 57.9% male) with acute ischemic stroke or transient ischemic attack were included and their cervicocerebral arteries imaged with computed tomography angiography. The presence of atherosclerotic findings was scored for 25 artery segments and points were summed as a Cervicocerebral Atherosclerosis Burden (CAB) score, analyzed as quartiles. Data on all-cause mortality came from Statistics Finland. After a median follow-up of 7.3 years, 147 (33.5%) patients had died. Compared with surviving patients, those who died had a higher median CAB score (5, interquartile range 2-10 versus 11, 7-16; P<0.001). Cumulative mortality increased from 8.9% (95% CI, 7.0-10.8) in the lowest to 61.4% (95% CI, 55.4-67.4) in the highest quartile of CAB score. Adjusted for demographics, cardiovascular risk factors, secondary preventive medication, and admission National Institute of Health Stroke Scale score, every CAB score point increased probability of death by 3%. Analyzed in quartiles, the highest CAB quartile was associated with a 2.5-fold likelihood of all-cause mortality. CONCLUSIONS The main findings of our study were the increasing mortality with the total burden of computed tomography angiography-defined atherosclerosis in the brain supplying arteries after ischemic stroke or transient ischemic attack and that the CAB score-integrating this pathology-independently increased all-cause mortality.
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Affiliation(s)
- Kati Lainelehto
- Department of NeurologyKanta Häme Central HospitalHämeenlinnaFinland
- Emergency Department AcutaTampere University HospitalTampereFinland
| | | | - Sirpa Savilahti
- Department of RadiologyTampere University HospitalTampereFinland
| | - Heini Huhtala
- Faculty of Social SciencesTampere UniversityTampereFinland
| | - Heikki Numminen
- Department of Neuroscience and RehabilitationTampere University HospitalTampereFinland
| | - Jukka Putaala
- Department of NeurologyHelsinki University Hospital and University of HelsinkiFinland
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2
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Fan J, Yang Y, Jia X, Wang Y, Zhao C, Wang N, Ding S, Shi X. Metabolic score and its components are associated with carotid plaque prevalence in young adults. Endocrine 2024:10.1007/s12020-024-03903-3. [PMID: 38849645 DOI: 10.1007/s12020-024-03903-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 05/29/2024] [Indexed: 06/09/2024]
Abstract
PURPOSE No study has comprehensively assessed the relationship of metabolic factors including insulin resistance, hypertension, hyperuricemia, and hypercholesterolemia with the development of carotid plaque. Therefore, we constructed metabolic scores based on the above metabolic factors and examined its association with carotid plaque in young and older Chinese adults. METHODS This study included 17,396 participants who underwent carotid ultrasound examinations, including 14,173 young adults (<65 years) and 3,223 older adults (≥65 years). Individual metabolic score was calculated using triglyceride-glucose (TyG) index, mean arterial pressure (MAP), uric acid, and total cholesterol (TC). Logistic regression models were conducted to examine the role of metabolic score and its components in the prevalence of carotid plaque. The nonlinear relationship was examined using restricted cubic spline regression. Meanwhile, subgroup, interaction, and sensitivity analyses were conducted. RESULTS The multivariate logistic regression analysis showed that TyG (OR: 1.088; 95%CI: 1.046-1.132), MAP (OR: 1.121; 95%CI: 1.077-1.168), TC (OR: 1.137; 95%CI: 1.094-1.182) and metabolic score (OR: 1.064; 95%CI: 1.046-1.082) were associated with carotid plaque prevalence in young adults rather than older adults. The nonlinear association was not observed for metabolic scores and carotid plaque. Subgroup analyses showed significant associations between metabolic scores and carotid plaque prevalence in men, women, normal-weight, and overweight young adults. No interaction of metabolic score with sex and BMI were observed. CONCLUSIONS The results support that control of TyG, MAP, TC, and metabolic scores is a key point in preventing the prevalence of carotid plaque in the young adults.
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Affiliation(s)
- Jingwen Fan
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Yongli Yang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Xiaocan Jia
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Yuping Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Chenyu Zhao
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Nana Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Suying Ding
- Health Management Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
| | - Xuezhong Shi
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, China.
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3
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Kumagai G, Wada K, Asari T, Nitobe Y, Kinoshita H, Kushikata T, Hirota K, Ishibashi Y. Association of cervical atherosclerosis on Doppler ultrasonography and postoperative delirium in patients undergoing spinal surgery: a single-center, retrospective, observational study. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2023; 32:3352-3359. [PMID: 37326838 DOI: 10.1007/s00586-023-07823-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 06/03/2023] [Accepted: 06/07/2023] [Indexed: 06/17/2023]
Abstract
PURPOSE This study aimed to evaluate the association between cervical atherosclerosis on Doppler ultrasonography and postoperative delirium (POD) in patients undergoing spinal surgery. METHODS In this retrospective observational study using prospectively collected data, 295 consecutive patients aged > 50 years underwent spine surgery at a single institution between March 2015 and February 2021. Cervical atherosclerosis was defined as the intima-media thickness (IMT) of the common carotid artery (CCA) being ≥ 1.1 mm on pulsed-wave Doppler ultrasonography. Univariate and multivariate logistic regression analyses were performed with the prevalence of postoperative delirium as a dependent variable. Age, sex, body mass index, medical history, American Society of Anesthesiologists Physical Status (ASA-PS), CHADS2 score (an assessment score for stroke), instrumentation, duration of surgery, blood loss, and cervical arteriosclerosis were the independent variables. RESULTS Twenty-seven patients of 295 (9.2%) developed delirium postoperatively. Forty-one (13.9%) of the 295 patients had cervical atherosclerosis. Their univariate analyses showed that age (P = 0.001), hypertension (P = 0.016), cancer (P = 0.046), antiplatelet agent use (P < 0.001), ASA-PS ≥ 3 (P < 0.001), CHADS2 score (P < 0.001), cervical atherosclerosis (P = 0.008), and right CCA-IMT (P = 0.007) were significantly associated with POD. However, multivariate logistic regression analyses showed older age (odds ratio [OR], 1.109; 95% confidence interval [CI] 1.035-1.188; P = 0.03) and antiplatelet agent use (OR, 3.472; 95% CI 1.221-9.870; P = 0.020) to be significantly associated with POD. CONCLUSIONS There was a significant association between POD and the prevalence of cervical atherosclerosis using the univariate logistic regression analysis. Furthermore, multivariate logistic regression analyses showed that older age and antiplatelet agent use were independently associated with POD.
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Affiliation(s)
- Gentaro Kumagai
- Department of Orthopaedic Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, Aomori, 036-8562, Japan.
| | - Kanichiro Wada
- Department of Orthopaedic Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, Aomori, 036-8562, Japan
| | - Toru Asari
- Department of Orthopaedic Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, Aomori, 036-8562, Japan
| | - Yohshiro Nitobe
- Department of Orthopaedic Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, Aomori, 036-8562, Japan
| | - Hirotaka Kinoshita
- Department of Anesthesiology, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, Aomori, 036-8562, Japan
| | - Tetsuya Kushikata
- Department of Anesthesiology, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, Aomori, 036-8562, Japan
| | - Kazuyoshi Hirota
- Department of Anesthesiology, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, Aomori, 036-8562, Japan
| | - Yasuyuki Ishibashi
- Department of Orthopaedic Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, Aomori, 036-8562, Japan
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Ihle‐Hansen H, Vigen T, Berge T, Walle‐Hansen MM, Hagberg G, Ihle‐Hansen H, Thommessen B, Ariansen I, Røsjø H, Rønning OM, Tveit A, Lyngbakken M. Carotid Plaque Score for Stroke and Cardiovascular Risk Prediction in a Middle-Aged Cohort From the General Population. J Am Heart Assoc 2023; 12:e030739. [PMID: 37609981 PMCID: PMC10547315 DOI: 10.1161/jaha.123.030739] [Citation(s) in RCA: 1] [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: 05/28/2023] [Accepted: 07/27/2023] [Indexed: 08/24/2023]
Abstract
Background We aimed to explore the predictive value of the carotid plaque score, compared with the Systematic Coronary Risk Evaluation 2 (SCORE2) risk prediction algorithm, on incident ischemic stroke and major adverse cardiovascular events and establish a prognostic cutoff of the carotid plaque score. Methods and Results In the prospective ACE 1950 (Akershus Cardiac Examination 1950 study), carotid plaque score was calculated with ultrasonography at inclusion in 2012 to 2015. The largest plaque diameter in each extracranial segment of the carotid artery on both sides was scored from 0 to 3 points. The sum of points in all segments provided the carotid plaque score. The cohort was followed up by linkage to national registries for incident ischemic stroke and major adverse cardiovascular events (nonfatal ischemic stroke, nonfatal myocardial infarction, and cardiovascular death) throughout 2020. Carotid plaque score was available in 3650 (98.5%) participants, with mean±SD age of 63.9±0.64 years at inclusion. Only 462 (12.7%) participants were free of plaque, and and 970 (26.6%) had a carotid plaque score of >3. Carotid plaque score predicted ischemic stroke (hazard ratio [HR], 1.25 [95% CI, 1.15-1.36]) and major adverse cardiovascular events (HR, 1.21 [95% CI, 1.14-1.27]) after adjustment for SCORE2 and provided strong incremental prognostic information to SCORE2. The best cutoff value of carotid plaque score for ischemic stroke was >3, with positive predictive value of 2.5% and negative predictive value of 99.3%. Conclusions The carotid plaque score is a strong predictor of ischemic stroke and major adverse cardiovascular events, and it provides incremental prognostic information to SCORE2 for risk prediction. A cutoff score of >3 seems to be suitable to discriminate high-risk subjects. Registration Information clinicaltrials.gov. Identifier: NCT01555411.
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Affiliation(s)
- Håkon Ihle‐Hansen
- Department of Medical ResearchBærum Hospital, Vestre Viken Hospital TrustGjettumNorway
| | - Thea Vigen
- Division of Medicine, Department of NeurologyAkershus University HospitalLørenskogNorway
| | - Trygve Berge
- Department of Medical ResearchBærum Hospital, Vestre Viken Hospital TrustGjettumNorway
| | - Marte M. Walle‐Hansen
- Department of Medical ResearchBærum Hospital, Vestre Viken Hospital TrustGjettumNorway
| | - Guri Hagberg
- Department of Medical ResearchBærum Hospital, Vestre Viken Hospital TrustGjettumNorway
- Stroke Unit, Department of NeurologyOslo University HospitalOsloNorway
| | - Hege Ihle‐Hansen
- Department of Medical ResearchBærum Hospital, Vestre Viken Hospital TrustGjettumNorway
- Stroke Unit, Department of NeurologyOslo University HospitalOsloNorway
| | - Bente Thommessen
- Division of Medicine, Department of NeurologyAkershus University HospitalLørenskogNorway
| | - Inger Ariansen
- Department of Chronic DiseasesNorwegian Institute of Public HealthOsloNorway
| | - Helge Røsjø
- K.G. Jebsen Center for Cardiac Biomarkers, Institute of Clinical Medicine, Faculty of MedicineUniversity of OsloOsloNorway
- Division of Research and InnovationAkershus University HospitalLørenskogNorway
| | - Ole Morten Rønning
- Division of Medicine, Department of NeurologyAkershus University HospitalLørenskogNorway
- Institute of Clinical Medicine, Faculty of MedicineUniversity of OsloOsloNorway
| | - Arnljot Tveit
- Department of Medical ResearchBærum Hospital, Vestre Viken Hospital TrustGjettumNorway
- Institute of Clinical Medicine, Faculty of MedicineUniversity of OsloOsloNorway
| | - Magnus Lyngbakken
- K.G. Jebsen Center for Cardiac Biomarkers, Institute of Clinical Medicine, Faculty of MedicineUniversity of OsloOsloNorway
- Division of Medicine, Department of CardiologyAkershus University HospitalLørenskogNorway
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Ghaznawi R, Vonk JM, Zwartbol MH, Bresser JD, Rissanen I, Hendrikse J, Geerlings MI. Low-grade carotid artery stenosis is associated with progression of brain atrophy and cognitive decline. The SMART-MR study. J Cereb Blood Flow Metab 2023; 43:309-318. [PMID: 36250500 PMCID: PMC9903227 DOI: 10.1177/0271678x221133859] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Asymptomatic low-grade carotid artery stenosis (LGCS) is a common finding in patients with manifest arterial disease, however its relationship with brain MRI changes and cognitive decline is unclear. We included 902 patients (58 ± 10 years; 81% male) enrolled in the Second Manifestations of Arterial Disease - Magnetic Resonance (SMART-MR) study without a history of cerebrovascular disease. LGCS was defined as 1-49% stenosis on baseline carotid ultrasound, whereas no LGCS (reference category) was defined as absence of carotid plaque. Brain and white matter hyperintensity (WMH) volumes and cognitive function were measured at baseline and after 4 (n = 480) and 12 years (n = 222) of follow-up. Using linear mixed-effects models, we investigated associations of LGCS with progression of brain atrophy, WMH, and cognitive decline. LGCS was associated with greater progression of global brain atrophy (estimate -0.03; 95%CI, -0.06 to -0.01; p = 0.002), and a greater decline in executive functioning (estimate -0.02; 95%CI, -0.031 to -0.01; p < 0.001) and memory (estimate -0.012; 95%CI, -0.02 to -0.001; p = 0.032), independent of demographics, cardiovascular risk factors, and incident brain infarcts on MRI. No association was observed between LGCS and progression of WMH. Our results indicate that LGCS may represent an early marker of greater future brain atrophy and cognitive decline.
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Affiliation(s)
- Rashid Ghaznawi
- Department of Radiology, University Medical Center Utrecht and Utrecht University, Utrecht, the Netherlands.,Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht and Utrecht University, Utrecht, the Netherlands
| | - Jet Mj Vonk
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht and Utrecht University, Utrecht, the Netherlands
| | - Maarten Ht Zwartbol
- Department of Radiology, University Medical Center Utrecht and Utrecht University, Utrecht, the Netherlands
| | - Jeroen de Bresser
- Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Ina Rissanen
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht and Utrecht University, Utrecht, the Netherlands
| | - Jeroen Hendrikse
- Department of Radiology, University Medical Center Utrecht and Utrecht University, Utrecht, the Netherlands
| | - Mirjam I Geerlings
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht and Utrecht University, Utrecht, the Netherlands
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- Listed in the Acknowledgements
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Nyman E, Grönlund C, Vanoli D, Liv P, Norberg M, Bengtsson A, Wennberg P, Wester P, Näslund U. Reduced progression of carotid intima media thickness by personalised pictorial presentation of subclinical atherosclerosis in VIPVIZA-A randomised controlled trial. Clin Physiol Funct Imaging 2023. [PMID: 36642849 DOI: 10.1111/cpf.12811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 12/16/2022] [Accepted: 01/11/2023] [Indexed: 01/17/2023]
Abstract
OBJECTIVES Reduced progression of atherosclerosis can decrease the risk of cardiovascular disease (CVD). This study aimed at evaluating the effect of a pictorial intervention showing atherosclerotic severity on the progression of carotid atherosclerosis. METHODS A prospective randomised open-label blinded end-point trial with participants aged 40-60 years enroled from a routine CVD prevention programme. The intervention group (n: 1575) and their treating physicians received an image based presentation of subclinical atherosclerotic severity measured by carotid ultrasound. The control group (n: 1579) did not receive any information about ultrasound results. Carotid ultrasound at baseline and at 3-year follow-up contained plaque detection and measurements of carotid intima media thickness (cIMT). The left, right and bilateral-mean-cIMT, plaque prevalence and total plaque area (TPA) at 3-year follow-up were compared between groups. Significance level was set to p = 0.01 to adjust for multiple comparisons. RESULTS The intervention group revealed reduced cIMT progression in the left-mean-cIMT of -0.011 mm (p = 0.001) compared with the control group. The intervention effect on cIMT progression was most prominent in individuals with increased cIMT and plaque prevalence at baseline (-0.021 mm, p = 0.005). There were no differences in progression between groups for the right-and bilateral-mean-cIMT (-0.005 mm, p = 0.223 and -0.005 mm, p = 0.036, respectively), nor any differences between groups for plaque prevalence or TPA (odds ratio 0.88, p = 0.09 and 0.89, p = 0.21, respectively). CONCLUSION Pictorial presentation of subclinical atherosclerotic severity sent to both the individual and their treating physician resulted in significantly reduced left cIMT progression. Pictorial presentation has the potential to increase adherence in CVD prevention.
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Affiliation(s)
- Emma Nyman
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | | | - Davide Vanoli
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Per Liv
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Margareta Norberg
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Anna Bengtsson
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.,Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden
| | - Patrik Wennberg
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Per Wester
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Ulf Näslund
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
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Guo S, Jing Y, Li C, Zhu D, Wang W. Carotid atherosclerosis: An independent risk factor for small fiber nerve dysfunction in patients with type 2 diabetes mellitus. J Diabetes Investig 2022; 14:289-296. [PMID: 36350031 PMCID: PMC9889662 DOI: 10.1111/jdi.13936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 10/08/2022] [Accepted: 10/13/2022] [Indexed: 11/11/2022] Open
Abstract
AIMS/INTRODUCTION To explore whether carotid atherosclerosis is an independent risk factor for small fiber nerve dysfunction in type 2 diabetes mellitus patients. MATERIALS AND METHODS A total of 247 type 2 diabetes patients from Nanjing Drum Tower Hospital received carotid ultrasonography and quantitative sensory testing, including cold and warm detection thresholds, and some patients received cold and heat pain detection thresholds, respectively. According to the results of quantitative sensory testing, patients were divided into normal small fiber nerve function (NSF) and small fiber nerve dysfunction (SFD) group. Meanwhile, patients were divided into the non-carotid atherosclerosis group, carotid intimal thickening, unilateral carotid atherosclerosis and bilateral carotid atherosclerosis group. The correlation between carotid ultrasonography with quantitative sensory testing parameters was analyzed by SPSS 26.0. RESULTS First, the incidence rate of SFD increased significantly in patients with carotid atherosclerosis (72.2%, P < 0.001) especially in bilateral carotid atherosclerosis (81.7%, P < 0.001). Second, compared with the NS group, the carotid intima-media thickness in SFD was thicker (P = 0.018) and the size of atherosclerotic plaque was larger (P < 0.001). In addition, the cold detection threshold decreased (P < 0.001), whereas the warm detection threshold (P < 0.001) and heat pain detection threshold (P < 0.001) increased as aggravation of carotid atherosclerosis. In the correlation analysis, the size of atherosclerotic plaque presented a positive correlation with the warm detection threshold (r = 0.476, P < 0.001) and heat pain detection threshold (r = 0.213, P < 0.001), but presented a negative correlation with the cold detection threshold (r = -0.239, P < 0.01). Furthermore, carotid atherosclerosis (odds ratio 2.326, P = 0.017), especially bilateral carotid atherosclerosis (odds ratio 5.042, P = 0.001), was an independent risk factor for SFD (P < 0.05). CONCLUSIONS Carotid atherosclerosis was significantly associated with quantitative sensory testing and found to be an independent risk factor for small fiber nerve dysfunction in type 2 diabetes patients.
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Affiliation(s)
- Simin Guo
- Nanjing Drum Tower HospitalChinese Academy of Medical Science, Peking Union Medical College, Peking Union Medical College Hospital, Graduate School of Peking Union Medical CollegeNanjingChina
| | - Yali Jing
- Department of EndocrinologyDrum Tower Hospital Affiliated to Nanjing University Medical School, Branch of National Clinical Research Center for Metabolic DiseasesNanjingChina,Endocrine and Metabolic Disease Medical CenterDrum Tower Hospital affiliated to Nanjing University Medical SchoolNanjingChina
| | - Chenxi Li
- Department of EndocrinologyDrum Tower Hospital Affiliated to Nanjing University Medical School, Branch of National Clinical Research Center for Metabolic DiseasesNanjingChina,Endocrine and Metabolic Disease Medical CenterDrum Tower Hospital affiliated to Nanjing University Medical SchoolNanjingChina
| | - Dalong Zhu
- Department of EndocrinologyDrum Tower Hospital Affiliated to Nanjing University Medical School, Branch of National Clinical Research Center for Metabolic DiseasesNanjingChina,Endocrine and Metabolic Disease Medical CenterDrum Tower Hospital affiliated to Nanjing University Medical SchoolNanjingChina
| | - Weimin Wang
- Department of EndocrinologyDrum Tower Hospital Affiliated to Nanjing University Medical School, Branch of National Clinical Research Center for Metabolic DiseasesNanjingChina,Endocrine and Metabolic Disease Medical CenterDrum Tower Hospital affiliated to Nanjing University Medical SchoolNanjingChina
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8
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França V, Gomes ÉIL, de Campos EVS, Zago VHDS, Nunes VS, de Faria EC. Relationship between lipoprotein (a) and subclinical carotid atherosclerosis in asymptomatic individuals. Clinics (Sao Paulo) 2022; 77:100107. [PMID: 36179527 PMCID: PMC9520202 DOI: 10.1016/j.clinsp.2022.100107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 07/21/2022] [Accepted: 08/29/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND This study aimed to evaluate the associations between Lipoprotein (a) ‒ Lp(a) levels and carotid Intima-Media Thickness (cIMT) and with carotid plaques in healthy subjects because of previous contradictory data. METHODS A total of 317 healthy normolipidemic subjects (20‒77 years old) were selected. The cIMT and atherosclerotic plaques were determined by B-mode ultrasonography. Mann-Whitney tests were performed to compare the groups according to Lp(a) levels and to explore the associations between Lp(a), carotid plaques, and cIMT, logistic and linear regression analyses were performed. RESULTS Studied population (51% females, median age 43 years old) presented carotid plaques and cIMT ≥ 0.9 mm in 23% and 18% of the participants, respectively. The group with Lp(a) levels > 30 mg/dL presented significantly higher age and atherosclerotic plaques. Indeed, multivariate linear regression analysis showed a significant association between Lp(a), age, and race. On the other hand, logistic regression analysis demonstrated that the subjects with Lp(a) > 30 mg/dL have a significantly high risk of carotid plaques. CONCLUSION The data from the present study indicate that Lp(a) levels above 30 mg/dL contribute to the development of carotid plaques even in apparently healthy participants.
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Affiliation(s)
- Victor França
- Department of Clinical Pathology, Faculdade de Ciências Médicas da Universidade Estadual de Campinas, Campinas, SP, Brazil.
| | - Érica Ivana Lázaro Gomes
- Department of Clinical Pathology, Faculdade de Ciências Médicas da Universidade Estadual de Campinas, Campinas, SP, Brazil
| | - Edite Vieira Silva de Campos
- Department of Clinical Pathology, Faculdade de Ciências Médicas da Universidade Estadual de Campinas, Campinas, SP, Brazil
| | | | - Valéria Sutti Nunes
- Laboratorio de Lipides (LIM10), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Eliana Cotta de Faria
- Department of Clinical Pathology, Faculdade de Ciências Médicas da Universidade Estadual de Campinas, Campinas, SP, Brazil
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Miyamatsu Y, Nakamizo A, Amano T, Matsuo S, Kuwashiro T, Yasaka M, Okada Y, Mizoguchi M, Yoshimoto K. Ankle-Brachial Index and Cardio-Ankle Vascular Index as Predictors of Cognitive Decline Over Time After Carotid Endarterectomy. Cureus 2022; 14:e26534. [PMID: 35936185 PMCID: PMC9345772 DOI: 10.7759/cureus.26534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/02/2022] [Indexed: 11/21/2022] Open
Abstract
Objective: Patients with carotid stenosis risk cognitive impairment even after carotid endarterectomy (CEA) because of the long-term presence of vascular risk factors. Early prediction of cognitive decline is useful because early appropriate training for impaired cognitive domains can improve their functions. Ankle-brachial index (ABI) and cardio-ankle vascular index (CAVI) are frequently used as general indicators of systemic atherosclerosis and are associated with cognitive function in the general population. This study aimed to evaluate the utility of those vascular biomarkers for predicting cognitive decline in patients after CEA. Methods: Patients who had undergone both CEA at our institute and cognitive evaluations between March 2016 and January 2022 were invited to participate in this study. Associations between ABI or CAVI three years before baseline and cognitive function at baseline were assessed retrospectively in 94 patients, and associations between ABI or CAVI at baseline and three-year changes in cognitive functions were assessed prospectively in 24 patients. Cognitive functions were assessed using the Frontal Assessment Battery (FAB) and Neurobehavioral Cognitive Status Examination (Cognistat). Results: Low ABI three years before baseline was associated with poor performances on Cognistat and FAB at baseline. ABI, as a continuous measure, three years before baseline, showed positive linear associations with total Cognistat score and subscores for naming, construction, and judgment at baseline. The Wilcoxon signed-rank test showed that the total Cognistat score, total FAB score, and subscores for attention and inhibitory control declined after three years. CAVI at baseline was negatively associated with three-year changes in total Cognistat score and subscores for naming, construction, and memory. Conclusion: Cognitive function can decline over time in patients with carotid stenosis even after CEA. ABI and CAVI might be useful to predict cognitive function and its decline among patients who have undergone CEA.
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Ihle-Hansen H, Ihle-Hansen H, Sandset EC, Hagberg G. Subclinical Carotid Artery Atherosclerosis and Cognitive Function: A Mini-Review. Front Neurol 2021; 12:705043. [PMID: 34393982 PMCID: PMC8355501 DOI: 10.3389/fneur.2021.705043] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 06/30/2021] [Indexed: 12/23/2022] Open
Abstract
Carotid artery atherosclerosis, the result of a multitude of vascular risk factors, is a promising marker for use in risk stratification. Recent evidence suggests that carotid artery atherosclerosis affects cognitive function and is an independent risk factor for the development of cognitive impairment. Both atherosclerosis and cognitive impairment develop over a prolonged period (years), and due to the aging population, markers to identify persons at risk are needed. Carotid artery atherosclerosis can easily be visualized using non-invasive ultrasound, potentially enabling early and intensified risk factor management to preserve cognitive function or delay further decline. However, the burden of atherosclerosis and temporal exposure required to pose a risk of cognitive impairment is unclear. This mini-review aims to explore the available evidence on the association between carotid atherosclerosis and cognition, and furthermore identify the remaining gaps in knowledge.
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Affiliation(s)
- Håkon Ihle-Hansen
- Department of Medicine, Bærum Hospital- Vestre Viken Hospital Trust, Drammen, Norway
| | - Hege Ihle-Hansen
- Department of Medicine, Bærum Hospital- Vestre Viken Hospital Trust, Drammen, Norway.,Oslo Stroke Unit, Department of Neurology, Oslo University Hospital, Ullevål, Norway
| | | | - Guri Hagberg
- Department of Medicine, Bærum Hospital- Vestre Viken Hospital Trust, Drammen, Norway.,Oslo Stroke Unit, Department of Neurology, Oslo University Hospital, Ullevål, Norway
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11
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Lyngbakken MN, Vigen T, Ihle-Hansen H, Brynildsen J, Berge T, Rønning OM, Tveit A, Røsjø H, Omland T. Cardiac troponin I measured with a very high sensitivity assay predicts subclinical carotid atherosclerosis: The Akershus Cardiac Examination 1950 Study. Clin Biochem 2021; 93:59-65. [PMID: 33861986 DOI: 10.1016/j.clinbiochem.2021.04.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 03/16/2021] [Accepted: 04/08/2021] [Indexed: 11/25/2022]
Abstract
AIMS Concentrations of cardiac troponin I (cTnI) are associated with incident ischemic stroke and predict the presence and severity of coronary atherosclerosis. Accordingly, we hypothesized that concentrations of cTnI measured with a very high sensitivity (hs-) assay would be associated with subclinical stages of carotid atherosclerosis in the general population. METHODS We measured hs-cTnI on the Singulex Clarity System in 1745 women and 1666 men participating in the prospective observational Akershus Cardiac Examination 1950 Study. All study participants were free from known coronary heart disease and underwent extensive cardiovascular phenotyping at baseline, including carotid ultrasound. We quantified carotid atherosclerosis by the carotid plaque score, carotid intima-media thickness (cIMT) and the presence of hypoechoic plaques. RESULTS Concentrations of hs-cTnI were measurable in 99.8% of study participants and were significantly associated with increased carotid plaque score (odds ratio for quartile 4 of hs-cTnI 1.59, 95% CI 1.22 to 2.07, p for trend < 0.001) and cIMT (odds ratio for quartile 4 of hs-cTnI 1.57, 95% CI 1.02 to 2.42, p for trend = 0.036), but not with the presence of hypoechoic plaques. hs-cTnI concentrations significantly improved reclassification and discrimination models in predicting carotid plaques when added to cardiovascular risk factors, no improvements were evident in predicting cIMT or hypoechoic plaques. CONCLUSION Concentrations of cTnI measured with a very high sensitivity assay are predictive of carotid atherosclerotic burden, a phenomenon likely attributable to common risk factors of subclinical myocardial injury, coronary and carotid atherosclerosis.
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Affiliation(s)
- Magnus Nakrem Lyngbakken
- Department of Cardiology, Division of Medicine, Akershus University Hospital, Lørenskog, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Thea Vigen
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Neurology, Division of Medicine, Akershus University Hospital, Lørenskog, Norway
| | - Håkon Ihle-Hansen
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Medical Research, Bærum Hospital, Vestre Viken Hospital Trust, Norway
| | - Jon Brynildsen
- Department of Cardiology, Division of Medicine, Akershus University Hospital, Lørenskog, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Trygve Berge
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Medical Research, Bærum Hospital, Vestre Viken Hospital Trust, Norway
| | - Ole Morten Rønning
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Neurology, Division of Medicine, Akershus University Hospital, Lørenskog, Norway
| | - Arnljot Tveit
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Medical Research, Bærum Hospital, Vestre Viken Hospital Trust, Norway
| | - Helge Røsjø
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Division of Research and Innovation, Akershus University Hospital, Lørenskog, Norway
| | - Torbjørn Omland
- Department of Cardiology, Division of Medicine, Akershus University Hospital, Lørenskog, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
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12
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Genkel VV, Kuznetsova AS, Lebedev EV, Shaposhnik II. Prognostic significance of atherosclerosis of one or two vascular systems in patients with high and very high cardiovascular risk. КАРДИОВАСКУЛЯРНАЯ ТЕРАПИЯ И ПРОФИЛАКТИКА 2021. [DOI: 10.15829/1728-8800-2021-2669] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Aim. To study the prognostic significance of atherosclerosis of one and several vascular systems in patients with high and very high cardiovascular risk (CVR).Material and methods. The study included 171 patients with high (26,9%) and very high (73,1%) CVR. All patients underwent duplex ultrasound of the carotid and lower limb arteries. The composite endpoint (CE) was cardiovascular death, nonfatal myocardial infarction, nonfatal stroke, and coronary revascularization.Results. The follow-up period lasted 31,1 (17,8; 47,9) months. CE events occurred in 29 (16,9%) patients: cardiovascular death — 3 (1,75%) patients; nonfatal myocardial infarction — 7 (4,09%) patients; nonfatal stroke — 6 (3,51%) patients; coronary revascularization — 13 (7,60%) patients. Cumulative survival of patients with high and very high CVR with atherosclerotic plaques in the same vascular system did not significantly differ from that in patients with intact peripheral arteries (p=0,977). The event-free survival of patients with combined lesions of the carotid and lower limb arteries was significantly lower in comparison with patients with one vascular system involvement (p=0,011). The combined lesion of the carotid and lower limb arteries was associated with an increase in the relative risk (RR) of adverse cardiovascular events (RR, 3,15 (95% CI, 1,02-9,74; p=0,046), adjusted for sex, age, and peripheral arterial disease symptoms.Conclusion. In patients with high and very high CVR, atherosclerotic lesion of two vascular systems of peripheral arteries is associated with an increase in the RR of adverse cardiovascular events, adjusted for sex, age, and peripheral arterial disease symptoms. The presence of atherosclerotic plaques in one vascular bed was not associated with an increase in the risk of CE events.
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13
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Gender differences in the risk factors associated with atherosclerosis by carotid intima-media thickness, plaque score, and pulse wave velocity. Heart Vessels 2021; 36:934-944. [PMID: 33495857 DOI: 10.1007/s00380-021-01775-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Accepted: 01/08/2021] [Indexed: 10/22/2022]
Abstract
Cardiovascular disease (CVD) remains the leading cause of death, but the risk factors for CVD differ between men and women. Although carotid intima-media thickness (IMT), carotid plaque, and pulse wave velocity (PWV) are useful atherosclerotic parameters, patient backgrounds have differed in previous reports. Therefore, this study aimed to investigate gender differences in associations between these three parameters and traditional risk factors in the same population. We enrolled 3888 participants (women: 743) who underwent routine health checkups. High IMT, high carotid plaque score (PS), or high brachial-ankle PWV (baPWV) were defined by the median values for each gender. We analyzed the association between each parameter and atherosclerotic risk factors, such as obesity, smoking, blood pressure (BP) elevation, impaired fasting glucose (IFG), and dyslipidemia (DL). In both sexes, BP elevation was the only common risk factor for high IMT, high PS, and high baPWV in the multivariate logistic regression analysis adjusted for age. In men, IFG and DL were common risk factors for the three parameters. Furthermore, obesity was an additional risk factor for high IMT and smoking was an additional risk factor for high IMT and high PS. In contrast, in women, obesity, DL, or IFG was an additional risk factor for high IMT, high PS, or high baPWV, respectively. The risk factors for IMT, PS, and baPWV differ in in men and women. The management for atherosclerotic risk factors on early stage should be considered in terms of gender-specific risk factors.
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14
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Paul P, George N, Shan BP. Relative Estimate of Revised Cardiovascular Risk Combining Traditional and Non-traditional Image-based CV Markers: A Kerala Based Study. Curr Med Imaging 2020; 16:1131-1153. [PMID: 32108001 DOI: 10.2174/1573405616666200218125539] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 01/05/2020] [Accepted: 01/27/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Non-traditional image markers can improve the traditional cardiovascular risk estimation, is untested in Kerala based participants. OBJECTIVE To identify the relationship between the 'Modified CV risk' categories with traditional and non-traditional image-based risk markers. The correlation and improvement in reclassification, achieved by pooling atherosclerotic non-traditional markers with Intermediate (≥7.5% and <20%) and High (≥20%) 10-year participants is evaluated. METHODS The cross-sectional study with 594 participants has the ultrasound measurements recorded from the medical archives of clinical locations at Ernakulum district, Kerala. With carotid Intima-Media Thickness (cIMT) measurement, the Plaque (cP) complexity was computed using selected plaque characteristics to compute the carotid Total Plaque Risk Score (cTPRS) for superior risk tagging. Statistical analysis was done using RStudio, the classification accuracy was verified using the decision tree algorithm. RESULTS The mean age of the participants was (58.14±10.05) years. The mean cIMT was (0.956±0.302) mm, with 65.6% plaque incidence. With 94.90% variability around its mean, the Multinomial Logistic Regression model identifies cIMT and cTPRS, age, diabetics, Familial Hypercholesterolemia (FH), Hypertension treatment, the presence of Rheumatoid Arthritis (RA), Chronic Kidney Disease (CKD) as significant (p<0.05). cIMT and cP were found significant for 'Intermediate High', 'High' and 'Very High' 'Modified CV risk' categories. However, age, diabetes, gender and use of hypertension treatment are significant for the 'Intermediate' 'Modified CV risk' category. The overall performance of the MLR model was 80.5%. The classification accuracy verified using the decision tree algorithm has 78.7% accuracy. CONCLUSION The use of atherosclerotic markers shows a significant correlation suitable for a nextlevel reclassification of the traditional CV risk.
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Affiliation(s)
- Paulin Paul
- Research Scholar, Sathyabama Institute of Science and Technology, Chennai, India
| | - Noel George
- Department of Biostatistics, St. Thomas College, Pala, M.G. University, Kottayam, India
| | - B Priestly Shan
- School of Electrical, Electronics and Communication Engineering, Galgotias University, Delhi, India
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15
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Huang ZX, Chen LH, Xiong R, He YN, Zhang Z, Zeng J, Cai Q, Liu Z. Essen Stroke Risk Score Predicts Carotid Atherosclerosis in Chinese Community Populations. Healthc Policy 2020; 13:2115-2123. [PMID: 33116991 PMCID: PMC7568636 DOI: 10.2147/rmhp.s274340] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 09/28/2020] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Carotid atherosclerosis (CA) is closely related to stroke, and Framingham Risk Score (FRS) has been used for CA risk evaluation. However, FRS could only be used for subjects of up to 74 years old. The present study was to determine if Essen Stroke Risk Score (ESRS) could be used to estimate CA risk in community populations without age limits. METHODS In the present prospective multi-community screening study, we evaluated the prevalence of CA using high-resolution ultrasound in 521 males and 1039 females (35 to 91 years old). Both FRS and ESRS were calculated for the subjects. Multivariate logistic regression analysis was used to determine the predictive values of FRS and ESRS for CA in these subjects. RESULTS Ultrasound data showed that CA was present in 56.2% of the participants (total of 1560). Multivariate logistic regression analysis showed that ESRS was associated with CA with odds ratio (OR): 1.34 (95% confidence interval (CI), 1.12-1.60, p=0.001). Central obesity (OR: 1.40, CI: 1.07-1.83, p=0.015), female (OR: 0.55, CI: 0.39-0.77, p <0.001) and age (OR: 2.63, CI: 2.27-3.06, p <0.001) were also associated with CA. Based on the estimated area under curve (AUC), FRS (AUC 0.775) was better than ESRS (AUC 0.693) (z statistic 6.774, p <0.001) for CA prediction for individuals of ≤74 years old. However, receiver operating characteristic analysis showed ESRS was a good CA predictor for all subjects (AUC of 0.715). CONCLUSION ESRS could be used as an alternative to FRS to predict CA in community population of all age.
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Affiliation(s)
- Zhi-Xin Huang
- Department of Neurology, Guangdong Second Provincial General Hospital, Guangzhou, Guangdong, People's Republic of China.,Department of Neurology, The Second School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, People's Republic of China
| | - Li-Hua Chen
- Department of Neurology, BenQ Medical Center, The Affiliated BenQ Hospital of Nanjing Medical University, Nanjing, Jiangsu, People's Republic of China
| | - Ran Xiong
- Department of Ultrasonography, Guangdong Second Provincial General Hospital, Guangzhou, Guangdong, People's Republic of China
| | - Yan-Ni He
- Department of Ultrasonography, Guangdong Second Provincial General Hospital, Guangzhou, Guangdong, People's Republic of China
| | - Zhu Zhang
- Department of Neurology, Guangdong Second Provincial General Hospital, Guangzhou, Guangdong, People's Republic of China.,Department of Neurology, The Second School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, People's Republic of China
| | - Jie Zeng
- Department of Center for Clinical Epidemiology and Methodology, Guangdong Second Provincial General Hospital, Guangzhou, Guangdong, People's Republic of China
| | - Qiankun Cai
- Department of Neurology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian Province, People's Republic of China
| | - Zhenguo Liu
- Center for Precision Medicine and Division of Cardiovascular Medicine, Department of Medicine, University of Missouri School of Medicine, Columbia, MO, USA
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16
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Ihle-Hansen H, Vigen T, Berge T, Hagberg G, Engedal K, Rønning OM, Thommessen B, Lyngbakken MN, Nygård S, Røsjø H, Tveit A, Ihle-Hansen H. Carotid Atherosclerosis and Cognitive Function in a General Population Aged 63-65 Years: Data from the Akershus Cardiac Examination (ACE) 1950 Study. J Alzheimers Dis 2020; 70:1041-1049. [PMID: 31306128 DOI: 10.3233/jad-190327] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Studies on the relationship between carotid atherosclerosis and cognitive function in subjects from the general population are few and results have been inconsistent. OBJECTIVE We aimed to investigate the association between carotid atherosclerotic burden and cognitive function in a cross-sectional analysis of a population-based cohort aged 63-65 years. METHODS All habitants born in 1950 from Akershus County, Norway were invited to participate. A linear regression model was used to assess the association between carotid atherosclerosis and cognitive function. We used carotid plaque score as a measure of carotid atherosclerotic burden and the Montreal Cognitive Assessment (MoCA) for global cognitive function. RESULTS We analyzed 3,413 individuals aged 63-65 with mean MoCA score 25.3±2.9 and 87% visible carotid plaques. We found a negative correlation between carotid plaque score and MoCA score (r = -0.14, p < 0.001), but this association was lost in multivariable analysis. In contrast, diameter or area of the thickest plaque was independently associated with MoCA score. Lower educational level, male sex, current smoking, and diabetes were also associated with lower MoCA score in multivariable analysis. CONCLUSION Carotid atherosclerotic burden was, unlike other measures of advanced carotid atherosclerosis, not independently associated with global cognitive function.
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Affiliation(s)
- Håkon Ihle-Hansen
- Department of Medical Research, B-rum Hospital, Vestre Viken Hospital Trust, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Thea Vigen
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Medicine, Akershus University Hospital, L-renskog, Norway
| | - Trygve Berge
- Department of Medical Research, B-rum Hospital, Vestre Viken Hospital Trust, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Guri Hagberg
- Department of Medical Research, B-rum Hospital, Vestre Viken Hospital Trust, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Knut Engedal
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway.,Department of Geriatric Medicine, Oslo University Hospital, Ullevaal, Oslo, Norway
| | - Ole Morten Rønning
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Medicine, Akershus University Hospital, L-renskog, Norway
| | - Bente Thommessen
- Division of Medicine, Akershus University Hospital, L-renskog, Norway
| | - Magnus N Lyngbakken
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Medicine, Akershus University Hospital, L-renskog, Norway
| | - Ståle Nygård
- Bioinformatics Core facility, Oslo University Hospital and the University of Oslo, Norway
| | - Helge Røsjø
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Medicine, Akershus University Hospital, L-renskog, Norway
| | - Arnljot Tveit
- Department of Medical Research, B-rum Hospital, Vestre Viken Hospital Trust, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Hege Ihle-Hansen
- Department of Medical Research, B-rum Hospital, Vestre Viken Hospital Trust, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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17
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Liu H, Liu J, Huang W, Zhao H, Zhao N, Wang H. Association between multi-site atherosclerotic plaques and systemic arteriosclerosis: results from the BEST study (Beijing Vascular Disease Patients Evaluation Study). Cardiovasc Ultrasound 2020; 18:30. [PMID: 32738905 PMCID: PMC7395974 DOI: 10.1186/s12947-020-00212-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 07/24/2020] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Arteriosclerosis can be reflected in various aspect of the artery, including atherosclerotic plaque formation or stiffening on the arterial wall. Both arteriosclerosis and atherosclerosis are important and closely associated with cardiovascular disease (CVD). The aim of the study was to evaluate the association between systemic arteriosclerosis and multi-site atherosclerotic plaques. METHODS The study was designed as an observational cross-sectional study. A total of 1178 participants (mean age 67.4 years; 52.2% male) enrolled into the observational study from 2010 to 2017. Systemic arteriosclerosis was assessed by carotid femoral artery pulse wave velocity (CF-PWV) and multi-site atherosclerotic plaques (MAP, > = 2 of the below sites) were reflected in the carotid or subclavian artery, abdominal aorta and lower extremities arteries using ultrasound equipment. The associations were assessed by multivariable logistic regression. RESULTS The prevalence of CF-PWV > 12 m/s and MAP were 40.2% and 74.4%. Atherosclerotic plaques in 3 sites were more common in male compared with that in female (48.9% versus 36.9%, p < 0.05). All CVD factors were worse in participants with MAP than that with <=1 site. Participants with CF-PWV > 12 m/s corresponded to a mean 82% probability of MAP with age and sex-adjusted. Patients with peripheral artery disease showed the highest odds ratio (OR) (3.88) for MAP, followed by smoking (2.485), CF-PWV > 12 m/s (2.25), dyslipidemia (1.89), male (1.84), stroke (1.64), hypoglycemic agents (1.56) and age (1.09) (all p < 0.001). CONCLUSIONS MAP was highly prevalent in this cohort, with male showing a higher prevalence than female. Higher systemic arteriosclerosis was independently associated with MAP, which indicating the supplementary value of arteriosclerosis for the earlier identification and intervention on MAP. TRIAL REGISTRATION Clinical Trial, URL: http://www.clinicaltrials.gov . Unique identifier: NCT02569268 .
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Affiliation(s)
- Huan Liu
- Vascular Medicine Center, Peking University Shougang Hospital, NO. 9 Jinyuanzhuang Road, Shijingshan District, Beijing, China.,Vascular Health Research Center of Peking University Health Science Center, Beijing, China
| | - Jinbo Liu
- Vascular Medicine Center, Peking University Shougang Hospital, NO. 9 Jinyuanzhuang Road, Shijingshan District, Beijing, China.,Vascular Health Research Center of Peking University Health Science Center, Beijing, China
| | - Wei Huang
- Vascular Medicine Center, Peking University Shougang Hospital, NO. 9 Jinyuanzhuang Road, Shijingshan District, Beijing, China
| | - Hongwei Zhao
- Vascular Medicine Center, Peking University Shougang Hospital, NO. 9 Jinyuanzhuang Road, Shijingshan District, Beijing, China
| | - Na Zhao
- Vascular Medicine Center, Peking University Shougang Hospital, NO. 9 Jinyuanzhuang Road, Shijingshan District, Beijing, China
| | - Hongyu Wang
- Vascular Medicine Center, Peking University Shougang Hospital, NO. 9 Jinyuanzhuang Road, Shijingshan District, Beijing, China. .,Vascular Health Research Center of Peking University Health Science Center, Beijing, China. .,Key Laboratory of Molecular Cardiovascular Sciences (Peking University), Ministry of Education, Beijing, China. .,Peking University Clinical Research Institute, Beijing, China.
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18
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Plasma Trans Fatty Acid Levels, Cardiovascular Risk Factors and Lifestyle: Results from the Akershus Cardiac Examination 1950 Study. Nutrients 2020; 12:nu12051419. [PMID: 32423040 PMCID: PMC7284775 DOI: 10.3390/nu12051419] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 05/10/2020] [Accepted: 05/12/2020] [Indexed: 01/13/2023] Open
Abstract
Intake of industrially produced trans fatty acids (iTFAs) has previously been associated with dyslipidemia, insulin resistance, hypertension and inflammation, as well as increased cardiovascular (CV) morbidity and mortality. iTFA intake declined in Norway after the introduction of legislative bans against iTFA consumption. However, the relationship between the current iTFA intake and CV health is unclear. The aim of the present study was to investigate the association between current iTFA intake, reflected by plasma iTFA levels, and established CV risk factors. We also examined the associations between plasma ruminant TFA levels and CV risk factors. In this cross-sectional study, we included 3706 participants from a Norwegian general population, born in 1950 and residing in Akershus County, Norway. The statistical method was multivariable linear regression. Plasma iTFA levels were inversely associated with serum triglycerides (p < 0.001), fasting plasma glucose (p < 0.001), body mass index (p < 0.001), systolic and diastolic blood pressure (p = 0.001 and p = 0.03) and C-reactive protein (p = 0.001). Furthermore, high plasma iTFA levels were associated with higher education and less smoking and alcohol consumption. We found that plasma ruminant trans fatty acids (rTFA) levels were favorably associated with CV risk factors. Furthermore, plasma iTFA levels were inversely associated with CV risk factors. However, our results might have been driven by lifestyle factors. Overall, our findings suggest that the current low intake of iTFAs in Norway does not constitute a threat to CV health.
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19
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Chandra A, Røsjø H, Svensson M, Vigen T, Ihle-Hansen H, Orstad EB, Rønning OM, Lyngbakken MN, Nygård S, Berge T, Schmidt EB, Omland T, Tveit A, Eide IA. Plasma linoleic acid levels and cardiovascular risk factors: results from the Norwegian ACE 1950 Study. Eur J Clin Nutr 2020; 74:1707-1717. [PMID: 32341488 DOI: 10.1038/s41430-020-0641-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 04/08/2020] [Accepted: 04/08/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND A high intake of linoleic acid (LA), the major dietary polyunsaturated fatty acid (PUFA), has previously been associated with reduced cardiovascular (CV) morbidity and mortality in observational studies. However, recent secondary analyses from clinical trials of LA-rich diet suggest harmful effects of LA on CV health. METHODS A total of 3706 participants, all born in 1950, were included in this cross-sectional study. We investigated associations between plasma phospholipid levels of LA and CV risk factors in a Norwegian general population, characterized by a relative low LA and high marine n-3 PUFA intake. The main statistical approach was multivariable linear regression. RESULTS Plasma phospholipid LA levels ranged from 11.4 to 32.0 wt%, with a median level of 20.8 wt% (interquartile range 16.8-24.8 wt%). High plasma LA levels were associated with lower serum low-density lipoprotein cholesterol levels (standardized regression coefficient [Std. β-coeff.] -0.04, p = 0.02), serum triglycerides (Std. β-coeff. -0.10, p < 0.001), fasting plasma glucose (Std. β-coeff. -0.10, p < 0.001), body mass index (Std. β-coeff. -0.13, p < 0.001), systolic and diastolic blood pressure (Std. β-coeff. -0.04, p = 0.03 and Std. β-coeff. -0.02, p = 0.02, respectively) and estimated glomerular filtration rate (Std. β-coeff. -0.09, p < 0.001). We found no association between plasma LA levels and high-density lipoprotein cholesterol levels, glycated hemoglobin, carotid intima-media thickness, or C-reactive protein. CONCLUSION High plasma LA levels were favorably associated with several CV risk factors in this study of a Norwegian general population.
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Affiliation(s)
- Anupam Chandra
- Department of Renal Medicine, Division of Medicine, Akershus University Hospital, Lørenskog, Norway. .,Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
| | - Helge Røsjø
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Research and Innovation, Akershus University Hospital, Lørenskog, Norway
| | - My Svensson
- Department of Renal Medicine, Division of Medicine, Akershus University Hospital, Lørenskog, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Thea Vigen
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Medicine, Akershus University Hospital, Lørenskog, Norway
| | - Håkon Ihle-Hansen
- Department of Medical Research, Bærum Hospital, Vestre Viken Hospital Trust, Drammen, Norway
| | | | - Ole Morten Rønning
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Medicine, Akershus University Hospital, Lørenskog, Norway
| | - Magnus Nakrem Lyngbakken
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Medicine, Akershus University Hospital, Lørenskog, Norway
| | - Ståle Nygård
- Centre for Bioinformatics, Department of Informatics, University of Oslo, Oslo, Norway.,Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway
| | - Trygve Berge
- Department of Medical Research, Bærum Hospital, Vestre Viken Hospital Trust, Drammen, Norway
| | - Erik Berg Schmidt
- Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark
| | - Torbjørn Omland
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Medicine, Akershus University Hospital, Lørenskog, Norway
| | - Arnljot Tveit
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Medical Research, Bærum Hospital, Vestre Viken Hospital Trust, Drammen, Norway
| | - Ivar Anders Eide
- Department of Renal Medicine, Division of Medicine, Akershus University Hospital, Lørenskog, Norway
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Zago VHS, Parra ES, Virgínio VWM, Vendrame F, Gomes ÉIL, Scherrer DZ, Marson FAL, de Faria EC. Lipase C, Hepatic Type -250A/G (rs2070895) Variant Enhances Carotid Atherosclerosis in Normolipidemic and Asymptomatic Individuals from Brazil. Lipids 2020; 55:225-237. [PMID: 32196671 DOI: 10.1002/lipd.12232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 02/20/2020] [Accepted: 02/27/2020] [Indexed: 11/08/2022]
Abstract
The common genetic variant in the promoter region of the hepatic lipase gene [LIPC -250G/A(rs2070895)] has an ambiguous association with cardiovascular disease. In this context, our study was performed to identify the relationships between the rs2070895 with carotid atherosclerosis, plasma lipids, and parameters of reverse cholesterol transport. A total of 285 normolipidemic and asymptomatic participants from an initial sample of 598,288 individuals (inclusion criteria: LDL-C ≤130 mg/dL and triglycerides ≤150 mg/dL; age: 20-75 years, both genders; confirmation of clinical, anthropometric and laboratory data; attended all visits; DNA was achieved to perform genetic analysis) were enrolled and the rs2070895 variant was genotyped by TaqMan® OpenArray® Plataform. Carotid intima-media thickness and the screening of atherosclerotic plaques were determined by B-mode ultrasonography. The rs2070895 genotype frequencies were 0.44, 0.41, and 0.15 (GG, GA, and AA, respectively). Logistic regression analysis showed that the risk of having plaques was increased in participants carrying the AA or AG genotypes (OR = 3.90; 95% CI = 1.54-10.33), despite an increase in high-density lipoprotein cholesterol levels, HDL diameter and apolipoprotein A-I, as compared to the GG genotype. Hepatic lipase and endogenous lecithin cholesterol acyl transferase activities were reduced (38% and 19%, respectively) and lipoprotein lipase was increased by 30% (AA vs GG). Our results provide evidence that the AA or AG genotypes of the rs2070895 were associated with carotid atherosclerosis in apparently healthy participants, probably as a consequence of reduced reverse cholesterol transport and accumulation of HDL subfraction 2 rich in triglycerides and depleted in cholesteryl esters that could become dysfunctional.
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Affiliation(s)
- Vanessa H S Zago
- Department of Clinical Pathology, Faculty of Medical Sciences, State University of Campinas, Tessália Vieira de Camargo St, 126, Campinas, São Paulo, 13084-971, Brazil
| | - Eliane S Parra
- Department of Clinical Pathology, Faculty of Medical Sciences, State University of Campinas, Tessália Vieira de Camargo St, 126, Campinas, São Paulo, 13084-971, Brazil
| | - Vítor W M Virgínio
- Department of Clinical Pathology, Faculty of Medical Sciences, State University of Campinas, Tessália Vieira de Camargo St, 126, Campinas, São Paulo, 13084-971, Brazil
| | - Felipe Vendrame
- Department of Clinical Pathology, Faculty of Medical Sciences, State University of Campinas, Tessália Vieira de Camargo St, 126, Campinas, São Paulo, 13084-971, Brazil
| | - Érica I L Gomes
- Department of Clinical Pathology, Faculty of Medical Sciences, State University of Campinas, Tessália Vieira de Camargo St, 126, Campinas, São Paulo, 13084-971, Brazil
| | - Daniel Z Scherrer
- Department of Clinical Pathology, Faculty of Medical Sciences, State University of Campinas, Tessália Vieira de Camargo St, 126, Campinas, São Paulo, 13084-971, Brazil
| | - Fernando A L Marson
- Department of Pediatric, Faculty of Medical Sciences, State University of Campinas, Tessália Vieira de Camargo St, 126, Campinas, São Paulo, 13084-971, Brazil.,Department of Medical Genetics and Genomic Medicine, Faculty of Medical Sciences, State University of Campinas, Tessália Vieira de Camargo St, 126, Campinas, São Paulo, 13084-971, Brazil.,Laboratory of Human and Medical Genetics, Post Graduate Program in Health Science, São Francisco University, São Francisco de Assis Av, 218, Jardim São José, Bragança Paulista, São Paulo, 12916-900, Brazil
| | - Eliana C de Faria
- Department of Clinical Pathology, Faculty of Medical Sciences, State University of Campinas, Tessália Vieira de Camargo St, 126, Campinas, São Paulo, 13084-971, Brazil
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Vigen T, Ihle‐Hansen H, Lyngbakken MN, Berge T, Thommessen B, Ihle‐Hansen H, Orstad EB, Enger S, Røsjø H, Tveit A, Rønning OM. Carotid Atherosclerosis is Associated with Middle Cerebral Artery Pulsatility Index. J Neuroimaging 2019; 30:233-239. [DOI: 10.1111/jon.12684] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Revised: 11/13/2019] [Accepted: 11/13/2019] [Indexed: 01/01/2023] Open
Affiliation(s)
- Thea Vigen
- Division of Medicine Akershus University Hospital Lørenskog Norway
- Institute of Clinical Medicine University of Oslo Oslo Norway
- Department of Neurology Akershus University Hospital Lørenskog Norway
| | - Håkon Ihle‐Hansen
- Department of Medical Research Bærum Hospital, Vestre Viken Hospital Trust Drammen Norway
| | - Magnus N Lyngbakken
- Division of Medicine Akershus University Hospital Lørenskog Norway
- Institute of Clinical Medicine University of Oslo Oslo Norway
- Department of Cardiology Akershus University Hospital Lørenskog Norway
| | - Trygve Berge
- Department of Medical Research Bærum Hospital, Vestre Viken Hospital Trust Drammen Norway
| | - Bente Thommessen
- Division of Medicine Akershus University Hospital Lørenskog Norway
- Department of Neurology Akershus University Hospital Lørenskog Norway
| | - Hege Ihle‐Hansen
- Institute of Clinical Medicine University of Oslo Oslo Norway
- Department of Medical Research Bærum Hospital, Vestre Viken Hospital Trust Drammen Norway
| | - Eivind B Orstad
- Division of Medicine Akershus University Hospital Lørenskog Norway
- Department of Cardiology Akershus University Hospital Lørenskog Norway
| | - Steve Enger
- Department of Medical Research Bærum Hospital, Vestre Viken Hospital Trust Drammen Norway
| | - Helge Røsjø
- Division of Medicine Akershus University Hospital Lørenskog Norway
- Institute of Clinical Medicine University of Oslo Oslo Norway
- Department of Cardiology Akershus University Hospital Lørenskog Norway
| | - Arnljot Tveit
- Institute of Clinical Medicine University of Oslo Oslo Norway
- Department of Medical Research Bærum Hospital, Vestre Viken Hospital Trust Drammen Norway
| | - Ole Morten Rønning
- Division of Medicine Akershus University Hospital Lørenskog Norway
- Institute of Clinical Medicine University of Oslo Oslo Norway
- Department of Neurology Akershus University Hospital Lørenskog Norway
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Ammirati E, Moroni F, Magnoni M, Rocca MA, Anzalone N, Cacciaguerra L, Di Terlizzi S, Villa C, Sizzano F, Palini A, Scotti I, Besana F, Spagnolo P, Rimoldi OE, Chiesa R, Falini A, Filippi M, Camici PG. Progression of brain white matter hyperintensities in asymptomatic patients with carotid atherosclerotic plaques and no indication for revascularization. Atherosclerosis 2019; 287:171-178. [DOI: 10.1016/j.atherosclerosis.2019.04.230] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2019] [Revised: 04/08/2019] [Accepted: 04/30/2019] [Indexed: 12/29/2022]
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Plasma marine n-3 polyunsaturated fatty acids and cardiovascular risk factors: data from the ACE 1950 study. Eur J Nutr 2019; 59:1505-1515. [PMID: 31123865 DOI: 10.1007/s00394-019-02007-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Accepted: 05/16/2019] [Indexed: 12/19/2022]
Abstract
PURPOSE A high intake of marine n-3 polyunsaturated fatty acids (PUFAs) might improve cardiovascular (CV) health. We conducted a cross-sectional study to investigate associations between plasma phospholipid levels of marine n-3 PUFAs and CV risk factors, educational level, physical activity and smoking habits. METHODS A total of 3706 individuals from a general population, all born in 1950 and residing in Akershus County, Norway, were included in this study. The main statistical approach was multivariable adjusted linear regression. RESULTS Plasma marine n-3 PUFA levels ranged from 2.7 to 20.3 wt%, with a median level of 7.7 wt% (interquartile range 4.3-11.1 wt%). High levels of plasma marine n-3 PUFAs were associated with lower serum triglycerides [Standardized regression coefficient (Std.β-coeff.) - 0.14, p < 0.001], body mass index (Std. β-coeff. -0.08, p < 0.001), serum creatinine (Std. β-coeff. -0.03, p = 0.05), C-reactive protein levels (Std. β-coeff. - 0.03, p = 0.04), higher levels of serum high-density lipoprotein cholesterol (Std. β-coeff. 0.08, p < 0.001) and low-density lipoprotein cholesterol (Std. β-coeff. 0.04, p = 0.003). High levels of plasma marine n-3 PUFAs were also associated with lower glycated hemoglobin (Std. β-coeff. - 0.04, p = 0.01), however, only in individuals without diabetes. We found no associations between plasma marine n-3 PUFA levels and fasting plasma glucose or carotid intima-media thickness. High levels of plasma marine n-3 PUFAs were associated with higher educational level, more physical activity and lower prevalence of smoking. CONCLUSION In this cross-sectional study of Norwegian individuals born in 1950, high levels of plasma marine n-3 PUFAs were favourably associated with several CV risk factors, suggesting that fish consumption might improve CV health.
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Blood pressure at age 40 predicts carotid atherosclerosis two decades later: data from the Akershus Cardiac Examination 1950 Study. J Hypertens 2019; 37:1982-1990. [PMID: 31116158 DOI: 10.1097/hjh.0000000000002131] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE We assessed the impact of a single time-point measurement of SBP, DBP and pulse pressure at the age of 40, on carotid plaque burden, echolucent plaques and carotid intima-media thickness late midlife. METHODS Individuals participating in two separate studies, 23 years apart, defined our cohort (n = 2714). 'The Age 40 Program', a nationwide Norwegian cardiovascular screening survey, performed 1985-1999, assessed cardiovascular risk factors and lifestyle variables at age 40. 'The ACE 1950 Study', a population-based cohort study on individuals born in 1950, performed 2012-2015, included ultrasound examinations of the carotid arteries. Blood pressure (BP) determinants of carotid atherosclerosis were assessed by regression models adjusted for cardiovascular risk factors at age 40, and late midlife BP. RESULTS The participants, 50.3% women, had a mean age of 40 (SD 0.3) years in the first study, and 64 (SD 0.6) years in the second. At age 40, mean SBP was 128 (SD 14) mmHg, mean DBP was 78 (SD 10) mmHg and mean pulse pressure was 50 (SD 9) mmHg. SBP and DBP at age 40 predicted carotid plaque burden in late midlife. Only DBP predicted echolucent plaques, and none of the BP components predicted carotid intima-media thickness. CONCLUSION A single time-point measurement of SBP and DBP at age 40 is associated with carotid plaque burden late midlife, also after adjustment for other cardiovascular risk factors at age 40, and of late midlife BP. Our findings emphasize the strong association between BP and atherosclerosis.
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25
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Müller-Scholden L, Kirchhof J, Morbach C, Breunig M, Meijer R, Rücker V, Tiffe T, Yurdadogan T, Wagner M, Gelbrich G, Bots ML, Störk S, Heuschmann PU. Segment-specific association of carotid-intima-media thickness with cardiovascular risk factors - findings from the STAAB cohort study. BMC Cardiovasc Disord 2019; 19:84. [PMID: 30947692 PMCID: PMC6449987 DOI: 10.1186/s12872-019-1044-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Accepted: 03/14/2019] [Indexed: 11/30/2022] Open
Abstract
Background The guideline recommendation to not measure carotid intima-media thickness (CIMT) for cardiovascular risk prediction is based on the assessment of just one single carotid segment. We evaluated whether there is a segment-specific association between different measurement locations of CIMT and cardiovascular risk factors. Methods Subjects from the population-based STAAB cohort study comprising subjects aged 30 to 79 years of the general population from Würzburg, Germany, were investigated. CIMT was measured on the far wall of both sides in three different predefined locations: common carotid artery (CCA), bulb, and internal carotid artery (ICA). Diabetes, dyslipidemia, hypertension, smoking, and obesity were considered as risk factors. In multivariable logistic regression analysis, odds ratios of risk factors per location were estimated for the endpoint of individual age- and sex-adjusted 75th percentile of CIMT. Results 2492 subjects were included in the analysis. Segment-specific CIMT was highest in the bulb, followed by CCA, and lowest in the ICA. Dyslipidemia, hypertension, and smoking were associated with CIMT, but not diabetes and obesity. We observed no relevant segment-specific association between the three different locations and risk factors, except for a possible interaction between smoking and ICA. Conclusions As no segment-specific association between cardiovascular risk factors and CIMT became evident, one simple measurement of one location may suffice to assess the cardiovascular risk of an individual.
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Affiliation(s)
- Lara Müller-Scholden
- Comprehensive Heart Failure Center Würzburg, University and University Hospital Würzburg, Straubmühlweg 15, 97080, Würzburg, Germany
| | - Jan Kirchhof
- Comprehensive Heart Failure Center Würzburg, University and University Hospital Würzburg, Straubmühlweg 15, 97080, Würzburg, Germany
| | - Caroline Morbach
- Comprehensive Heart Failure Center Würzburg, University and University Hospital Würzburg, Straubmühlweg 15, 97080, Würzburg, Germany.,Department of Internal Medicine I, University Hospital Würzburg, Würzburg, Germany
| | - Margret Breunig
- Comprehensive Heart Failure Center Würzburg, University and University Hospital Würzburg, Straubmühlweg 15, 97080, Würzburg, Germany.,Department of Internal Medicine I, University Hospital Würzburg, Würzburg, Germany
| | - Rudy Meijer
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Viktoria Rücker
- Institute of Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany
| | - Theresa Tiffe
- Comprehensive Heart Failure Center Würzburg, University and University Hospital Würzburg, Straubmühlweg 15, 97080, Würzburg, Germany.,Institute of Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany
| | - Tino Yurdadogan
- Comprehensive Heart Failure Center Würzburg, University and University Hospital Würzburg, Straubmühlweg 15, 97080, Würzburg, Germany
| | - Martin Wagner
- Institute of Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany
| | - Götz Gelbrich
- Institute of Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany.,Clinical Trial Center, University Hospital Würzburg, Würzburg, Germany
| | - Michiel L Bots
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Stefan Störk
- Comprehensive Heart Failure Center Würzburg, University and University Hospital Würzburg, Straubmühlweg 15, 97080, Würzburg, Germany. .,Department of Internal Medicine I, University Hospital Würzburg, Würzburg, Germany.
| | - Peter U Heuschmann
- Comprehensive Heart Failure Center Würzburg, University and University Hospital Würzburg, Straubmühlweg 15, 97080, Würzburg, Germany.,Institute of Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany.,Clinical Trial Center, University Hospital Würzburg, Würzburg, Germany
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