Carotid Intima-Media Thickness and Risk of Cardiovascular Events in High-Risk Patients

Kitagawa, Kazuo; Hougaku, Hidetaka; Yamagami, Hiroshi; Hashimoto, Hiroyuki; Ito, Takuya; Shimizu, Yoshiomi; Takahashi, Daisuke; Murata, Shinji; Seike, Yujiro; Kondo, Kimito; Hoshi, Taku; Furukado, Shigetaka; Abe, Yuko; Yagita, Yoshiki; Sakaguchi, Manabu; Tagaya, Masayoshi; Etani, Hideki; Fukunaga, Ryuzo; Nagai, Yoji; Matsumoto, Masayasu; Hori, Masatsugu

doi:10.1159/000103114

Cited by 85 publications

(39 citation statements)

References 35 publications

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“…The present findings support the use of the IBS index to discover factors related to plaque vulnerability. In our follow-up study for carotid atherosclerosis [26], Yamagami et al [21] confirmed the association between a low IBS index and risk factors such as smoking and dyslipidemia and showed that increased blood IL-6 levels are related to a low IBS index, pointing to the role of inflammation in plaque vulnerability. The IBS index analysis may allow examination of the involvement of genetic factors and gene polymorphism in plaque instability; such involvement has rarely been examined but is undoubtedly important.…”

Section: Discussionsupporting

confidence: 56%

Quantitative Evaluation of Carotid Plaque Echogenicity by Integrated Backscatter Analysis: Correlation with Symptomatic History and Histologic Findings

Nagano

Yamagami²,

Tsukamoto³

et al. 2008

Cerebrovasc Dis

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Background and Purpose: Echogenicity of carotid plaque well reflects the risk of ischemic stroke and may be predictive of the histologic content of the plaque. However, objective evaluation of plaque echogenicity has been hampered by a lack of established quantitative measures. This study examined the relation between echogenicity assessed by integrated backscatter (IBS) analysis and (1) symptomatic history and (2) histologic features of carotid plaques. Methods: We used acoustic densitometry to quantify by IBS analysis the echogenicity of 31 carotid plaques of 26 patients undergoing carotid endarterectomy or stenting. IBS was subsequently compared with histologic findings of the respective tissue in 10 patients who underwent endarterectomy. The IBS value was calibrated with 2 reference structures (vessel lumen and adventitia) as the IBS index. Results: The IBS index of symptomatic plaques was lower than that of asymptomatic plaques (23.1 ± 12.5 vs. 36.5 ± 18.2, p < 0.05). The IBS index in fatty/necrotic atheromatous sites (n = 20, 16.6 ± 10.7) was lower than that in fibrous (n = 26, 42.4 ± 13.6, p < 0.01) or calcified (n = 11, 87.7 ± 17.4, p < 0.01) sites and the same as that in intraplaque hemorrhagic sites (n = 50, 23.6 ± 16.9). Conclusions: Carotid plaque echogenicity, as quantitatively assessed by IBS analysis, correlates well with the presence or absence of prior symptoms and histologic contents of the plaques. IBS analysis may aid in the assessment of carotid plaque-related risk of stroke.

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Section: Discussionsupporting

confidence: 56%

Quantitative Evaluation of Carotid Plaque Echogenicity by Integrated Backscatter Analysis: Correlation with Symptomatic History and Histologic Findings

Nagano

Yamagami²,

Tsukamoto³

et al. 2008

Cerebrovasc Dis

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“…The IMT measured by B-mode sonography is an accepted marker of atherosclerosis [25,26,27]. For this reason, in the present study CCA IMT was measured by B-mode sonography, as an index of early atherosclerosis.…”

Section: Discussionmentioning

confidence: 99%

Association between Human Paraoxonase 1 Activity and Intima-Media Thickness in Subjects under 55 Years of Age with Carotid Artery Disease

et al. 2007

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Background: Human serum paraoxonase (PON1) protects lipoproteins against oxidation by hydrolyzing lipid peroxides in oxidized low-density lipoprotein (oxLDL); therefore, it may protect against atherosclerosis. PON1 activity and polymorphisms have been inconsistently associated with carotid artery disease. The goal of this study was to clarify the role of PON1 activity and phenotype on carotid artery disease and its correlation with some inflammatory and immune markers in subjects under 55 years with early-onset carotid atherosclerosis. Methods: Sixty patients with occlusive carotid artery disease and 30 healthy controls were enrolled. Intima-media thickness (IMT) was measured by high-resolution ultrasound of both common carotid arteries. Anti-oxLDL antibody levels were determined by ELISA. Results: In the whole study population we found a negative correlation between PON1 activity and IMT (r = –0.27, p = 0.011), and between salt-stimulated PON1 activity and IMT (r = –0.24, p = 0.02). Both PON1 activity and salt-stimulated PON1 activity negatively correlated with anti-oxLDL levels (r = –0.28, p = 0.008; r = –0.26, p = 0.01). PON1 activity was lower in patients compared to controls; however, the difference was not significant.PON1 phenotype distribution of patients and controls did not differ significantly. Conclusion: The importance of PON1 activity as a predictive risk factor for early-onset occlusive carotid artery disease should be assessed in future studies.

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“…The methods used for the recruitment of participants and the definitions of atherosclerotic risk factors have been described elsewhere. 6 In brief, subjects were enrolled if they had ≥1 vascular risk factors such as hypertension, diabetes mellitus, dyslipidemia, or a current smoking status or a history of cardiovascular disease. Patients with collagen disease, malignant disease, and chronic inflammatory disease were excluded.…”

Section: Subjectsmentioning

confidence: 99%

Association of Interleukin-6 With the Progression of Carotid Atherosclerosis

Okazaki

Sakaguchi

Miwa

et al. 2014

Stroke

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Background and Purpose-Limited information is available on the long-term effects of interleukin-6 (IL-6) on systemic atherosclerosis. The purpose of the present study was to clarify the relationship between chronic elevation of IL-6 and the long-term progression of carotid atherosclerosis. Methods-We prospectively evaluated 210 patients with ≥1 vascular risk factors for 9.0±1.0 years. Carotid mean-maximal intima-media thickness (mmIMT), the serum high-sensitivity C-reactive protein (hs-CRP) level, and the serum IL-6 level were measured at baseline and every 3 years. The associations between the progression of mmIMT and the long-term average levels of hs-CRP and IL-6 were analyzed. Results-Carotid mmIMT increased throughout the study period (0.031±0.026 mm/y). Baseline mmIMT was significantly associated with baseline hs-CRP (P=0.002) and baseline IL-6 (P<0.001) levels. Progression of mmIMT was positively correlated with average hs-CRP (P=0.001) and average IL-6 (P<0.001) levels. When adjusted for age, sex, traditional risk factors, and baseline mmIMT, mmIMT progression remained significantly associated only with the average IL-6 level (standardized β=0.17; P=0.02), but not with the average hs-CRP level (standardized β=0.10; P=0.18). Conclusions-Chronic elevation of serum IL-6 was associated with the progression of atherosclerosis in patients with vascular risk factors. IL-6 could be used as a quantitative marker and a potential therapeutic target for accelerated atherosclerosis. (Stroke. 2014;45:2924-2929.)

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Carotid Intima-Media Thickness and Risk of Cardiovascular Events in High-Risk Patients

Cited by 85 publications

References 35 publications

Quantitative Evaluation of Carotid Plaque Echogenicity by Integrated Backscatter Analysis: Correlation with Symptomatic History and Histologic Findings

Quantitative Evaluation of Carotid Plaque Echogenicity by Integrated Backscatter Analysis: Correlation with Symptomatic History and Histologic Findings

Association between Human Paraoxonase 1 Activity and Intima-Media Thickness in Subjects under 55 Years of Age with Carotid Artery Disease

Association of Interleukin-6 With the Progression of Carotid Atherosclerosis

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