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Sablić S, Dolić K, Kraljević I, Budimir Mršić D, Čičmir-Vestić M, Benzon B, Lovrić Kojundžić S, Marinović Guić M. The Presence of Communicating Arteries in the Circle of Willis Is Associated with Higher Rate of Functional Recovery after Anterior Circulation Ischemic Stroke. Biomedicines 2023; 11:3008. [PMID: 38002008 PMCID: PMC10669712 DOI: 10.3390/biomedicines11113008] [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: 10/14/2023] [Revised: 11/02/2023] [Accepted: 11/06/2023] [Indexed: 11/26/2023] Open
Abstract
Acute ischemic stroke (AIS) is the world's second leading cause of mortality. An established method for treating stroke patients in acute settings is endovascular therapy (EVT). However, the correlation of the successful endovascular treatment of AIS with the presence of communicating arteries in the circle of Willis needs to be proven. Our study examined clinical and radiological data of 158 consecutive patients treated with mechanical thrombectomy (MT) at our comprehensive stroke center. We analyzed their CT angiograms and digital subtraction angiography (DSA) to assess anatomical variants of Willis' circle and formed two groups-collateral-negative and collateral-positive group. The first group included patients with aplasia of both anterior (ACoA) and posterior communicating Artery (PCoA). The second group included patients that have at least one communicating artery (either anterior or posterior). We evaluated their reperfusion outcomes and functional recovery three months later. Our results showed that patients with communicating arteries had smaller areas of infarction on post-interventional CT and higher rates of functional recovery (Modified Rankin Score). The ACoA had a higher impact on early and late outcomes, confirmed by lower control CT scores and more favorable functional recovery. Therefore, anatomic variants of Willis' circle should be considered as a significant prognostic factor in AIS.
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Affiliation(s)
- Sara Sablić
- Clinical Department of Diagnostic and Interventional Radiology, University Hospital of Split, 21000 Split, Croatia; (S.S.)
| | - Krešimir Dolić
- Clinical Department of Diagnostic and Interventional Radiology, University Hospital of Split, 21000 Split, Croatia; (S.S.)
- University of Split School of Medicine, 21000 Split, Croatia
- University Department of Health Studies of the University of Split, 21000 Split, Croatia
| | - Ivan Kraljević
- Clinical Department of Diagnostic and Interventional Radiology, University Hospital of Split, 21000 Split, Croatia; (S.S.)
| | - Danijela Budimir Mršić
- Clinical Department of Diagnostic and Interventional Radiology, University Hospital of Split, 21000 Split, Croatia; (S.S.)
- University of Split School of Medicine, 21000 Split, Croatia
- University Department of Health Studies of the University of Split, 21000 Split, Croatia
| | - Mate Čičmir-Vestić
- Department of Neurology, University Hospital of Split, 21000 Split, Croatia
| | - Benjamin Benzon
- University of Split School of Medicine, 21000 Split, Croatia
| | - Sanja Lovrić Kojundžić
- Clinical Department of Diagnostic and Interventional Radiology, University Hospital of Split, 21000 Split, Croatia; (S.S.)
- University of Split School of Medicine, 21000 Split, Croatia
- University Department of Health Studies of the University of Split, 21000 Split, Croatia
| | - Maja Marinović Guić
- Clinical Department of Diagnostic and Interventional Radiology, University Hospital of Split, 21000 Split, Croatia; (S.S.)
- University of Split School of Medicine, 21000 Split, Croatia
- University Department of Health Studies of the University of Split, 21000 Split, Croatia
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Oliveira MS, da Silva Torquato BG, Tsuji SY, Aguiar LS, Juliano GR, da Silveira LAM, Miranda Corrêa RR, Rocha LB, da Fonseca Ferraz ML. Morphological and Histopathological Study of Autopsied Patients with Atherosclerosis and HIV. Curr HIV Res 2021; 19:121-127. [PMID: 33135614 DOI: 10.2174/1570162x18999201029123356] [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: 04/30/2020] [Revised: 08/18/2020] [Accepted: 10/02/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Chronic infection by HIV evolves with a vascular inflammatory action causing endothelial dysfunction. The action of the virus, as well as the side effects of antiretroviral drugs, contribute to the progression of cardiovascular diseases. The present study aimed to evaluate the percentage of collagen fibers and the density of mast cells, chymase and tryptase, in aortas of patients with and without HIV, and also patients with and without atherosclerosis. METHODS Aortic fragments were obtained from autopsied patients aged 22-69 years and selected regardless of the cause of death or underlying disease. The samples were divided into four groups, (1) Group with HIV and with atherosclerosis; (2) Group with HIV and without atherosclerosis; (3) Group without HIV and with atherosclerosis; (4) Group without HIV and without atherosclerosis (Control). The percentage of collagen fibers was analyzed in the intima-media layer and the density of mast cells was analyzed in all aortic layers. Graphpad Prism 5.0® software was used for statistical analysis. RESULTS There were more collagen fibers in HIV patients, with or without atherosclerosis. The group with HIV and atherosclerosis presented a higher density of chymase and tryptase mast cells. The correlation between collagen fibers and age was negative in the non-HIV group and with atherosclerosis. CONCLUSION The inflammatory process resulting from HIV infection may be relevant in the alteration of aortic collagen fibers and in triggering or accelerating atherosclerosis. The study is important because HIV patients have increased risks for the development of cardiovascular diseases, and follow-up is necessary to prevent such diseases.
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Affiliation(s)
- Mariana Silva Oliveira
- General Pathology Department, Triângulo Mineiro Federal University, St: Frei Paulino, 30. Zip Code: 38025-180, Uberaba, Minas Gerais, Brazil
| | - Bianca Gonçalves da Silva Torquato
- General Pathology Department, Triângulo Mineiro Federal University, St: Frei Paulino, 30. Zip Code: 38025-180, Uberaba, Minas Gerais, Brazil
| | - Simone Yumi Tsuji
- General Pathology Department, Triângulo Mineiro Federal University, St: Frei Paulino, 30. Zip Code: 38025-180, Uberaba, Minas Gerais, Brazil
| | - Laura Sanches Aguiar
- General Pathology Department, Triângulo Mineiro Federal University, St: Frei Paulino, 30. Zip Code: 38025-180, Uberaba, Minas Gerais, Brazil
| | - Guilherme Ribeiro Juliano
- General Pathology Department, Triângulo Mineiro Federal University, St: Frei Paulino, 30. Zip Code: 38025-180, Uberaba, Minas Gerais, Brazil
| | - Luciano Alves Matias da Silveira
- General Pathology Department, Triângulo Mineiro Federal University, St: Frei Paulino, 30. Zip Code: 38025-180, Uberaba, Minas Gerais, Brazil
| | - Rosana Rosa Miranda Corrêa
- General Pathology Department, Triângulo Mineiro Federal University, St: Frei Paulino, 30. Zip Code: 38025-180, Uberaba, Minas Gerais, Brazil
| | - Lenaldo Branco Rocha
- General Pathology Department, Triângulo Mineiro Federal University, St: Frei Paulino, 30. Zip Code: 38025-180, Uberaba, Minas Gerais, Brazil
| | - Mara Lúcia da Fonseca Ferraz
- General Pathology Department, Triângulo Mineiro Federal University, St: Frei Paulino, 30. Zip Code: 38025-180, Uberaba, Minas Gerais, Brazil
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Msoka TF, Van Guilder GP, van Furth M, Smulders Y, Meek SJ, Bartlett JA, Vissoci JRN, van Agtmael MA. The effect of HIV infection, antiretroviral therapy on carotid intima-media thickness: A systematic review and meta-analysis. Life Sci 2019; 235:116851. [PMID: 31499070 PMCID: PMC10496646 DOI: 10.1016/j.lfs.2019.116851] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Revised: 09/05/2019] [Accepted: 09/05/2019] [Indexed: 01/09/2023]
Abstract
AIMS We performed a systematic review and meta-analysis on the effect of HIV infection and antiretroviral therapy (ART) on carotid intima-media thickness (cIMT) to elucidate the role of HIV infection and ART. Also, an analysis on the role of ethnicity and gender on cIMT in HIV-infected populations was performed. MAIN METHODS We searched the PubMed, Web of Science, the WHO websites and International AIDS Society for published observational studies were conducted by two independent reviewers for studies comparing HIV-infected antiretroviral-experienced patients and/or inexperienced with healthy controls on cIMT. The primary outcome was the standardized mean difference (SMD) of cIMT. FINDINGS Twenty studies (five cohort, 15 cross-sectional, and two both cohort and cross-sectional studies) were identified comprising 7948 subjects (4656 HIV-infected; 3292 controls). In cohort studies, the standardized mean 1-year change in cIMT between HIV-infected patients and uninfected controls was not significantly different (0.16 mm/yr; 95% CI, -0.16, 0.49; p = 0.326). In 17 cross-sectional studies, the SMD in cIMT was significantly higher in HIV-infected than uninfected persons (0.27 mm; 95% CI, 0.04, 0.49; p = 0.027). HIV-infected patients on ART exhibited significantly higher SMD in cIMT compared to those not on ART (0.75 mm; 95% CI, 0.30, 1.19; p = 0.001). No confounding effect of gender and ethnicity could be established using meta-regression p > 0.05. SIGNIFICANCE HIV infection itself and ART appear to influence the progression of cIMT and hence may be risk factors for cardiovascular events. No firm conclusions could be drawn on the effect of ethnic/race and gender differences on cIMT in HIV-infected populations.
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Affiliation(s)
- Titus F Msoka
- Kilimanjaro Christian Medical Centre, Department of Internal Medicine, Moshi, Tanzania.
| | - Gary P Van Guilder
- Department of Health and Nutritional Sciences, South Dakota State University, USA
| | | | - Yvo Smulders
- VUmc Hospital Amsterdam, Department Infectiology, Netherlands
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Eickemberg M, Amorim LDAF, de Almeida MDCC, de Aquino EML, da Fonseca MDJM, Santos IDS, Chor D, Diniz MDFS, Barreto SM, de Matos SMA. Indicators of Abdominal Adiposity and Carotid Intima-Media Thickness: Results from the Longitudinal Study of Adult Health (ELSA-Brazil). Arq Bras Cardiol 2019; 112:220-227. [PMID: 30916202 PMCID: PMC6424038 DOI: 10.5935/abc.20180273] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Revised: 07/23/2018] [Accepted: 07/23/2018] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Abdominal adiposity is a risk factor for cardiovascular disease. OBJECTIVE To determine the magnitude of the association between abdominal adiposity, according to five different indicators, and the carotid intima-media thickness (CIMT). METHODS Data from 8,449 participants aged 35 to 74 years from the ELSA-Brazil study were used. The effect of waist circumference (WC), waist-to-hip ratio (WHR), conicity index (C index), lipid accumulation product (LAP) and visceral adiposity index (VAI) on CIMT were evaluated. Data were stratified by gender and analyzed using multivariate linear and logistic regressions. A significance level of 5% was considered. RESULTS Participants with CIMT > P75 showed a higher frequency of abdominal adiposity (men >72% and women >66%) compared to those with CIMT < P75. Abdominal adiposity was associated with the mean CIMT, mainly through WC in men (0.04; 95%CI: 0.033; 0.058). The abdominal adiposity identified by the WC, WHR, LAP, and VAI indicators in women showed an effect of 0.02 mm on the CIMT (WC: 0.025, 95%CI: 0.016, 0.035; WHR: 0.026, 95%CI: 0.016, 0.035; LAP: 0.024, 95%CI: 0.014; 0.034; VAI: 0.020, 95%CI: 0.010, 0.031). In the multiple logistic regression, the abdominal adiposity diagnosed by WC showed an important effect on the CIMT in both genders (men: OR = 1.47, 95%CI: 1.22-1.77, women: OR = 1.38; 95%CI: 1.17-1.64). CONCLUSION Abdominal adiposity, identified through WC, WHR, LAP, and VAI, was associated with CIMT in both genders, mainly for the traditional anthropometric indicator, WC.
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Affiliation(s)
- Michaela Eickemberg
- Universidade Federal da Bahia, Salvador, BA - Brazil
- Escola Bahiana de Medicina e Saúde Pública, Salvador,
BA - Brazil
| | | | | | | | | | | | - Dora Chor
- Escola Nacional de Saúde Pública - Fiocruz, Rio de
Janeiro, RJ - Brazil
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Bez LG, Navarro TP. Study of carotid disease in patients with peripheral artery disease. Rev Col Bras Cir 2016; 41:311-8. [PMID: 25467094 DOI: 10.1590/0100-69912014005003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2013] [Accepted: 01/09/2014] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To study the stenosis of the carotid arteries in patients with symptomatic peripheral arterial disease. METHODS we assessed 100 consecutive patients with symptomatic peripheral arterial disease in stages of intermittent claudication, rest pain or ulceration. Carotid stenosis was studied by echo-color-doppler, and considered significant when greater than or equal to 50%. We used univariate analysis to select potential predictors of carotid stenosis, later taken to multivariate analysis. RESULTS The prevalence of carotid stenosis was 84%, being significant in 40% and severe in 17%. The age range was 43-89 years (mean 69.78). Regarding gender, 61% were male and 39% female. Half of the patients had claudication and half had critical ischemia. Regarding risk factors, 86% of patients had hypertension, 66% exposure to smoke, 47% diabetes, 65% dyslipidemia, 24% coronary artery disease, 16% renal failure and 60% had family history of cardiovascular disease. In seven patients, there was a history of ischemic cerebrovascular symptoms in the carotid territory. The presence of cerebrovascular symptoms was statistically significant in influencing the degree of stenosis in the carotid arteries (p = 0.02 at overall assessment and p = 0.05 in the subgroups of significant and non-significant stenoses). CONCLUSION the study of the carotid arteries by duplex scan examination is of paramount importance in the evaluation of patients with symptomatic peripheral arterial disease, and should be systematically conducted in the study of such patients.
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Affiliation(s)
| | - Túlio Pinho Navarro
- Department of Surgery, Faculty of Medicine, Universidade Federal de Minas Gerais
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Menshawi K, Mohr JP, Gutierrez J. A Functional Perspective on the Embryology and Anatomy of the Cerebral Blood Supply. J Stroke 2015; 17:144-58. [PMID: 26060802 PMCID: PMC4460334 DOI: 10.5853/jos.2015.17.2.144] [Citation(s) in RCA: 114] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2014] [Revised: 02/26/2015] [Accepted: 02/27/2015] [Indexed: 11/11/2022] Open
Abstract
The anatomy of the arterial system supplying blood to the brain can influence the development of arterial disease such as aneurysms, dolichoectasia and atherosclerosis. As the arteries supplying blood to the brain develop during embryogenesis, variation in their anatomy may occur and this variation may influence the development of arterial disease. Angiogenesis, which occurs mainly by sprouting of parent arteries, is the first stage at which variations can occur. At day 24 of embryological life, the internal carotid artery is the first artery to form and it provides all the blood required by the primitive brain. As the occipital region, brain stem and cerebellum enlarge; the internal carotid supply becomes insufficient, triggering the development of the posterior circulation. At this stage, the posterior circulation consists of a primitive mesh of arterial networks that originate from projection of penetrators from the distal carotid artery and more proximally from carotid-vertebrobasilar anastomoses. These anastomoses regress when the basilar artery and the vertebral arteries become independent from the internal carotid artery, but their persistence is not uncommon in adults (e.g., persistent trigeminal artery). Other common remnants of embryological development include fenestration or duplication (most commonly of the basilar artery), hypoplasia (typically of the posterior communicating artery) or agenesis (typically of the anterior communicating artery). Learning more about the hemodynamic consequence that these variants may have on the brain territories they supply may help understand better the underlying physiopathology of cerebral arterial remodeling and stroke in patients with these variants.
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Affiliation(s)
- Khaled Menshawi
- Department of Neurology, Columbia University Medical Center, New York, NY, USA
| | - Jay P Mohr
- Department of Neurology, Columbia University Medical Center, New York, NY, USA
| | - Jose Gutierrez
- Department of Neurology, Columbia University Medical Center, New York, NY, USA
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Ikama SM, Nsitou BM, Ossou-Nguiet PM, Otiobanda GF, Matali E. [Contribution of vascular ultrasonography in patients with ischemic strokes in Brazzaville (Congo)]. JOURNAL DES MALADIES VASCULAIRES 2014; 39:178-82. [PMID: 24680313 DOI: 10.1016/j.jmv.2014.02.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2013] [Accepted: 02/10/2014] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To determine the prevalence of the carotid lesions during ischemic strokes. METHODS This was a descriptive cross-sectional study, conducted in Brazzaville from January 2011 to June 2012 in a consecutive series of 73 patients, victims of a transient ischemic attack or ischemic stroke, documented by a brain computed tomography. All patients underwent vascular ultrasonography of the supra-aortic trunks, carried out within the framework of etiological assessment. The examination searched for plaques, parietal infiltration (measurement of intima-media thickness), and carotid stenosis or occlusion. RESULTS There were 49 men (67%) and 24 women (33%), mean age 58.7 ± 11.8 years. Eleven patients (15%) had a transient ischemic attack and 62 (85%) an ischemic stroke. The identified independent vascular risk factors were known and treated hypertension (n=66, 90.4%), dyslipidemia (n=16, 22%), diabetes mellitus (n=9, 12.3%), and smoking (n=5, 6.8%), with on average 2.5 factors per individual. Vascular ultrasonography of the supra-aortic trunks, normal in 44 patients (60.3%) was pathological in the other 29 (39.7%). The main anomalies were atheromatous plaque (n=10, 13.7%), parietal infiltration (n=19, 26%). On average intima-media thickness was 0.86 ± 0.11 mm on the left and 0.83 ± 0.11 mm on the right. Two cases of moderate stenosis were noted on the right and left internal carotids, respectively. CONCLUSION This preliminary study confirms the existence of carotid atherosclerosis anomalies during ischemic strokes. These lesions, though non-significant, must nevertheless be taken into consideration when searching for the cause of stroke in high-risk vascular patients.
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Affiliation(s)
- S M Ikama
- Service de cardiologie et médecine interne, CHU de Brazzaville, BP 2234, Brazzaville, Congo.
| | - B M Nsitou
- Service de cardiologie et médecine interne, CHU de Brazzaville, BP 2234, Brazzaville, Congo
| | | | - G F Otiobanda
- Service de réanimation polyvalente, CHU de Brazzaville, Brazzaville, Congo
| | - E Matali
- Service de neurologie, CHU de Brazzaville, Brazzaville, Congo
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Mahmoud MZ. Sonography of common carotid arteries' intima: media thickness in the normal adult population in Sudan. NORTH AMERICAN JOURNAL OF MEDICAL SCIENCES 2013; 5:88-94. [PMID: 23641368 PMCID: PMC3624725 DOI: 10.4103/1947-2714.107523] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Background: Carotid ultrasonography is a useful diagnostic tool for assessing carotid disease. It is highly reliable, has no radiation risk, and has no risks when compared to conventional angiography. Aim: The study was to determine the common carotid artery (CCA) intima–media thickness (IMT) in the normal adult Sudanese so as to create standards for defining abnormalities. Materials and Methods: In 440 participants, the intima–media thickness was obtained sonographically in the supine position at the point of 1 cm section distal to the carotid bulb. Due to ethnic variations, participants were divided into a five ethnic groups according to their geographic distribution in Sudan. Results: The ranges of IMT found in the study were from 0.04 cm to 0.07 cm in carotids. Ethnically, males and females from West and East of Sudan show the highest IMT (0.070 ± 0.00 cm and 0.065 ± 0.01 cm) for CCA while males and females from the South of Sudan show the lowest IMT (0.055 ± 0.01 cm and 0.058 ± 0.004 cm). Conclusion: Mean carotids’ IMT was slightly higher in females compared to males. No significant differences were found between IMT and different ethnics but significance was noted among participants’ age and IMT of both sexes.
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Affiliation(s)
- Mustafa Z Mahmoud
- Department of Radiology and Medical Imaging, Salman bin Abdulaziz University, College of Applied Medical Science, Al-Kharj, Kingdom of Saudi Arabia, Sudan ; Department of Fundamental Medical Radiologic Sciences, Sudan University of Science and Technology, College of Medical Radiological Science, Khartoum, Sudan
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Ferraz MLDF, Nascimento DMS, Rorato JPH, Espindula AP, Oliveira LF, Ramalho LS, Soares MH, Cavellani CL, Oliveira FA, Pereira SADL, Corrêa RRM, Teixeira VDPA. Correlation of lifetime progress of atherosclerosis and morphologic markers of severity in humans: new tools for a more sensitive evaluation. Clinics (Sao Paulo) 2012; 67:1071-5. [PMID: 23018306 PMCID: PMC3438249 DOI: 10.6061/clinics/2012(09)15] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2012] [Accepted: 05/07/2012] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVES To describe the morphological features of atherosclerosis in the aortas of autopsied patients (ranging from young adults to the elderly), thus providing new tools for a more sensitive morphological evaluation. METHOD We collected 141 aorta samples. We assessed the macroscopic degree of atherosclerosis, thickness of the intima and media, lipid and collagen depositions in the intima, and the infiltration of mast cells into the layers of the aorta. We correlated the findings with gender, age, race and cause of death. RESULTS The degree of atherosclerosis was significantly higher in the elderly. The aorta was thicker in the elderly and in cases with a cardiovascular cause of death. The thickness of the intima was significantly greater in the elderly, in males and in cases with a cardiovascular cause of death. The lipid content in the intima of the aorta was significantly higher in Caucasians. Older people and men had a significantly higher number of mast cells. CONCLUSION A macroscopic evaluation is a good indicator of the severity of atherosclerosis, but a more detailed analysis, namely evaluating the thickness of the layers of the aorta and the number of mast cells, may further elucidate the changes in the constituents of this vessel.
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Patel KK, Caramelli B, Silva MRE. Original research articles on the cardiopulmonary system recently appeared in Brazilian clinical and surgical journals. Rev Assoc Med Bras (1992) 2011. [DOI: 10.1590/s0104-42302011000600022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Original research articles on the cardiopulmonary system recently appeared in Brazilian clinical and surgical journals. Rev Assoc Med Bras (1992) 2011. [DOI: 10.1016/s0104-4230(11)70140-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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12
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Pastorius CA, Medina-Lezama J, Corrales-Medina F, Bernabé-Ortiz A, Paz-Manrique R, Salinas-Najarro B, Khan ZA, Takahashi J, Toshima G, Zea-Diaz H, Postigo-Macdowall M, Chirinos-Pacheco J, Ibañez F, Chirinos DA, Saif H, Chirinos JA. Normative values and correlates of carotid artery intima-media thickness and carotid atherosclerosis in Andean-Hispanics: The Prevencion Study. Atherosclerosis 2010; 211:499-505. [PMID: 20510418 DOI: 10.1016/j.atherosclerosis.2010.04.009] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2010] [Revised: 04/12/2010] [Accepted: 04/12/2010] [Indexed: 10/19/2022]
Abstract
OBJECTIVES Carotid intima-media thickness (cIMT) is an independent predictor of cardiovascular risk. Furthermore, ethnicity and gender-specific normative data are required to assess cIMT, which are not available for Andean-Hispanics. In addition, data regarding correlates of subclinical atherosclerosis in ethnic population are needed. METHODS We studied 1448 adults enrolled in a population-based study in Peru. cIMT and carotid plaque were measured with high-resolution ultrasonography. A healthy reference sample (n=472) with no cardiovascular disease, normal weight and normal metabolic parameters was selected to establish normative cIMT values. Correlates of abnormal cIMT and carotid plaque were assessed in the entire population. RESULTS In the reference sample, 95th-percentile cIMT values were both age and gender-dependent. In stepwise regression, selected predictors of increasing cIMT were: older age, impaired fasting glucose, diabetes mellitus, higher systolic blood pressure, higher LDL-cholesterol, smoking and male gender. Predictors of carotid plaque included older age, male gender, higher systolic blood pressure, lower diastolic blood pressure and higher LDL-cholesterol. HDL-cholesterol and C-reactive protein were not associated with cIMT or carotid plaque. The lack of association with HDL-cholesterol was confirmed using high performance liquid chromatography. CONCLUSIONS We present ethnic-specific cut-offs for abnormal cIMT applicable to Andean-Hispanics and correlates of subclinical atherosclerosis in this population. Pending longitudinal studies, our data supports several risk associations seen in other populations and can be used to identify Andean-Hispanics at increased risk for atherosclerotic cardiovascular disease. The lack of association between HDL-C and cIMT or carotid plaque in this population requires further investigation.
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