Carotid atherosclerosis progression and cerebrovascular events in patients with diabetes

Vouillarmet, Julien; Helfre, M.; Maucort-Boulch, Delphine; Riche, Benjamin; Thivolet, Charles; Grangé, C.

doi:10.1016/j.jdiacomp.2016.01.022

Cited by 19 publications

(23 citation statements)

References 37 publications

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“…According to lipid profile, high level of TC was observed in 44.3%, LDL C in 37.2%, TG in 27%. The progression of CA atherosclerosis was associated with a higher level of TG, LDL-C, or a lower level of HDL-C [33]. We had observed a highest prevalence of tight stenosis in patients with high level of HDL had tight stenosis (100%).…”

Section: Characteristics Of Population Studymentioning

confidence: 63%

Extracranial Carotid Atherosclerosis and Acute Ischemic Stroke in a Tertiary Hospital in Burkina Faso

Dabilgou¹,

Dravé²,

Kyelem³

et al. 2019

WJNS

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Objective: To determine the prevalence and risk factors of carotid atherosclerosis among ischemic stroke patients in a tertiary hospital in Burkina Faso. Methodology: This was a descriptive and analytical retrospective study of patients admitted at neurology department of Yalgado Ouedraogo University Teaching Hospital with ischemic stroke and cerebral large vessel atherosclerosis in the period from January 1, 2012 to December 31, 2016. Results: The prevalence of extracranial carotid atherosclerosis was 23.9%. The mean age of patients was 63.5 years (Range 31-90 years). The study population included 65% of men and 35% of women. Hypertension was the most common vascular risk factor (75.6%). Stroke was mostly located in the anterior circulation in 23.9%. Low HDL-C was present in 52% of patients. The majority of plaque was homogeneous (85.2%). Plaque were located in carotid bulbar artery (38.5%) followed by common carotid artery (28.2%) and extracranial internal carotid artery (18.6%). According to cerebral lesion, plaque was bilateral in 45.5%, ipsilateral in 42.3% and contralateral in 12.1% of cases. Tight stenosis was found in 30.1% of patients. There was a significant link between male gender and tight stenosis (p = 0.004). Aspirin was the most antiplatelet therapy used (95.5%). Statin therapy was used in 91% of patients. The mean duration of hospitalization was 12.5 days with a mortality rate of 7.1%. Conclusions: Our study showed that extra carotid atherosclerosis was the most common cause of ischemic stroke in Burkina Faso. Man gender was most represented than women.

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Section: Characteristics Of Population Studymentioning

confidence: 63%

Extracranial Carotid Atherosclerosis and Acute Ischemic Stroke in a Tertiary Hospital in Burkina Faso

Dabilgou¹,

Dravé²,

Kyelem³

et al. 2019

WJNS

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“…Indeed, individuals with carotid plaques are considered a very-high risk category according to the most recent guidelines, and carotid artery plaque assessment using ultrasonography may be considered to be a valid risk modifier in cardiovascular prediction [ 17 – 19 ]. Patients with diabetes mellitus are at high risk of cardiovascular events; therefore, the added potential of carotid plaque detection in risk assessment would be different from those cases without diabetes [ 20 – 22 ]. However, primary prevention targets are often not reached in patients with diabetes, and carotid plaque detection could focus more intensive preventive strategies in these cases, especially in those patients without known organ damage or important associated cardiovascular risk factors [ 18 , 19 , 23 ].…”

Section: Introductionmentioning

confidence: 99%

Preclinical carotid atherosclerosis in patients with latent autoimmune diabetes in adults (LADA), type 2 diabetes and classical type 1 diabetes

Hernández

López

Real

et al. 2017

Cardiovasc Diabetol

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BackgroundLADA is probably the most prevalent form of autoimmune diabetes. Nevertheless, there are few data about cardiovascular disease in this group of patients. The aim of this study was to investigate the frequency of carotid atherosclerotic plaques in patients with LADA as compared with patients with classic type 1 diabetes and type 2 diabetes.MethodsPatients with LADA were matched for age and gender in different proportions to patients with type 2 diabetes, and classic type 1 diabetes. None of the patients had clinical cardiovascular disease. All subjects underwent B-mode carotid ultrasound to detect atheroma plaques. Demographics were obtained from all subjects.ResultsWe included 71 patients with LADA, 191 patients with type 2 diabetes and 116 patients with type 1 diabetes. Carotid atherosclerosis was more frequent in patients with LADA compared with type 2 diabetes (73.2% vs. 56.9%, P = 0.0018) and classic type 1 diabetes (57.1%, P = 0.026); these changes occurred despite healthier macrovascular risk profiles in the former. Age (P < 0.001), smoking (P = 0.003) and hypertension (P = 0.019) were independently associated with carotid atherosclerosis. Multiple plaques were also more frequent in patients with LADA as compared with classic type 1 diabetes and type 2 diabetes (45.1% and 33.6% vs. 27.2%, respectively, P = 0.022). The frequency of carotid plaques increased with increasing diabetes duration in LADA patients compared with type 2 diabetes (85.7% vs. 58.8%, inverse OR 5.72 [1.5–21.8]; P = 0.009).ConclusionsLADA patients do not present with less carotid atherosclerosis than patients with type 1 and type 2 diabetes. Their macrovascular risk occurs despite a healthier macrovascular risk profile than those patients with type 2 diabetes.

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“…The determinants of CA IMT were LDL-C levels, systolic blood pressure, body mass index and smoking in childhood, and systolic blood pressure, body mass index and smoking in adulthood [59] . Other previous studies reported that the progression of CA atherosclerosis was associated with a higher level of TC, LDL-C, or a lower level of HDL-C [60] . In patients with type 2 diabetes, regression of CA IMT was observed when LDL-C and systolic blood pressure were reduced to a lower target [61] .…”

Section: Dyslipidemia and Ca Stenosismentioning

confidence: 79%

Section: Dyslipidemia and Ca Stenosismentioning

confidence: 99%

“…Several studies investigated if TG can be a risk factor for the progression of CA stenosis [60,62] . In patients with diabetes, the CA atherosclerosis progression tended to occur more frequently when fasting TG levels were higher [60] . Recently, Kitagami et al [62] reported that a higher level of TG was an independent risk factor for the progression of CA atherosclerosis in patients with moderate to severe CA stenosis who were treated with CA stenting (CAS), CEA, or other treatments under well-controlled LDL-C levels.…”

Section: Dyslipidemia and Ca Stenosismentioning

confidence: 99%

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Dyslipidemia and atherosclerotic carotid artery stenosis

Miura¹,

Suzuki²

2019

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Carotid artery atherosclerosis or stenosis is frequently present at the carotid bifurcation or the internal carotid artery, accounting for at least 20% of all ischemic strokes. High levels of serum total cholesterol and low-density lipoprotein cholesterol are established risk factors for genesis and progression of atherosclerotic lesions through various mechanisms. In addition, accumulating evidence has shown that a high level of triglyceride is associated with increased atherosclerosis risks. The so-called "vulnerable plaque" with a large lipid core, thin fibrous cap and intra-plaque hemorrhage tends to cause subsequent thromboembolic ischemic events. Statins are known not only to lower serum cholesterol levels but also to promote plaque stabilization via pleiotropic effects such as reducing subclinical systemic inflammation, endothelial activation, leukocyte intra-plaque infiltration, and increasing intimal smooth muscle cell migration. This article discusses the mechanisms of atherosclerosis formation induced by dyslipidemia and the role of lipid-lowering agents including statins in patients with symptomatic and asymptomatic atherosclerotic carotid artery stenosis.

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Carotid atherosclerosis progression and cerebrovascular events in patients with diabetes

Cited by 19 publications

References 37 publications

Extracranial Carotid Atherosclerosis and Acute Ischemic Stroke in a Tertiary Hospital in Burkina Faso

Extracranial Carotid Atherosclerosis and Acute Ischemic Stroke in a Tertiary Hospital in Burkina Faso

Preclinical carotid atherosclerosis in patients with latent autoimmune diabetes in adults (LADA), type 2 diabetes and classical type 1 diabetes

Dyslipidemia and atherosclerotic carotid artery stenosis

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