In order to study the relationship between serum C-reactive protein (CRP) levels, leukocyte count and carotid plaque in patients with ischemic stroke, carotid duplex examination was performed by high-definition imagin...In order to study the relationship between serum C-reactive protein (CRP) levels, leukocyte count and carotid plaque in patients with ischemic stroke, carotid duplex examination was performed by high-definition imaging (HDI) 5000 triplex system. Serum CRP was measured by nephelometry within 72 h after index ischemic stroke. A lesion was considered a plaque in the presence of a maximum intimal-medial wall thickness (IMT) 1.2 mm. Results of carotid ultrasonography were divided into two groups: M1, normal (IMT <1.2 mm) and M2, abnormal (IMT ≥1.2 mm). The results showed that the mean age of M2 was significantly older than that of M1 (69.7±10.4 versus 62.5±9.6, P =0.001). The patients with hypertension and diabetes mellitus (78 %, 35 % respectively)in M2 were significantly more than those (52 %, 18 % respectively) in M1 ( P <0.01, P <0.05). There were 32 (65 % ) patients with elevated CRP levels in M2, but 33 (46 %) patients with elevated CRP levels in M1, with the difference being significant between the two groups ( P <0.05). The levels of serum glucose and leukocyte count (8.1±5.5, 10.3±4.0, respectively) in abnormal CRP group were significantly higher than that of normal CRP group (6.4±2.8, 8.7±3.4) ( P <0.05, P <0.05); elevated CRP levels was found in 42 (62 %) patients with territory infarction and 23 (43 %) patients with lacunar infarction respectively, with the difference being significant between these two groups ( P <0.05). It was concluded that the elevation of CRP levels was an significant clinical index for carotid plaque in patients with acute cerebral infarction.展开更多
This study was undertaken to investigate the correlation of the enhancement degree on contrast-enhanced ultrasound(CEUS) with the histopathology of carotid plaques and the serum high sensitive C-reactive protein(hs-CR...This study was undertaken to investigate the correlation of the enhancement degree on contrast-enhanced ultrasound(CEUS) with the histopathology of carotid plaques and the serum high sensitive C-reactive protein(hs-CRP) levels in patients undergoing carotid endarterectomy(CEA). Carotid CEUS was performed preoperatively in 115 patients who would undergo CEA, and the enhancement degree of the carotid plaques was evaluated by both the visual semiquantitative analysis and the quantitative time-intensity curve analysis. Serum hs-CRP levels were detected using the particle-enhanced immunoturbidimetric assay also before the operation. Additionally, the carotid plaque samples were subjected to histopathological examination postoperatively. The density of neovessels and the number of macrophages in the plaques were assessed by immunohistochemistry. The results showed that among the 115 patients, grade 0 plaque contrast enhancement was noted in 35 patients, grade 1 in 48 patients and grade 2 in 32 patients. The degree of plaque enhancement, the density of neovessels, the number of macrophages, and the hs-CRP levels were highest in the grade 2 patients. Correlation analysis showed that the enhancement degree of the carotid plaques was closely related to the immunohistochemical parameters of the plaques and the serum hs-CRP levels. It was suggested that the carotid plaque enhancement on CEUS can be used to evaluate the vulnerability of carotid plaques.展开更多
It is very common that increased carotid intima media thickness （CIMT） and carotid plaque coexist in a single subject in elderly patients with white matter lesions （WMLs）. In this study we inves- tigated whether t...It is very common that increased carotid intima media thickness （CIMT） and carotid plaque coexist in a single subject in elderly patients with white matter lesions （WMLs）. In this study we inves- tigated whether the coexistence of increased CIMT and carotid plaque is more strongly associated with the presence and extent of WMLs than either alone. All patients were classified into 1 of the following 4 groups： without either increased CIMT （I） or carotid plaque （P）： I（-）P（-）; with only increased CIMT： I（＋）P（-）; with only carotid plaque： I（-）P（＋）; and with both increased CIMT and carotid plaque： I（＋）P（＋） The presence and severity of periventricular WMLs （PWMLs） and deep WMLs （DWMLs） were as- sessed and the prevalence of MRI findings by the Cochran-Armitage trend test was calculated. The characteristics of subjects showed that the percentages of patients with increased CIMT and carotid plaque in the DWMLs group and the PWMLs group were significantly higher than those without WMLs group. Both DWMLs and PWMLs were strongly associated with age, carotid plaque and CIMT. Furthermore, the Cochran-Armitage trend test indicated that the prevalence of MRI findings of PWMLs and DWMLs increased in the order of I（-）P（-）〈 I（＋）P（-）〈 I（-）P（＋）〈 I（＋）P（＋） （P〈0.0001）. For the pa- tients with DWMLs, the grades of both I（＋）P（-） and I（＋）P（＋） were increased significantly compared to I（-）P（-） （P〈0.0025, P〈0.05, respectively） without such a difference found in patients with PWMLs. Our results suggested that the coexistence of increased CIMT and carotid plaque is most closely associated with WMLs, and that increased CIMT is associated with the severity of DWMLs, whereas carotid plaque is related to the presence of WMLs.展开更多
Objectives:To evaluate the efficacy of 18F-FDG-PET/CT in detection toward the vulnerabilities of carotid plaque and review systematically best evidence to prevent acute stroke from unstable carotid plaque.Methods:A se...Objectives:To evaluate the efficacy of 18F-FDG-PET/CT in detection toward the vulnerabilities of carotid plaque and review systematically best evidence to prevent acute stroke from unstable carotid plaque.Methods:A search was conducted on Medline(PubMed),Web of science,Cochrane and WHIC using the search terms‘PET/CT’AND‘18F-FDG’AND‘fluorodeoxyglucose’AND‘carotid plaque’,from 2013/01/01 to now.Two authors will independently extract data following the study characteristics,eligibility criteria,interventions,outcome measurements,duration,adverse events,results and the type of needle used.All searched articles were inserted into in EndNote software that can automatically save,manage,and delete duplicate documents.Results:There were 3 articles included in the systematic review finally and form the study population analysis.The total 89 patients(64 males and 25 females)identified from the included studies.The mean 18F-FDG injected dose was 4.58 MBq/kg.The last three articles have demonstrated that 18F-FDG can accurately identify the stability of carotid plaques and can accurately locate and identify high-inflammation areas by histological analysis.Conclusions:18F-FDG-PET/CT is very efficient and practical for the identification of carotid vulnerable plaques.TBR(max and mean values)as a parameter for identifying inflammatory plaques is more reliable than SUV.展开更多
The degree of vessel lumen narrowing is an independent predictor of ischemic stroke. New developments in carotid plaque morphology imaging (MR, CT), may bring new insights to the relationship between carotid atheroscl...The degree of vessel lumen narrowing is an independent predictor of ischemic stroke. New developments in carotid plaque morphology imaging (MR, CT), may bring new insights to the relationship between carotid atherosclerotic disease and stroke risk. Our aim is to review the stroke risk in a symptomatic patient with moderate carotid stenosis by CT imaging and histopathology. A 72-year-old patient with low ABCD2 scores TIA and moderate left internal carotid stenosis (50% by carotid ultrasound), was discharged with an optimized medical therapy. Four months later, he presented an ischemic stroke in the left frontal area. Carotid angiography showed a 60% stenosis in the left-internal carotid artery with a regular surface. CT plaque imaging detected a thin fibrous cap with calcification and an intraplaque hemorrhage (high-risk plaque). These findings were confirmed in the histolopathological study of the atherosclerotic plaque performed after the endarterectomy. After 1 year of follow-up, the patient returned independently to his daily activities. We propose, in this study, the inclusion of noninvasive plaque imaging in the evaluation of acute TIA with moderate carotid stenosis to better select patients with higher risk of stroke recurrence.展开更多
Background Atherosclerotic plaques indicate the occurrence of ischemia events and it is a difficult task for clinical physicians. Grape seed proanthocyanidin extract （GSPE） has been reported to exert an antiatheroge...Background Atherosclerotic plaques indicate the occurrence of ischemia events and it is a difficult task for clinical physicians. Grape seed proanthocyanidin extract （GSPE） has been reported to exert an antiatherogenic effect by inducing regression of atherosclerotic plaques in animal experimental studies. In this study, the antiatherogenic effect of GSPE has been investigated in clinical use. Methods Consecu- tive 287 patients diagnosed with asymptomatic carotid plaques or abnormal plaque free carotid intima-media thickness （CIMT） were ran- domly assigned to the GSPE group （n = 146） or control group （n = 141）. The patients in the GSPE group received GSPE 200 mg per day orally, while patients in the control group were only enrolled in a lifestyle intervention program. Carotid ultrasound examination was per- formed at baseline and 6, 12, 24 months during follow-up. Mean maximum CIMT （MMCIMT）, plaque score, echogenicity of plaques and ischemic vascular events were recorded. Results As anticipated, after treatment, GSPE resulted in significant reduction in MMCIMT pro- gression （4.2% decrease after six months, 4.9% decrease after 12 months and 5.8% decrease after 24 months） and plaque score （10.9% de- crease after six months, 24.1% decrease after 12 months and 33.1% decrease after 24 months） for the primary outcome, while MMCIMT and plaque score were stable and even increased with the time going on in control group. The number of plaques and unstable plaques also de- creased after treatment of GSPE. Furthermore, the carotid plaque can disappear after treatment with GSPE. The incidence rate for transitory ischemic attack （TIA）, arterial revascularization procedure, and hospital readmission for unstable angina in GSPE group were statistically significant lower （P = 0.02, 0.08, 0.002, respectively） compared with the control group. Conclusions GSPE inhibited the progression of MMCIMT and reduced carotid plaque size in GSPE treated patients, and with extended treatment, the superior efficacy on MMCIMT and carotid plaque occurred. Furthermore, the GSPE group showed lower rates of clinical vascular events.展开更多
Background It has been long suggested that abnormal clinical factors in the body, such as dyslipidemia and diabetes, can affect the presence of atherosclerosis. However, few studies on the effect of factors within the...Background It has been long suggested that abnormal clinical factors in the body, such as dyslipidemia and diabetes, can affect the presence of atherosclerosis. However, few studies on the effect of factors within the normal range, such as the loss of renal function with age, on the prevalence of atherosclerosis are few know in healthy individuals. The aim of this study was to investigate risk factors affecting the presence of asymptomatic carotid plaques in a middle-aged and elderly healthy population. Methods In this regard, we prospectively evaluated 245 healthy individuals （98 males and 147 females） at baseline and after 5 years. Changes in the presence of carotid plaque between 2003 and 2008 were categorized into four groups, i.e. subjects without plaque at entry （n=165）： Group 1 （without plaque on two occasions, n=129） and Group 2 （with nascent plaque at follow-up, n=36）; subjects with plaque at entry （n=80）; Group 3 （with plaque regression at follow-up, n=29） and Group 4 （with plaque on two occasions, n=51）. Results Univariate analysis showed that the positive rate of carotid plaques in males was higher than that in females at the baseline, and that a significantly inverse correlation existed between the prevalence rate of plaque and aging. Logistic regression analysis of cross-sectional research showed that independent risk factors for the prevalence of atherosclerosis were male gender, lower estimated glomerular filtration rate （eGFR） and higher low-density lipoprotein cholesterol （LDL-C） at the baseline, and older age and lower eGFR were involved in the presence of carotid plaques at follow-up point. However, logistic regression analysis of the longitudinal data showed that older age, decreased eGFR and increased systolic blood pressure （SBP） independently predicted the presence of carotid plaques after 5 years in subjects without plaque at entry. In addition, in subjects with plaque at entry, age, changes in eGFR and the baseline levels of serum albumin （ALB） and serum total bilirubin （BIL） dependently influenced the outcome of carotid plaque. Conclusion Physiological decline of renal function, together with advancing age, was an independent risk factor which consistently affected the presence of carotid atherosclerosis in two categories of healthy individuals.展开更多
<strong>Background:</strong><span style="font-family:Verdana;"> Chronic kidney disease (CKD) patients have considerably high atherosclerotic changes which predict cardiovascular events</...<strong>Background:</strong><span style="font-family:Verdana;"> Chronic kidney disease (CKD) patients have considerably high atherosclerotic changes which predict cardiovascular events</span><span style="font-family:Verdana;">;</span><span style="font-family:Verdana;">hence</span><span style="font-family:Verdana;">,</span><span style="font-family:;" "=""><span style="font-family:Verdana;"> this study evaluated the prevalence of carotid atherosclerotic plaques in pre-dialysis CKD patients at a tertiary institution in south-east, Nigeria. </span><b><span style="font-family:Verdana;">Materials</span></b><span style="font-family:Verdana;"> </span><b><span style="font-family:Verdana;">and</span></b><span style="font-family:Verdana;"> </span><b><span style="font-family:Verdana;">Method: </span></b><span style="font-family:Verdana;">107 pre-dialysis CKD patients were consecutively recruited for the study. 81 subjects who were screened and had no kidney disease served as control. The control group was sex and age matched with the CKD patients. A pre-tested questionnaire was administered to all participants and physical examination was done. Presence of atheromatous plaques was assessed using doppler ultrasound at 3 sites—distal common carotid artery (CCA), the internal carotid artery (ICA) and the carotid bulb by a single skilled radiologist specialized in doppler ultrasound. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> Atheromatous plaques were significantly increased in CKD patients. 14.2% of CKD patients had atheromatous plaques versus 2.5% in the control group (p value < 0.05). Commonest site of occurrence was at the common carotid artery (CCA-7.5% versus ICA-4.7% versus bulb 1.8%). </span><b><span style="font-family:Verdana;">Conclusions:</span></b><span style="font-family:Verdana;"> Atheromatous plaques are prevalent in CKD patients. It is recommended that carotid doppler ultrasound should be done in CKD patients to identify patients for possible intervention.</span></span>展开更多
Objective:To evaluate the correlation between MRI plaque characteris-tics and ischemic stroke in patients with carotid artery stenosis≤50%.Methods:From September 2014 to February 2016,43 patients with carotid artery ...Objective:To evaluate the correlation between MRI plaque characteris-tics and ischemic stroke in patients with carotid artery stenosis≤50%.Methods:From September 2014 to February 2016,43 patients with carotid artery plaque with stenosis less than or equal to 50%were selected by ultrasound.All patients were examined by black blood MRI.The correlation between MRI plaque characteristics and other risk fac-tors and ischemic stroke was evaluated by single factor and multi factor analysis.Results:The median follow-up time of all patients was 11.8 months.Kaplan Meier survival analy-sis showed that the median time of stroke free was significantly shorter in patients with intracoronary hemorrhage than in patients without intracoronary hemorrhage,which was 14.3 months and 18.6 months,respectively(P=0.001);the median time of stroke free was also significantly shorter in patients with coronary heart disease than in patients without coronary heart disease,which was 12.1 months and 18.7 months,respectively(P=0.029).Cox regression analysis showed that coronary heart disease(HR=27.4;95%CI,1.6-464.3;P=0.022)and intraplaque hemorrhage(HR=18.2;95%CI,2.7-123.3;P=0.003)were inde-pendent risk factors for ischemic stroke.Conclusion:In the patients with carotid artery stenosis≤50%,plaque hemorrhage and coronary heart disease are independent risk factors of ischemic stroke.展开更多
Objective To analyze the correlation of autophagylevel and carotid plaque of ischemic cerebrovascular disease,so as to provide data evidence to its pathomechanism.Methods 127 patients with ischemic cerebrovascular dis...Objective To analyze the correlation of autophagylevel and carotid plaque of ischemic cerebrovascular disease,so as to provide data evidence to its pathomechanism.Methods 127 patients with ischemic cerebrovascular disease were divided into 3 groups according to carotid plague scores.The count and degree of cranial artery stenosis were observed with digital subtraction angiogra-展开更多
Objective: To investigate the correlation between fundus atherosclerosis and carotid arterial atherosclerosis. Methods: A total of 516 people undergoing physical examination in Deyang People’s Hospital between June 2...Objective: To investigate the correlation between fundus atherosclerosis and carotid arterial atherosclerosis. Methods: A total of 516 people undergoing physical examination in Deyang People’s Hospital between June 2020 and December 2022 were randomly selected. Fundus atherosclerosis and carotid arterial atherosclerosis were evaluated by fundus photography and carotid artery ultrasonography, respectively. Results: Among the 516 physical examination patients, 198 (38.4%) had normal fundus examination, and 318 (61.6%) had fundus arteriosclerosis. Among them, 166 cases were of grade I (32.2%), 86 cases were of grade II (16.7%), and 66 cases were of grade III (12.8%). There were 286 cases (55.4%) without carotid atherosclerosis, 201 cases (38.9%) with carotid atherosclerotic plaque, and 33 cases (6.4%) with carotid stenosis. Fundus arteriosclerosis is independently associated with carotid artery intima-media thickness, vulnerable plaques, plaque scores, and carotid artery stenosis (P Conclusion: In summary, there is a close relationship between carotid artery disease and the degree of arteriosclerosis in the eyeground. Fundus photography is a simple, non-invasive, and easily acceptable method of inspection. The results obtained from it are useful in determining the severity of carotid atherosclerosis and guiding early detection and intervention in clinical cases. This can help reduce the incidence of cardiovascular and cerebrovascular diseases.展开更多
<div style="text-align:justify;"> <span style="font-family:Verdana;"><strong>Objectives: </strong>To study relationship between carotid artery plaques characteristics and ha...<div style="text-align:justify;"> <span style="font-family:Verdana;"><strong>Objectives: </strong>To study relationship between carotid artery plaques characteristics and haemodynamic changes after carotid stenting. <strong>Patients and Methods: </strong>This observational prospective (pilot) study included 20 patients—who underwent CAS. The study was carried out in Ain shams university hospitals—Railway hospital (ERMED) and Suez insurance hospital from December 2018 to February 2020. Inclusion criteria, Symptomatic (defined as amaurosis fugax, TIA, Minor stroke or Major stroke) stenosis > 70%. Asymptomatic stenosis > 80% (accidentally discovered during pre-operative assessment for CABG and during full assessment for irrelevant stroke). <strong>Results:</strong> Regarding to plaque character for degree of stenosis, calcification and ulceration revealed significantly higher degree of stenosis in hemodynamic events group (P = 0.024). On the other hand, that there was no statistically significant difference between the two groups as regard calcification, ulceration and lesion location. <strong>Conclusion: </strong>The study revealed that HI is a common occurrence following CAS procedures and significantly higher degree of stenosis in hemodynamic events group. Plaque shape, ulcerations hardly affect haeodynamic instability after carotid stenting.</span> </div>展开更多
Objective To access the correlations between characteristics of carotid plaque in MRI and ischemic stroke in patients with≤50%carotid artery stenosis.Methods A total of 43 patients with≤50%carotid artery stenosis we...Objective To access the correlations between characteristics of carotid plaque in MRI and ischemic stroke in patients with≤50%carotid artery stenosis.Methods A total of 43 patients with≤50%carotid artery stenosis were selected for ultrasound from September 2014 to February 2016.A further test using magnetic resonance(MR)black blood imaging examination were carried out to distinguish the anatomy of the vessel as well the composition of the atherosclerotic plaque with remarkable details.The relationship between carotid plaque characteristics in MRI and other risk factors of patients with ischemic stroke was analyzed by univariate and multivariate analysis.Results The mean follow-up time was 11.8 months.During the follow-up period,4 of the 43 individuals experienced an ipsilateral ischemic stroke.Kaplan-Meier survival analysis showed the mean ischemic stroke free survival of patients with coronary heart disease(CHD)was significantly shorter than that in patients without CHD,which were 12.1 months and 18.7 months respectively(P=0.029).The mean ischemic stroke free survival of patients with intra-plaque hemorrhage(IPH)was significantly shorter than that in patients without IPH,which were 14.3 months and 18.6 months respectively(P=0.001).COX regression analysis showed that coronary heart disease(HR=27.4;95%CI,1.6-464.3;P=0.022)and IPH(HR=18.2;95%CI,2.7-123.3;P=0.003)were independent risk factors for ischemic stroke.Conclusion For patients with carotid artery stenosis≤50%,IPH of carotid plaques and CHD are independent risk factors for ischemic stroke.展开更多
AIM To investigate the association between carotid atherosclerosis and cystatin C(CysC) and to determine the optimal CysC cut-off value.METHODS One hundred twenty-eight subjects were included in this study. Atheroscle...AIM To investigate the association between carotid atherosclerosis and cystatin C(CysC) and to determine the optimal CysC cut-off value.METHODS One hundred twenty-eight subjects were included in this study. Atherosclerosis was defined as a maximum carotid plaque thickness(MCPT) of greater than 2 mm. A receiver operating characteristic curve analysis was used to determine the diagnostic value of serum CysC for atherosclerosis. The subjects were divided into two groups according to the CysC cut-off value. We screenedfor diabetes, hypertension, dyslipidemia, smoking status, alcohol consumption, and exercise behavior. The association between atherosclerosis and CysC levels was assessed using multivariate analysis.RESULTS The subjects were then divided into two groups according to the CysC cut-off value(0.73 mg/L). The median age of the high CysC group was 72 years(85% males), whereas that of the low CysC group was 61 years(63% males). The CysC levels were significantly correlated with Cr and estimated glomerular filtration rate(eGFR) values. Bodymass index, visceral fat area, hypertension, diabetes mellitus, and MCPT were significantly higher in the high CysC group than in the low CysC group. Furthermore, the eG FR was significantly lower in the high CysC group. Regarding lifestyle habits, only the exercise level was lower in the high CysC group than in the low CysC group. Multivariate analysis, adjusted for age and sex, revealed that high CysC levels were significantly associated with an MCPT of ≥ 2 mm(odds ratio: 2.92; 95%CI: 1.13-7.99).CONCLUSION Higher CysC levels were associated with an MCPT of ≥ 2 mm. The CysC cut-off value of 0.73 mg/L appears to aid in the diagnosis of atherosclerosis.展开更多
Backgroud Numerous studies have confirmed the effectiveness of slowing the progression of atherosclerosis by blood pressure （Bp） control in patients with hypertension and several studies also showed the efficacy of ...Backgroud Numerous studies have confirmed the effectiveness of slowing the progression of atherosclerosis by blood pressure （Bp） control in patients with hypertension and several studies also showed the efficacy of intensive glycemic control in decreasing progression of carotid intima-media thickness （CIMT） in patients with type 1 and type 2 diabetes. However, few studies have compared the relative importance of glycemic w＇. Bp control in patients with diabetes and hypertension. We aimed to investigate the association between Bp and glycemic control and subclinical carotid atherosclerosis in older patients with hypertension and type 2 diabetes. Methods In a cross-sectional study, B-mode high-resolution ultrasonography of the carotid artery was performed in 670 subjects （508 males and 162 females） aged 60 years or over who had self-reported hypertension and diabetes but no history of coronary heart disease or stroke. Subjects were categorized by their systolic blood pressure： tight control, 〈 130 mmHg; usual control, 130-139 mmHg; or uncontrolled, 〉 140 mmHg, and by their hemoglobin Alc （HbAlc） level： tight control, 〈 6.5%; usual control, 6.5%-7.5%; or uncontrolled, 〉 7.5%, respectively. Results The mean CIMT was 8.20 ±0.11 mm, and carotid plaque was found in 52.5% （352/670） subjects. Overall, 62.1% of the subjects had subclinical carotid atherosclerosis, defined as having either carotid plaque or elevated CIMT （≥ 1.1 ram）. The mean CIMT was significantly different between Bp control categories （7.60 ± 0.09 mm, 7.90 ±0.08 mm, and 8.60 ± 0.12 mm, respectively, P = 0.03） but not between glycemic control categories （8.20± 0.10 mm, 8.1 ±0.08 mm, and 8.40 ± 0.14 ram, respectively, P = 0.13） using ANCOVA analysis. Multivariable logistic regression adjusting for potential confounding factors showed that usual or uncontrolled Bp control were associated with having carotid plaque （OR = 1.08 and OR=1.42, respectively）, or elevated CIMT [Odd ratio （OR） = 1.17, 95% confidence interval （CI） 1.04-2.24, and OR = 1.54, 95% CI 1.36-2.96, respectively compared to tight Bp control; but did not show glycemic control as independent predictor of either having carotid plaque or elevated CIMT. Conclusions In older patients with hypertension and diabetes, blood pressure control, but not glycemic control is associated with subclinical carotid atherosclerosis.展开更多
BACKGROUND There is an increased risk of atherosclerosis in patients with chronic hepatitis C or human immunodeficiency virus,but there is scarce data on hepatitis B virus infection.The hypothesis of this study is tha...BACKGROUND There is an increased risk of atherosclerosis in patients with chronic hepatitis C or human immunodeficiency virus,but there is scarce data on hepatitis B virus infection.The hypothesis of this study is that hepatitis B virus infection increases the risk of carotid plaques and subclinical atherosclerosis in naïve hepatitis B e antigen(HBeAg)negative subjects.AIM To assess the rate of carotid plaques and subclinical atherosclerosis in naïve HBeAg negative subjects in comparison with a cohort of healthy controls.METHODS Prospective case-control collaborative study conducted in two tertiary hospitals.Four hundred and two subjects prospectively recruited at the outpatient clinic were included from May 2016 to April 2017:201 naïve HBeAg-negative hepatitis B virus-infected[49 chronic hepatitis B(CHB)and 152 inactive carriers(ICs)]and 201 healthy controls.Anthropomorphic and metabolic measures,liver stiffness and carotid Doppler ultrasound were performed.Subclinical atherosclerosis was established on an intima-media thickness increase of≥1.2 mm and/or the presence of carotid plaques.Normally distributed quantitative variables were compared with the Student t test and those with a non-normal distribution with the Mann-Whitney U test.Categorical variables were compared between groups using theχ2 or Fisher exact test.RESULTS Carotid plaques were found more often in CHB(32.7%)than ICs(17.1%)or controls(18.4%)(P=0.048).Subclinical atherosclerosis was also increased in CHB(40.8%)vsICs(19.1%)or controls(19.4%)(P=0.003).No differences in the risk of atherosclerosis were observed between controls and ICs.The factors independently associated with the presence of carotid plaques were age[odds ratio(OR)1.43,P<0.001]and CHB(OR 1.18,P=0.004)and for subclinical atherosclerosis,age(OR 1.45,P<0.001),CHB(OR 1.23,P<0.001)and diabetes(OR 1.13,P=0.028).In the subset of young subjects(<50 years),carotid plaques(12.5%vs 1.1%,P=0.027)and subclinical atherosclerosis(12.5%vs 2.2%,P=0.058)were more frequent among CHB than ICs.CONCLUSION Untreated HBeAg-negative CHB is an independent risk factor for carotid plaques and subclinical atherosclerosis,while ICs present a similar risk to controls.展开更多
Objective： As a vascular risk factor, carotid atherosclerosis is crucial to cognitive impairment. While carotid intima-media thickness, carotid artery plaque, and carotid stenosis can reflect carotid atherosclerosis ...Objective： As a vascular risk factor, carotid atherosclerosis is crucial to cognitive impairment. While carotid intima-media thickness, carotid artery plaque, and carotid stenosis can reflect carotid atherosclerosis in different stages, this review aimed to explore researches on the role of carotid intima-media thickness, carotid artery plaque, and carotid stenosis in the progress of cognitive impairment in nonstroke patients and tried to illustrate the possible mechanisms. Data Sources： We searched the PubMed database for recently published research articles up to July 2017, with the key words of ＂carotid atherosclerosis,＂ ＂carotid intima-media thickness,＂ ＂carotid plaque,＂ ＂carotid stenosis,＂ ＂nonstroke,＂ and ＂cognitive impairment.＂Study Selection： Articles were obtained and reviewed to analyze the role of carotid atherosclerosis such as carotid intima-thickness, carotid plaque, and carotid stenosis in the progress of cognitive impairment in nonstroke patients and the possible mechanisms. Results： In recent years, most studies proved that by evaluating carotid atherosclerosis with ultrasonography, carotid atherosclerosis accounts for the development of cognitive decline in nonstroke patients. Carotid atherosclerosis not only impairs the subtle general cognitive function but also decreases the specific domains of cognitive function, such as memory, motor function, visual perception, attention, and executive function. But, it is still controversial. The possible mechanisms of cognitive impairment in nonstroke patients with carotid atherosclerosis can be classified as systemic global cerebrovascular function, small-vessel diseases, and the mixed lesions. Conclusions： Carotid atherosclerosis can be used to predict the risk of cognitive impairment. Furthermore, diagnosing and treating carotid atherosclerosis at early stage might help clinicians prevent and treat vascular cognitive impairment in nonstroke patients.展开更多
文摘In order to study the relationship between serum C-reactive protein (CRP) levels, leukocyte count and carotid plaque in patients with ischemic stroke, carotid duplex examination was performed by high-definition imaging (HDI) 5000 triplex system. Serum CRP was measured by nephelometry within 72 h after index ischemic stroke. A lesion was considered a plaque in the presence of a maximum intimal-medial wall thickness (IMT) 1.2 mm. Results of carotid ultrasonography were divided into two groups: M1, normal (IMT <1.2 mm) and M2, abnormal (IMT ≥1.2 mm). The results showed that the mean age of M2 was significantly older than that of M1 (69.7±10.4 versus 62.5±9.6, P =0.001). The patients with hypertension and diabetes mellitus (78 %, 35 % respectively)in M2 were significantly more than those (52 %, 18 % respectively) in M1 ( P <0.01, P <0.05). There were 32 (65 % ) patients with elevated CRP levels in M2, but 33 (46 %) patients with elevated CRP levels in M1, with the difference being significant between the two groups ( P <0.05). The levels of serum glucose and leukocyte count (8.1±5.5, 10.3±4.0, respectively) in abnormal CRP group were significantly higher than that of normal CRP group (6.4±2.8, 8.7±3.4) ( P <0.05, P <0.05); elevated CRP levels was found in 42 (62 %) patients with territory infarction and 23 (43 %) patients with lacunar infarction respectively, with the difference being significant between these two groups ( P <0.05). It was concluded that the elevation of CRP levels was an significant clinical index for carotid plaque in patients with acute cerebral infarction.
基金supported by the Natural Science Foundation of Zhejiang Province,China(No.LY13H180007)
文摘This study was undertaken to investigate the correlation of the enhancement degree on contrast-enhanced ultrasound(CEUS) with the histopathology of carotid plaques and the serum high sensitive C-reactive protein(hs-CRP) levels in patients undergoing carotid endarterectomy(CEA). Carotid CEUS was performed preoperatively in 115 patients who would undergo CEA, and the enhancement degree of the carotid plaques was evaluated by both the visual semiquantitative analysis and the quantitative time-intensity curve analysis. Serum hs-CRP levels were detected using the particle-enhanced immunoturbidimetric assay also before the operation. Additionally, the carotid plaque samples were subjected to histopathological examination postoperatively. The density of neovessels and the number of macrophages in the plaques were assessed by immunohistochemistry. The results showed that among the 115 patients, grade 0 plaque contrast enhancement was noted in 35 patients, grade 1 in 48 patients and grade 2 in 32 patients. The degree of plaque enhancement, the density of neovessels, the number of macrophages, and the hs-CRP levels were highest in the grade 2 patients. Correlation analysis showed that the enhancement degree of the carotid plaques was closely related to the immunohistochemical parameters of the plaques and the serum hs-CRP levels. It was suggested that the carotid plaque enhancement on CEUS can be used to evaluate the vulnerability of carotid plaques.
基金supported by the National Natural Science Foundation of China (No. 30970962)
文摘It is very common that increased carotid intima media thickness （CIMT） and carotid plaque coexist in a single subject in elderly patients with white matter lesions （WMLs）. In this study we inves- tigated whether the coexistence of increased CIMT and carotid plaque is more strongly associated with the presence and extent of WMLs than either alone. All patients were classified into 1 of the following 4 groups： without either increased CIMT （I） or carotid plaque （P）： I（-）P（-）; with only increased CIMT： I（＋）P（-）; with only carotid plaque： I（-）P（＋）; and with both increased CIMT and carotid plaque： I（＋）P（＋） The presence and severity of periventricular WMLs （PWMLs） and deep WMLs （DWMLs） were as- sessed and the prevalence of MRI findings by the Cochran-Armitage trend test was calculated. The characteristics of subjects showed that the percentages of patients with increased CIMT and carotid plaque in the DWMLs group and the PWMLs group were significantly higher than those without WMLs group. Both DWMLs and PWMLs were strongly associated with age, carotid plaque and CIMT. Furthermore, the Cochran-Armitage trend test indicated that the prevalence of MRI findings of PWMLs and DWMLs increased in the order of I（-）P（-）〈 I（＋）P（-）〈 I（-）P（＋）〈 I（＋）P（＋） （P〈0.0001）. For the pa- tients with DWMLs, the grades of both I（＋）P（-） and I（＋）P（＋） were increased significantly compared to I（-）P（-） （P〈0.0025, P〈0.05, respectively） without such a difference found in patients with PWMLs. Our results suggested that the coexistence of increased CIMT and carotid plaque is most closely associated with WMLs, and that increased CIMT is associated with the severity of DWMLs, whereas carotid plaque is related to the presence of WMLs.
文摘Objectives:To evaluate the efficacy of 18F-FDG-PET/CT in detection toward the vulnerabilities of carotid plaque and review systematically best evidence to prevent acute stroke from unstable carotid plaque.Methods:A search was conducted on Medline(PubMed),Web of science,Cochrane and WHIC using the search terms‘PET/CT’AND‘18F-FDG’AND‘fluorodeoxyglucose’AND‘carotid plaque’,from 2013/01/01 to now.Two authors will independently extract data following the study characteristics,eligibility criteria,interventions,outcome measurements,duration,adverse events,results and the type of needle used.All searched articles were inserted into in EndNote software that can automatically save,manage,and delete duplicate documents.Results:There were 3 articles included in the systematic review finally and form the study population analysis.The total 89 patients(64 males and 25 females)identified from the included studies.The mean 18F-FDG injected dose was 4.58 MBq/kg.The last three articles have demonstrated that 18F-FDG can accurately identify the stability of carotid plaques and can accurately locate and identify high-inflammation areas by histological analysis.Conclusions:18F-FDG-PET/CT is very efficient and practical for the identification of carotid vulnerable plaques.TBR(max and mean values)as a parameter for identifying inflammatory plaques is more reliable than SUV.
文摘The degree of vessel lumen narrowing is an independent predictor of ischemic stroke. New developments in carotid plaque morphology imaging (MR, CT), may bring new insights to the relationship between carotid atherosclerotic disease and stroke risk. Our aim is to review the stroke risk in a symptomatic patient with moderate carotid stenosis by CT imaging and histopathology. A 72-year-old patient with low ABCD2 scores TIA and moderate left internal carotid stenosis (50% by carotid ultrasound), was discharged with an optimized medical therapy. Four months later, he presented an ischemic stroke in the left frontal area. Carotid angiography showed a 60% stenosis in the left-internal carotid artery with a regular surface. CT plaque imaging detected a thin fibrous cap with calcification and an intraplaque hemorrhage (high-risk plaque). These findings were confirmed in the histolopathological study of the atherosclerotic plaque performed after the endarterectomy. After 1 year of follow-up, the patient returned independently to his daily activities. We propose, in this study, the inclusion of noninvasive plaque imaging in the evaluation of acute TIA with moderate carotid stenosis to better select patients with higher risk of stroke recurrence.
文摘Background Atherosclerotic plaques indicate the occurrence of ischemia events and it is a difficult task for clinical physicians. Grape seed proanthocyanidin extract （GSPE） has been reported to exert an antiatherogenic effect by inducing regression of atherosclerotic plaques in animal experimental studies. In this study, the antiatherogenic effect of GSPE has been investigated in clinical use. Methods Consecu- tive 287 patients diagnosed with asymptomatic carotid plaques or abnormal plaque free carotid intima-media thickness （CIMT） were ran- domly assigned to the GSPE group （n = 146） or control group （n = 141）. The patients in the GSPE group received GSPE 200 mg per day orally, while patients in the control group were only enrolled in a lifestyle intervention program. Carotid ultrasound examination was per- formed at baseline and 6, 12, 24 months during follow-up. Mean maximum CIMT （MMCIMT）, plaque score, echogenicity of plaques and ischemic vascular events were recorded. Results As anticipated, after treatment, GSPE resulted in significant reduction in MMCIMT pro- gression （4.2% decrease after six months, 4.9% decrease after 12 months and 5.8% decrease after 24 months） and plaque score （10.9% de- crease after six months, 24.1% decrease after 12 months and 33.1% decrease after 24 months） for the primary outcome, while MMCIMT and plaque score were stable and even increased with the time going on in control group. The number of plaques and unstable plaques also de- creased after treatment of GSPE. Furthermore, the carotid plaque can disappear after treatment with GSPE. The incidence rate for transitory ischemic attack （TIA）, arterial revascularization procedure, and hospital readmission for unstable angina in GSPE group were statistically significant lower （P = 0.02, 0.08, 0.002, respectively） compared with the control group. Conclusions GSPE inhibited the progression of MMCIMT and reduced carotid plaque size in GSPE treated patients, and with extended treatment, the superior efficacy on MMCIMT and carotid plaque occurred. Furthermore, the GSPE group showed lower rates of clinical vascular events.
文摘Background It has been long suggested that abnormal clinical factors in the body, such as dyslipidemia and diabetes, can affect the presence of atherosclerosis. However, few studies on the effect of factors within the normal range, such as the loss of renal function with age, on the prevalence of atherosclerosis are few know in healthy individuals. The aim of this study was to investigate risk factors affecting the presence of asymptomatic carotid plaques in a middle-aged and elderly healthy population. Methods In this regard, we prospectively evaluated 245 healthy individuals （98 males and 147 females） at baseline and after 5 years. Changes in the presence of carotid plaque between 2003 and 2008 were categorized into four groups, i.e. subjects without plaque at entry （n=165）： Group 1 （without plaque on two occasions, n=129） and Group 2 （with nascent plaque at follow-up, n=36）; subjects with plaque at entry （n=80）; Group 3 （with plaque regression at follow-up, n=29） and Group 4 （with plaque on two occasions, n=51）. Results Univariate analysis showed that the positive rate of carotid plaques in males was higher than that in females at the baseline, and that a significantly inverse correlation existed between the prevalence rate of plaque and aging. Logistic regression analysis of cross-sectional research showed that independent risk factors for the prevalence of atherosclerosis were male gender, lower estimated glomerular filtration rate （eGFR） and higher low-density lipoprotein cholesterol （LDL-C） at the baseline, and older age and lower eGFR were involved in the presence of carotid plaques at follow-up point. However, logistic regression analysis of the longitudinal data showed that older age, decreased eGFR and increased systolic blood pressure （SBP） independently predicted the presence of carotid plaques after 5 years in subjects without plaque at entry. In addition, in subjects with plaque at entry, age, changes in eGFR and the baseline levels of serum albumin （ALB） and serum total bilirubin （BIL） dependently influenced the outcome of carotid plaque. Conclusion Physiological decline of renal function, together with advancing age, was an independent risk factor which consistently affected the presence of carotid atherosclerosis in two categories of healthy individuals.
文摘<strong>Background:</strong><span style="font-family:Verdana;"> Chronic kidney disease (CKD) patients have considerably high atherosclerotic changes which predict cardiovascular events</span><span style="font-family:Verdana;">;</span><span style="font-family:Verdana;">hence</span><span style="font-family:Verdana;">,</span><span style="font-family:;" "=""><span style="font-family:Verdana;"> this study evaluated the prevalence of carotid atherosclerotic plaques in pre-dialysis CKD patients at a tertiary institution in south-east, Nigeria. </span><b><span style="font-family:Verdana;">Materials</span></b><span style="font-family:Verdana;"> </span><b><span style="font-family:Verdana;">and</span></b><span style="font-family:Verdana;"> </span><b><span style="font-family:Verdana;">Method: </span></b><span style="font-family:Verdana;">107 pre-dialysis CKD patients were consecutively recruited for the study. 81 subjects who were screened and had no kidney disease served as control. The control group was sex and age matched with the CKD patients. A pre-tested questionnaire was administered to all participants and physical examination was done. Presence of atheromatous plaques was assessed using doppler ultrasound at 3 sites—distal common carotid artery (CCA), the internal carotid artery (ICA) and the carotid bulb by a single skilled radiologist specialized in doppler ultrasound. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> Atheromatous plaques were significantly increased in CKD patients. 14.2% of CKD patients had atheromatous plaques versus 2.5% in the control group (p value < 0.05). Commonest site of occurrence was at the common carotid artery (CCA-7.5% versus ICA-4.7% versus bulb 1.8%). </span><b><span style="font-family:Verdana;">Conclusions:</span></b><span style="font-family:Verdana;"> Atheromatous plaques are prevalent in CKD patients. It is recommended that carotid doppler ultrasound should be done in CKD patients to identify patients for possible intervention.</span></span>
文摘Objective:To evaluate the correlation between MRI plaque characteris-tics and ischemic stroke in patients with carotid artery stenosis≤50%.Methods:From September 2014 to February 2016,43 patients with carotid artery plaque with stenosis less than or equal to 50%were selected by ultrasound.All patients were examined by black blood MRI.The correlation between MRI plaque characteristics and other risk fac-tors and ischemic stroke was evaluated by single factor and multi factor analysis.Results:The median follow-up time of all patients was 11.8 months.Kaplan Meier survival analy-sis showed that the median time of stroke free was significantly shorter in patients with intracoronary hemorrhage than in patients without intracoronary hemorrhage,which was 14.3 months and 18.6 months,respectively(P=0.001);the median time of stroke free was also significantly shorter in patients with coronary heart disease than in patients without coronary heart disease,which was 12.1 months and 18.7 months,respectively(P=0.029).Cox regression analysis showed that coronary heart disease(HR=27.4;95%CI,1.6-464.3;P=0.022)and intraplaque hemorrhage(HR=18.2;95%CI,2.7-123.3;P=0.003)were inde-pendent risk factors for ischemic stroke.Conclusion:In the patients with carotid artery stenosis≤50%,plaque hemorrhage and coronary heart disease are independent risk factors of ischemic stroke.
文摘Objective To analyze the correlation of autophagylevel and carotid plaque of ischemic cerebrovascular disease,so as to provide data evidence to its pathomechanism.Methods 127 patients with ischemic cerebrovascular disease were divided into 3 groups according to carotid plague scores.The count and degree of cranial artery stenosis were observed with digital subtraction angiogra-
文摘Objective: To investigate the correlation between fundus atherosclerosis and carotid arterial atherosclerosis. Methods: A total of 516 people undergoing physical examination in Deyang People’s Hospital between June 2020 and December 2022 were randomly selected. Fundus atherosclerosis and carotid arterial atherosclerosis were evaluated by fundus photography and carotid artery ultrasonography, respectively. Results: Among the 516 physical examination patients, 198 (38.4%) had normal fundus examination, and 318 (61.6%) had fundus arteriosclerosis. Among them, 166 cases were of grade I (32.2%), 86 cases were of grade II (16.7%), and 66 cases were of grade III (12.8%). There were 286 cases (55.4%) without carotid atherosclerosis, 201 cases (38.9%) with carotid atherosclerotic plaque, and 33 cases (6.4%) with carotid stenosis. Fundus arteriosclerosis is independently associated with carotid artery intima-media thickness, vulnerable plaques, plaque scores, and carotid artery stenosis (P Conclusion: In summary, there is a close relationship between carotid artery disease and the degree of arteriosclerosis in the eyeground. Fundus photography is a simple, non-invasive, and easily acceptable method of inspection. The results obtained from it are useful in determining the severity of carotid atherosclerosis and guiding early detection and intervention in clinical cases. This can help reduce the incidence of cardiovascular and cerebrovascular diseases.
文摘<div style="text-align:justify;"> <span style="font-family:Verdana;"><strong>Objectives: </strong>To study relationship between carotid artery plaques characteristics and haemodynamic changes after carotid stenting. <strong>Patients and Methods: </strong>This observational prospective (pilot) study included 20 patients—who underwent CAS. The study was carried out in Ain shams university hospitals—Railway hospital (ERMED) and Suez insurance hospital from December 2018 to February 2020. Inclusion criteria, Symptomatic (defined as amaurosis fugax, TIA, Minor stroke or Major stroke) stenosis > 70%. Asymptomatic stenosis > 80% (accidentally discovered during pre-operative assessment for CABG and during full assessment for irrelevant stroke). <strong>Results:</strong> Regarding to plaque character for degree of stenosis, calcification and ulceration revealed significantly higher degree of stenosis in hemodynamic events group (P = 0.024). On the other hand, that there was no statistically significant difference between the two groups as regard calcification, ulceration and lesion location. <strong>Conclusion: </strong>The study revealed that HI is a common occurrence following CAS procedures and significantly higher degree of stenosis in hemodynamic events group. Plaque shape, ulcerations hardly affect haeodynamic instability after carotid stenting.</span> </div>
文摘Objective To access the correlations between characteristics of carotid plaque in MRI and ischemic stroke in patients with≤50%carotid artery stenosis.Methods A total of 43 patients with≤50%carotid artery stenosis were selected for ultrasound from September 2014 to February 2016.A further test using magnetic resonance(MR)black blood imaging examination were carried out to distinguish the anatomy of the vessel as well the composition of the atherosclerotic plaque with remarkable details.The relationship between carotid plaque characteristics in MRI and other risk factors of patients with ischemic stroke was analyzed by univariate and multivariate analysis.Results The mean follow-up time was 11.8 months.During the follow-up period,4 of the 43 individuals experienced an ipsilateral ischemic stroke.Kaplan-Meier survival analysis showed the mean ischemic stroke free survival of patients with coronary heart disease(CHD)was significantly shorter than that in patients without CHD,which were 12.1 months and 18.7 months respectively(P=0.029).The mean ischemic stroke free survival of patients with intra-plaque hemorrhage(IPH)was significantly shorter than that in patients without IPH,which were 14.3 months and 18.6 months respectively(P=0.001).COX regression analysis showed that coronary heart disease(HR=27.4;95%CI,1.6-464.3;P=0.022)and IPH(HR=18.2;95%CI,2.7-123.3;P=0.003)were independent risk factors for ischemic stroke.Conclusion For patients with carotid artery stenosis≤50%,IPH of carotid plaques and CHD are independent risk factors for ischemic stroke.
文摘AIM To investigate the association between carotid atherosclerosis and cystatin C(CysC) and to determine the optimal CysC cut-off value.METHODS One hundred twenty-eight subjects were included in this study. Atherosclerosis was defined as a maximum carotid plaque thickness(MCPT) of greater than 2 mm. A receiver operating characteristic curve analysis was used to determine the diagnostic value of serum CysC for atherosclerosis. The subjects were divided into two groups according to the CysC cut-off value. We screenedfor diabetes, hypertension, dyslipidemia, smoking status, alcohol consumption, and exercise behavior. The association between atherosclerosis and CysC levels was assessed using multivariate analysis.RESULTS The subjects were then divided into two groups according to the CysC cut-off value(0.73 mg/L). The median age of the high CysC group was 72 years(85% males), whereas that of the low CysC group was 61 years(63% males). The CysC levels were significantly correlated with Cr and estimated glomerular filtration rate(eGFR) values. Bodymass index, visceral fat area, hypertension, diabetes mellitus, and MCPT were significantly higher in the high CysC group than in the low CysC group. Furthermore, the eG FR was significantly lower in the high CysC group. Regarding lifestyle habits, only the exercise level was lower in the high CysC group than in the low CysC group. Multivariate analysis, adjusted for age and sex, revealed that high CysC levels were significantly associated with an MCPT of ≥ 2 mm(odds ratio: 2.92; 95%CI: 1.13-7.99).CONCLUSION Higher CysC levels were associated with an MCPT of ≥ 2 mm. The CysC cut-off value of 0.73 mg/L appears to aid in the diagnosis of atherosclerosis.
基金Acknowledgment This research was supported in part by the National Natural Science Foundation of China （81072355）, Beijing Medical Scientific Development Foundation （2007-2039）, Ministry of Science and Technology of China （2009BAI 86B01）.
文摘Backgroud Numerous studies have confirmed the effectiveness of slowing the progression of atherosclerosis by blood pressure （Bp） control in patients with hypertension and several studies also showed the efficacy of intensive glycemic control in decreasing progression of carotid intima-media thickness （CIMT） in patients with type 1 and type 2 diabetes. However, few studies have compared the relative importance of glycemic w＇. Bp control in patients with diabetes and hypertension. We aimed to investigate the association between Bp and glycemic control and subclinical carotid atherosclerosis in older patients with hypertension and type 2 diabetes. Methods In a cross-sectional study, B-mode high-resolution ultrasonography of the carotid artery was performed in 670 subjects （508 males and 162 females） aged 60 years or over who had self-reported hypertension and diabetes but no history of coronary heart disease or stroke. Subjects were categorized by their systolic blood pressure： tight control, 〈 130 mmHg; usual control, 130-139 mmHg; or uncontrolled, 〉 140 mmHg, and by their hemoglobin Alc （HbAlc） level： tight control, 〈 6.5%; usual control, 6.5%-7.5%; or uncontrolled, 〉 7.5%, respectively. Results The mean CIMT was 8.20 ±0.11 mm, and carotid plaque was found in 52.5% （352/670） subjects. Overall, 62.1% of the subjects had subclinical carotid atherosclerosis, defined as having either carotid plaque or elevated CIMT （≥ 1.1 ram）. The mean CIMT was significantly different between Bp control categories （7.60 ± 0.09 mm, 7.90 ±0.08 mm, and 8.60 ± 0.12 mm, respectively, P = 0.03） but not between glycemic control categories （8.20± 0.10 mm, 8.1 ±0.08 mm, and 8.40 ± 0.14 ram, respectively, P = 0.13） using ANCOVA analysis. Multivariable logistic regression adjusting for potential confounding factors showed that usual or uncontrolled Bp control were associated with having carotid plaque （OR = 1.08 and OR=1.42, respectively）, or elevated CIMT [Odd ratio （OR） = 1.17, 95% confidence interval （CI） 1.04-2.24, and OR = 1.54, 95% CI 1.36-2.96, respectively compared to tight Bp control; but did not show glycemic control as independent predictor of either having carotid plaque or elevated CIMT. Conclusions In older patients with hypertension and diabetes, blood pressure control, but not glycemic control is associated with subclinical carotid atherosclerosis.
基金IV Fellowship Gilead-Research projects in HIV and hepatitisfunded by Gilead Science,No.GLD16_00057.
文摘BACKGROUND There is an increased risk of atherosclerosis in patients with chronic hepatitis C or human immunodeficiency virus,but there is scarce data on hepatitis B virus infection.The hypothesis of this study is that hepatitis B virus infection increases the risk of carotid plaques and subclinical atherosclerosis in naïve hepatitis B e antigen(HBeAg)negative subjects.AIM To assess the rate of carotid plaques and subclinical atherosclerosis in naïve HBeAg negative subjects in comparison with a cohort of healthy controls.METHODS Prospective case-control collaborative study conducted in two tertiary hospitals.Four hundred and two subjects prospectively recruited at the outpatient clinic were included from May 2016 to April 2017:201 naïve HBeAg-negative hepatitis B virus-infected[49 chronic hepatitis B(CHB)and 152 inactive carriers(ICs)]and 201 healthy controls.Anthropomorphic and metabolic measures,liver stiffness and carotid Doppler ultrasound were performed.Subclinical atherosclerosis was established on an intima-media thickness increase of≥1.2 mm and/or the presence of carotid plaques.Normally distributed quantitative variables were compared with the Student t test and those with a non-normal distribution with the Mann-Whitney U test.Categorical variables were compared between groups using theχ2 or Fisher exact test.RESULTS Carotid plaques were found more often in CHB(32.7%)than ICs(17.1%)or controls(18.4%)(P=0.048).Subclinical atherosclerosis was also increased in CHB(40.8%)vsICs(19.1%)or controls(19.4%)(P=0.003).No differences in the risk of atherosclerosis were observed between controls and ICs.The factors independently associated with the presence of carotid plaques were age[odds ratio(OR)1.43,P<0.001]and CHB(OR 1.18,P=0.004)and for subclinical atherosclerosis,age(OR 1.45,P<0.001),CHB(OR 1.23,P<0.001)and diabetes(OR 1.13,P=0.028).In the subset of young subjects(<50 years),carotid plaques(12.5%vs 1.1%,P=0.027)and subclinical atherosclerosis(12.5%vs 2.2%,P=0.058)were more frequent among CHB than ICs.CONCLUSION Untreated HBeAg-negative CHB is an independent risk factor for carotid plaques and subclinical atherosclerosis,while ICs present a similar risk to controls.
文摘Objective： As a vascular risk factor, carotid atherosclerosis is crucial to cognitive impairment. While carotid intima-media thickness, carotid artery plaque, and carotid stenosis can reflect carotid atherosclerosis in different stages, this review aimed to explore researches on the role of carotid intima-media thickness, carotid artery plaque, and carotid stenosis in the progress of cognitive impairment in nonstroke patients and tried to illustrate the possible mechanisms. Data Sources： We searched the PubMed database for recently published research articles up to July 2017, with the key words of ＂carotid atherosclerosis,＂ ＂carotid intima-media thickness,＂ ＂carotid plaque,＂ ＂carotid stenosis,＂ ＂nonstroke,＂ and ＂cognitive impairment.＂Study Selection： Articles were obtained and reviewed to analyze the role of carotid atherosclerosis such as carotid intima-thickness, carotid plaque, and carotid stenosis in the progress of cognitive impairment in nonstroke patients and the possible mechanisms. Results： In recent years, most studies proved that by evaluating carotid atherosclerosis with ultrasonography, carotid atherosclerosis accounts for the development of cognitive decline in nonstroke patients. Carotid atherosclerosis not only impairs the subtle general cognitive function but also decreases the specific domains of cognitive function, such as memory, motor function, visual perception, attention, and executive function. But, it is still controversial. The possible mechanisms of cognitive impairment in nonstroke patients with carotid atherosclerosis can be classified as systemic global cerebrovascular function, small-vessel diseases, and the mixed lesions. Conclusions： Carotid atherosclerosis can be used to predict the risk of cognitive impairment. Furthermore, diagnosing and treating carotid atherosclerosis at early stage might help clinicians prevent and treat vascular cognitive impairment in nonstroke patients.
