Assessments of Carotid Artery Plaque Burden in Patients With Familial Hypercholesterolemia

Tada, Hayato; Kawashiri, Masa‐aki; Okada, Hirofumi; Nakahashi, Takuya; Sakata, Kenji; Nohara, Atsushi; Inazu, Akihiro; Mabuchi, Hiroshi; Yamagishi, Masakazu; Hayashi, Kenshi

doi:10.1016/j.amjcard.2017.08.012

Cited by 29 publications

(20 citation statements)

References 16 publications

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“…Accordingly, we aimed to compare the prognostic utility of these measurements among patients with ASCVD. Moreover, such modality could help us to estimate when and how rapidly coronary atherosclerosis in patients with ASCVD develop 8,11) . Accordingly, we aimed (1) to compare the prognostic utility of these measurements and (2) to estimate the onset and progression of carotid atherosclerosis in patients of a secondary prevention setting.…”

Section: Discussionmentioning

confidence: 99%

“…Accordingly, we suggest to assess cPS, rather than cIMT for the risk stratification and as a surrogate marker for the progression of atherosclerosis in patients of a secondary prevention settings, as suggested in the patients with FH. Based on regression lines from age and cPS among FH patients, we previously reported that carotid atherosclerosis may start to develop at 17 and 26 years of age in male and female FH patients, respectively 8) . In this study, we performed the same analyses, and found that carotid atherosclerosis starts to develop at 27 and 32 years of age in male and female patients of a secondary prevention settings, respectively.…”

Section: Discussionmentioning

confidence: 99%

“…Three cIMT determinations were measured in the walls at the site of the greatest thickness for each common carotid artery, and these measurements of both the arteries were averaged and expressed as the mean cIMT. In addition, cPS was computed by summing the maximal thickness of plaques, that were defined as focal intima-media thickening ≥ 1.1 mm, in each segment on both sides (a b c thickness of the contralateral plaques in each segment on both sides) as described previously 8,15) .…”

Section: Carotid Ultrasonographymentioning

confidence: 99%

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Clinical Impact of Carotid Plaque Score rather than Carotid Intima-Media Thickness on Recurrence of Atherosclerotic Cardiovascular Disease Events

Tada

Nakagawa

Okada

et al. 2020

JAT

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The official journal of the Japan Atherosclerosis Society and the Asian Pacific Society of Atherosclerosis and Vascular Diseases Original Article Aim: Carotid plaque score (cPS) reflecting throughout the carotid artery plaque burden may be a better marker than carotid intima-media thickness (cIMT) is. We aimed to compare the prognostic utility of these measurements in patients with atherosclerotic cardiovascular disease (ASCVD). Methods: We retrospectively examined 2,035 Japanese patients with ASCVD who underwent carotid ultrasonography between January 2008 and December 2015 at Kanazawa University Hospital. Median follow-up period was 4 years. We used Cox models that adjusted for established risk factors of ASCVD, including age, gender, hypertension, diabetes, smoking, and serum lipids to assess the association of cIMT as well as cPS with major adverse cardiac events (MACE). MACE was defined as all-cause mortality or rehospitalization for a cardiovascular-related illness. Results: During follow-up, 243 participants experienced MACE. After adjustment for established risk factors, cPS was associated with MACE (hazard ratio [HR] 3.38 for top quintile vs. bottom quintile of cPS; 95% confidence interval [CI] 1.82-6.27; P trend 0.001), while cIMT was not (HR=0.88, P 0.57). Addition of the cPS to established risk factors significantly improved risk discrimination (C-index 0.726 vs. 0.746; P 0.017). Conclusion: These results suggest that cPS, rather than cIMT may be a better marker to identify increased risk for recurrence of MACE among patients with secondary prevention setting. Carotid intima-media thickness (cIMT) determined by less-invasive ultrasonography has been shown to be a surrogate marker for coronary atherosclerosis 4) , and increased cIMT has been shown to be associated with future cardiovascular events 5-7). On the other hand, carotid plaque score (cPS) reflecting throughout the carotid artery plaque burden may be better marker. Our previous study has shown that the carotid plaque score (cPS), reflecting the cumulative atherosclerotic burden of the carotid artery, is a more useful parameter to predict the atherosclerotic severity of the coronary artery than cIMT in patients with familial hypercholesterolemia (FH) 8) .

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Carotid Ultrasonographymentioning

confidence: 99%

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Clinical Impact of Carotid Plaque Score rather than Carotid Intima-Media Thickness on Recurrence of Atherosclerotic Cardiovascular Disease Events

Tada

Nakagawa

Okada

et al. 2020

JAT

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“…These findings strongly suggest that measuring carotid IMT during follow-up of statin-treated FH patients has limited value [49]. When mentioning measurement of carotid plaques, a very recent study on 225 patients with FH showed that carotid plaque score determined by carotid ultrasonography may provide superior risk stratification in patients with FH compared with carotid IMT [50].…”

Section: Discussionmentioning

confidence: 99%

Pulse wave velocity as a measure of arterial stiffness in patients with familial hypercholesterolemia: a systematic review and meta-analysis

Reiner

Simental‐Mendía

Ruscica

et al. 2019

aoms

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IntroductionThe aim of this meta-analysis was to establish whether vascular pulse wave velocity (PWV) as a measure of arterial stiffness is changed in patients with familial hypercholesterolemia (FH).Material and methodsStudies comparing PWV between patients with FH and controls were searched in PubMed-Medline, SCOPUS, Web of Science and Google Scholar databases (up to November 26, 2017). A meta-analysis was conducted using Comprehensive Meta-Analysis V2 software. A random-effects model (using the DerSimonian-Laird method) and the generic inverse variance method were used to compensate for the heterogeneity of studies concerning demographic characteristics and differences in the studies’ design.ResultsThis meta-analysis of 8 studies involving 317 patients with FH and 244 non-FH individuals did not suggest a significantly altered PWV in FH patients versus controls (weighted mean difference (WMD): 0.17 m/s, 95% confidence interval (CI): –0.31, 0.65, p = 0.489; I2 = 80.15%). The result was robust in the sensitivity analysis and its significance was not influenced after omitting each of the included studies from the meta-analysis. Subanalysis of 6 of these studies which had data on intima-media thickness (IMT) indicated an increased IMT in FH patients when compared with controls (WMD = 0.03 mm, 95% CI: 0.003, 0.06, p = 0.034; I2 = 48.95%). However, the effect size was sensitive to some of the included studies.ConclusionsThis meta-analysis suggests that FH patients do not have significantly altered PWV when compared with normocholesterolemic individuals. However, a subanalysis of studies in which IMT was measured indicated that IMT is increased in FH patients compared with controls.

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“…The proportions of the subjects who exhibited CAD among the individuals highly suspected as FH was much lower than those previously described investigated in hospital-based settings [ 14 , 15 ]. It is reasonable to see such differences, since the subjects who are treated in hospitals should have much higher rate of CAD than those treated in clinics in communities.…”

Section: Discussionmentioning

confidence: 57%

Prevalence, self-awareness, and LDL cholesterol levels among patients highly suspected as familial hypercholesterolemia in a Japanese community

Tada

Shibayama

Nishikawa

et al. 2020

Practical Laboratory Medicine

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Backgrounds The prevalence of familial hypercholesterolemia (FH) among Japanese populations is still unclear. In addition, no prior data exist regarding the self-awareness. Accordingly, we aimed to investigate the prevalence, self-awareness, and LDL-C of patients with highly suspected as FH using data obtained in a community-based medical checkups. Methods This study included 52,276 subjects (18,588 men, 35.6%) aged ≥40 years who underwent the Japanese specific health checkup in Kanazawa City during 2018. We assessed the self-awareness of dyslipidemia (and the age) as well as the prevalence of patients with highly suspected as FH whose naïve LDL-C levels were ≥250 mg/dl. Naïve LDL-C levels were estimated by the adjustment (LDL-C/0.7) for those on lipid-lowering medication. We divided subjects into 3 groups based on their naïve LDL cholesterol level (≥250 mg/dl, 140–249, and ≤139 mg/dl). Results We identified 262 (0.5%) individuals highly suspected as FH whose naïve LDL-C levels were ≥250 mg/dl. Most of them (234 among 262, 89%) were under lipid-lowering medication; however, the self-awareness as dyslipidemia was not quite high (200 among 262, 76%), and their mean LDL-C level under lipid-lowering medication was 203 ± 35 mg/dl. Interestingly, the age of acknowledgement of dyslipidemia among the patients with highly suspected as FH was significantly younger than those in other categories (58 vs. 60/62 yrs, respectively, p < 0.05 for both). Conclusions The prevalence of patients highly suspected as FH was around 1 in 200, and their self-awareness as well as control were not still good enough among Japanese general populations.

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Assessments of Carotid Artery Plaque Burden in Patients With Familial Hypercholesterolemia

Cited by 29 publications

References 16 publications

Clinical Impact of Carotid Plaque Score rather than Carotid Intima-Media Thickness on Recurrence of Atherosclerotic Cardiovascular Disease Events

Clinical Impact of Carotid Plaque Score rather than Carotid Intima-Media Thickness on Recurrence of Atherosclerotic Cardiovascular Disease Events

Pulse wave velocity as a measure of arterial stiffness in patients with familial hypercholesterolemia: a systematic review and meta-analysis

Prevalence, self-awareness, and LDL cholesterol levels among patients highly suspected as familial hypercholesterolemia in a Japanese community

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