Carotid Atherosclerosis In Patients Research Articles

Correlation of arterial stiffness parameters with indicators of carotid atherosclerosis in patients with Metabolic Syndrome

Background: Many studies have shown that metabolic syndrome is accompanied by an increase in arterial stiffness. In connection therewith, early detection of an increase in arterial stiffness in patients with metabolic syndrome can help to prevent cardiovascular complications. Aim: To determine the relationship between arterial stiffness parameters such as cfPWV and CAVI with carotid atherosclerosis indicators (intima-media thickness, carotid plaque presence) in patients with metabolic syndrome. Material and methods: The study included 100 patients at the age of 40-70 years: 45 men and 55 women (56.54±8.98 years). Subjects were divided into 2 groups: 1st - 42 patients with metabolic syndrome; 2nd - 58 patients without metabolic syndrome. The arterial stiffness parameters such as CAVI and cfPWV were calculated. In the analysis we used threshold values recommended by manufacturers and European expert consensus document on arterial stiffness: for CAVI – <8, for cfPWV – ≤10 m/c). Duplex scanning carotid arteries was performed to evaluate the “intima-media thickness” and carotid plaque presence. Results: In the group with metabolic syndrome the CAVI is significantly associated with the indicators of carotid atherosclerosis: intima-media thickness (OR=4.94 95%; CI: 1.49-3.80; p=0.047), carotid plaque presence (OR=3.06; 95% CI: 1.42-2.28; p=0.065). But statistically significant associations of cfPWV with indicators of carotid atherosclerosis were not obtained (p>0.05). In the group without metabolic syndrome none of the arterial stiffness parameters (CAVI, cfPWV) statistically significantly correlated with any of the carotid atherosclerosis indicators (p>0.05). Conclusion: The CAVI parameter, in contrast to the cfPWV, statistically significantly correlated with indicators of carotid atherosclerosis in patients with metabolic syndrome. In this connection, this parameter can be used to identify signs of not only increased arterial stiffness but also to determine subclinical signs of carotid atherosclerosis in patients with metabolic syndrome.

Myeloid-related protein complex 8/14 increases in hypertensive patients with excessive renal damage

Hypertension is a complex condition, and it is difficult to know whether inflammation is a cause or an effect. Information on the association between MRP-8/14 (myeloid-related protein) and hypertension is limited. In this study, we aimed to examine the relationship of MRP-8/14 with carotid intima-media thickness (CIMT) and albuminuria in hypertensive patients and to investigate whether early assay of MRP-8/14 levels could be helpful in assessment of renal damage and carotid atherosclerosis among hypertensive patients. 61 hypertensive patients and 40 age-, gender-, and body mass index-matched controls were included into the study. Blood samples including fasting blood glucose, total cholesterol, triglycerides, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, total protein, albumin, urea creatinine, uric acid, sedimentation, C-reactive protein (CRP), and MRP-8/14 were collected. 24-hour urine albumin excretion and CIMT measurements were also obtained. All inflammatory variables including uric acid, CRP, sedimentation, MRP-8/14, and CIMT were statistically higher in patients with hypertension than in controls. MRP-8/14 was significantly higher in hypertensive patients with macroalbuminuria than in controls (339.3 (IQR (215.2-661.7)) ng/mL vs. 204.9 (IQR (140.1-339.3)) -ng/mL, p=0.005, respectively). The levels of CIMT were the highest in macroalbuminuric hypertensive patients (controls vs. normoalbuminuria, microalbuminuria, macroalbuminuria groups, 0.57 (0.53-0.67) mm vs. 0.84 (0.76-0.89) mm, p=0.000; 0.57 (0.53-0.67) mm vs. 0.87 (0.67-0.93) mm, p=0.000; 0.57 (0.53-0.67) mm vs. 0.92 (0.85-0.97) mm, p=0.000, respectively). Plasma MRP-8/14 levels were elevated in hypertensive patients with macroalbuminuria, however, it could not serve as an early marker to determine renal damage and carotid atherosclerosis in patients with hypertension. .

Febuxostat does not delay progression of carotid atherosclerosis in patients with asymptomatic hyperuricemia: A randomized, controlled trial.

BackgroundAn elevated level of serum uric acid (SUA) is associated with an increased risk of cardiovascular disease. Pharmacological intervention with urate-lowering agents, such as the conventional purine analogue xanthine oxidase (XO) inhibitor, allopurinol, has been used widely for a long period of time in clinical practice to reduce SUA levels. Febuxostat, a novel non-purine selective inhibitor of XO, has higher potency for inhibition of XO activity and greater urate-lowering efficacy than conventional allopurinol. However, clinical evidence regarding the effects of febuxostat on atherosclerosis is lacking. The purpose of the study was to test whether treatment with febuxostat delays carotid intima-media thickness (IMT) progression in patients with asymptomatic hyperuricemia.Methods and findingsThe study was a multicenter, prospective, randomized, open-label, blinded-endpoint clinical trial undertaken at 48 sites throughout Japan between May 2014 and August 2018. Adults with both asymptomatic hyperuricemia (SUA >7.0 mg/dL) and maximum IMT of the common carotid artery (CCA) ≥1.1 mm at screening were allocated equally using a central web system to receive either dose-titrated febuxostat (10–60 mg daily) or as a control-arm, non-pharmacological lifestyle modification for hyperuricemia, such as a healthy diet and exercise therapy. Of the 514 enrolled participants, 31 were excluded from the analysis, with the remaining 483 people (mean age 69.1 years [standard deviation 10.4 years], female 19.7%) included in the primary analysis (febuxostat group, 239; control group, 244), based on a modified intention-to-treat principal. The carotid IMT images were recorded by a single sonographer at each site and read in a treatment-blinded manner by a single analyzer at a central core laboratory. The primary endpoint was the percentage change from baseline to 24 months in mean IMT of the CCA, determined by analysis of covariance using the allocation adjustment factors (age, gender, history of type 2 diabetes, baseline SUA, and baseline maximum IMT of the CCA) as the covariates. Key secondary endpoints included changes in other carotid ultrasonographic parameters and SUA and the incidence of clinical events. The mean values (± standard deviation) of CCA-IMT were 0.825 mm ± 0.173 mm in the febuxostat group and 0.832 mm ± 0.175 mm in the control group (mean between-group difference [febuxostat − control], −0.007 mm [95% confidence interval (CI) −0.039 mm to 0.024 mm; P = 0.65]) at baseline; 0.832 mm ± 0.182 mm in the febuxostat group and 0.848 mm ± 0.176 mm in the control group (mean between-group difference, −0.016 mm [95% CI −0.051 mm to 0.019 mm; P = 0.37]) at 24 months. Compared with the control group, febuxostat had no significant effect on the primary endpoint (mean percentage change 1.2% [95% CI −0.6% to 3.0%] in the febuxostat group (n = 207) versus 1.4% [95% CI −0.5% to 3.3%] in the control group (n = 193); mean between-group difference, −0.2% [95% CI −2.3% to 1.9%; P = 0.83]). Febuxostat also had no effect on the other carotid ultrasonographic parameters. The mean baseline values of SUA were comparable between the two groups (febuxostat, 7.76 mg/dL ± 0.98 mg/dL versus control, 7.73 mg/dL ± 1.04 mg/dL; mean between-group difference, 0.03 mg/dL [95% CI −0.15 mg/dL to 0.21 mg/dL; P = 0.75]). The mean value of SUA at 24 months was significantly lower in the febuxostat group than in the control group (febuxostat, 4.66 mg/dL ± 1.27 mg/dL versus control, 7.28 mg/dL ± 1.27 mg/dL; mean between-group difference, −2.62 mg/dL [95% CI −2.86 mg/dL to −2.38 mg/dL; P < 0.001]). Episodes of gout arthritis occurred only in the control group (4 patients [1.6%]). There were three deaths in the febuxostat group and seven in the control group during follow-up. A limitation of the study was the study design, as it was not a placebo-controlled trial, had a relatively small sample size and a short intervention period, and only enrolled Japanese patients with asymptomatic hyperuricemia.ConclusionsIn Japanese patients with asymptomatic hyperuricemia, 24 months of febuxostat treatment did not delay carotid atherosclerosis progression, compared with non-pharmacological care. These findings do not support the use of febuxostat for delaying carotid atherosclerosis in this population.Trial registrationUniversity Hospital Medical Information Network Clinical Trial Registry UMIN000012911.

Serum cystatin C is associated with carotid atherosclerosis in patients with acute ischemic stroke.

Accumulating studies have shown that cystatin C may play important roles in the pathogenesis of arteriosclerosis. However, the association between serum cystatin C and the characteristics of carotid plaques has not been elucidated. Furthermore, the diagnostic value of serum cystatin C in carotid stenosis has not been studied. Serum cystatin C in 156 patients with acute ischemic stroke (AIS) in the carotid artery was measured by ELISA. Intima-media thickness (IMT), stenosis of the symptomatic common carotid artery (CCA), extra/intracranial internal carotid artery (ICA) stenosis, and plaque characteristics were measured and recorded. Receiver operating characteristic (ROC) curves were used to assess the diagnostic value of serum cystatin C in carotid stenosis. One hundred fifty-six patients were divided into two groups based on their cystatin C levels. The degree of arteriosclerosis, the severity of plaques, and stenosis of the symptomatic CCA were significantly higher in the patients with high cystatin C levels. In addition, the rate of unstable plaques was significantly higher in those with high cystatin C. Serum cystatin C levels of 1.075 and 1.125mg/L had diagnostic value in distinguishing stenosis of CCA and extracranial ICA, respectively. Higher cystatin C levels were strongly correlated with symptomatic CCA stenosis and the rate of unstable plaques. Analysis of cystatin C levels may be useful for the identification of CCA stenosis and extracranial ICA in patients with AIS.

Insulin resistance is associated with preclinical carotid atherosclerosis in patients with type 1 diabetes.

Although insulin resistance (IR) is a growing trait among type 1 diabetes (T1D) population, its relationship with atherosclerosis has been scarcely studied. We assessed the association between IR indexes and carotid atherosclerosis in T1D, a population at high cardiovascular disease (CVD) risk. We evaluated 191 participants with T1D and no prior CVD with at least one of the following criteria: ≥40 years old; diabetic nephropathy; or T1D duration ≥10 years harbouring ≥1 additional CVD risk factor. IR was assessed with the metabolic syndrome (MetS) harmonized definition proposed in 2009 and the estimated glucose disposal rate (eGDR), a T1D-specific IR surrogate marker (lower values indicating higher IR). Standardized carotid ultrasonography was performed, recording intima-media thickness (IMT), plaque presence and maximum height of plaque. Comparisons between patients according to their MetS status as well as concerning eGDR values were performed. The participants' median age was 47.4 (41.1-53.3) years and diabetes duration 25.7 (21.6-32.5) years. Plaque prevalence was higher in patients with greater IR (49.1%, 29.1% and 20%, P = .001, for any plaque according to decreasing eGDR tertiles). Conversely, no statistically significant higher plaque prevalence was found in participants with MetS. In multivariate analyses (adjusted for general- and T1D-specific risk factors, and statin treatment), MetS was associated with neither IMT nor plaque. On the contrary, eGDR was independently related to ≥2 plaques (P = .018) and maximum plaque height (P < .01). In T1D, IR assessed through eGDR but not by MetS definition was independently associated with plaque burden, a predictor of CVD.

The Relationship between the Mean Platelet Volume and Carotid Atherosclerosis and Prognosis in Patients with Acute Cerebral Infarction.

Objective To investigate the relationship between mean platelet volume (MPV) level and carotid atherosclerosis and prognosis in patients with acute cerebral infarction. Methods. A retrospectively included 160 patients with acute cerebral infarction classified by TOAST classification as aortic atherosclerosis as the observation group. To analyze the relationship between MPV and carotid atherosclerosis, and use receiver operating characteristic (ROC) curves to analyze the role of MPV in predicting the prognosis of acute cerebral infarction in the observation group, grouping patients with different MPV by cut-off value, and analyze the differences in factors between the two groups of patients.Results MPV has a positive correlation with carotid atherosclerosis in patients with acute cerebral infarction. Multivariate logistic regression analysis revealed that increased MPV was an independent predictor of poor functional outcome in patients with acute cerebral infarction (Odds Ratio (OR): 6.152, 95% CI: 2.385-13.625, P < 0.01). ROC curve analysis showed that the area under the curve for MPV to predict poor prognosis was 0.868 (95% CI: 0.787-949, P < 0.01). The cutoff value, sensitivity, and specificity were 12.65, 76.2%, and 87.6%. Compared with patients with MPV < 12.65 at admission, patients with higher MPV levels (MPV ≥ 12.65) at admission have larger infarct size, more severe carotid artery stenosis, poor short-term prognosis, and higher mortality. Conclusion MPV level is closely related to the degree of carotid atherosclerosis in patients with acute cerebral infarction, and it is also an independent predictor of poor prognosis in patients with acute cerebral infarction at 3 months.

Early detection of atherosclerotic changes associated with long use of antiepileptic drugs in epileptic patients

Objective Doppler ultrasound changes in the common carotid artery intima-media thickness (CCA IMT) and estimation of serum thiobarbituric acid reactive substances (TBARS) as predictors to the atherosclerotic complications of long use of antiepileptic drugs (AEDs). Patients and methods The study was done on 45 epileptic patients and 15 healthy individuals as a control group. All patients have been selected from the outpatient clinic of Neurology Department of Al-Zahraa University Hospital from period July 2018 to July 2020. They have been treated by monotherapy AEDs for at least 2 years. No other risk factors for atherosclerosis had been considered in these patients. They have been investigated for serum level of TBARS and Doppler ultrasound for assessment of CCA IMT. The patient group was also subdivided into three groups according to their type of treatment. Results The risk of carotid atherosclerosis in patients with epilepsy is linked with long use of older generation AEDs, namely carbamazepine and valproic acid, rather than levetiracetam which have no effect in vascular risk or CCA IMT changes. Conclusion The choice of AED therapy for long-term use should be guided with serum level of TBARS and CCA IMT as their mechanism of action as enzyme inducer might be a leading cause of vascular changes in epileptic patients.

No progression of subclinical atherosclerosis in HIV-infected patients starting an initial regimen including tenofovir alafenamide/emtricitabine plus raltegravir, dolutegravir or elvitegravir/cobicistat during a two-year follow-up

Objectives: Cardiovascular disease has become one of the most common comorbidities among HIV-infected patients, but available data about the correlation between antiretroviral drugs and progression rate of atherosclerotic disease are still limited. We evaluated the progression rate of carotid atherosclerosis in patients starting an initial antiretroviral regimen including one integrase strand transfer inhibitor (INSTI).Methods: Observational, prospective study involving HIV-1-infected, antiretroviral therapy-naive, adult patients who started an antiretroviral regimen including tenofovir alafenamide/emtricitabine (TAF/FTC) plus raltegravir (RAL group), elvitegravir/cobicistat (EVG/c group), or dolutegravir (DTG group). Patients with known cardiovascular disease or diabetes mellitus were excluded from the study. The progression rate of atherosclerosis has been assessed by carotid Doppler ultrasonography at baseline and after 24 months.Results: Overall, 102 patients were enrolled into the study: 73 males, with mean age of 48.7 years: 32, 36 and 34 patients were included in the RAL, EVG/c and DTG groups, respectively. The baseline features of the enrolled patients were comparable across the three groups. At 24 months, the mean intima-media thickness (IMT) increase at the carotid bifurcation was 0.026 mm in the RAL group, 0.029 mm in EVG/c group and 0.032 mm in DTG group. The mean IMT increases after 24 months were comparable across the three groups and statistically not significant in all the evaluated anatomical sites.Conclusions: The initial antiretroviral therapy with TAF/FTC plus RAL, EVG/c or DTG for 24 months led to a comparable and not significant effect on the progression rate of carotid atherosclerosis.

Carotid Atherosclerosis in Patients with Atrial Fibrillation.

This review aims to explore the relationship between AF and carotid atherosclerosis, and the impact on the outcomes of cardiovascular and cerebrovascular events. Also, our aim is to critically review current knowledge and delineate future directions for effective treatment or prevention as well as strategies for improvement of the quality of life and survival. Atrial fibrillation (AF) is the most common arrhythmia, increasing the risk of stroke and cardiovascular morbidity and mortality representing a significant worldwide public health problem. On the other hand, carotid artery atherosclerosis can also significantly increase the risk of stroke, transient ischemic attack (TIA), and death. Firstly, we report epidemiological data on AF patients in different countries and regions having carotid artery abnormalities such as carotid artery plaque formation, atherosclerotic, and even stenosis. Despite geographical variations, these abnormalities were more frequent in AF patients and correlated with the duration of AF and the value of CHA2DS2-VASc score. Moreover, it is evident that AF patients with carotid artery abnormalities have significantly increased risk of adverse outcomes from the heart and brain. According to the CHA(2)DS2 (-VASc) score, AF patients are managed with anticoagulation therapy. Reviewing existing data on the treatment for stroke prevention in patients with AF, carotid artery disease, or both, we found that antiplatelet therapy could be combined with anticoagulant therapy appropriately in certain circumstances. In addition, some emerging technologies, such as the percutaneous permanent carotid filter, may be used safely and effectively to prevent the occurrence of stroke in patients both with AF and carotid artery atherosclerosis.

Serum Magnesium is associated with Carotid Atherosclerosis in patients with high cardiovascular risk (CORDIOPREV Study)

This study aimed to ascertain whether there is an independent association between serum magnesium (Mg) and the Carotid Intima-Media Thickness (IMT-CC), a well-accepted atherosclerotic-biomarker surrogate of cardiovascular disease (CVD), in a population with high cardiovascular risk. Serum Mg and traditional atherosclerotic risk factors were recorded in 939 patients (mean age, 59.6 ± 0.3 years, 83.2% men) with coronary heart disease (CHD) enrolled in the CORDIOPREV trial. Serum Mg strongly associated with IMT-CC. Before adjusting for potential confounding factors, IMT-CC decreased by 0.111 ± 0.011 mm per mg/dl increase in serum Mg (p < 0.001). After adjustment, the effect of Mg did not appear mediated through factors related to glucose metabolism, the lipid profile or the mineral metabolism and renal function. Multivariate models showed the lower Mg levels (quartile 1) as a strong independent factor contributing to IMT-CC along with age, sex, SBP, HDL-C, and diuretic use. Logistic regression analysis confirmed the predictive ability of serum Mg to differentiate patients at higher atherosclerotic risk as defined by an IMT-CC ≥ 1.0 mm, yielding a OR for the lower quartile of 10.623 (95%CI 2.311–48.845; P = 0.002) and a ROC-derived cutoff of 1.61 mg/dl. Therefore, our findings outline low serum magnesium as a possible independent risk factor for carotid atherosclerosis.

A Review and Meta-Analysis of The Association Between Vitamin D and Carotid Atherosclerosis in Patients with Type-2 Diabetes

Research & Investigations in Sports Medicine A Review and Meta-Analysis of The Association Between Vitamin D and Carotid Atherosclerosis in Patients with Type-2 Diabetes Xin Mou*, Di Yi Zhou and Dan Yang Zhous Department of Endocrinology, China *Corresponding author:Xin Mou, Department of Endocrinology, Chinaorres, Psychiatrist in San Juan, Mexico Submission: November 20, 2018; Published: April 23, 2019 DOI: 10.31031/RISM.2019.04.00599 ISSN: 2577-1914 Volume4 Issue5

Aortic and Internal Carotid Atherosclerosis in Patients with Carotid Stenosis: Semiautomatic Volumetric Analysis of Low-Attenuation Plaque on Curved Planar Reformations Using MDCT Angiographic Data.

This retrospective study included 65 patients who underwent multidetector computed tomography (MDCT) carotid angiography; 28 patients were <70 years old (group 1), and 37 were ≥70 years old (group 2). Each low-attenuation (<30 Hounsfield units [HU]) plaque volume (LPV) and total uncalcified plaque volume ([TUPV] ≤150 HU) were semiautomatically measured on each aortic arch and internal carotid artery (ICA) curved planar reformations (CPR), using MDCT angiographic data. Correlation coefficients were employed to assess the impact of each plaque volume on various factors including ICA stenosis. The correlations (r > 0.5) were observed between aortic LPV and each ICA stenosis ratio and >30% stenosis in group 1, between aortic TUPV and male gender in group 1, and between ICA-TUPV and each aortic TUPV or the largest plaque thickness in group 2. Marginal correlations were observed between hyperlipidemia and aortic LPV and ICA-TUPV in group 1. There was no association between cerebral infarction and the aortic and ICA plaques. Both the aortic arch and ICA plaque volumes can be measured clinically. The increasing aortic LPV may be a significant factor associated with the development of ICA stenosis in patients younger than 70 years old.

Assessment of Serum Cystatin C as an Early Biomarker of Carotid Atherosclerosis

The aim of this study was to establish the correlation between the value of serum cystatin C (Cys C) and carotid atherosclerosis in patients without chronic kidney disease and to determine the serum Cys C cut-off level for carotid atherosclerosis diagnosis. The study was performed between October 2014 and June 2018, and included 256 patients from 20 family medicine offices of Timis County, both from urban and rural areas. The patients completed a socio-demographic questionnaire, and were clinically examined by their general practitioner and investigated by laboratory tests and carotid ultrasound. The mean age of the patients with high serum Cys C (study group 1) was 74 years (82% male), while in study group 2 (with low serum Cys C values) the mean age was 56 years old (63% male). Cys C levels were significantly correlated with serum creatinine and estimated glomerular filtration rate. In the group with elevated levels of Cys C we found an increased incidence of obesity, hypertension, diabetes and carotid atherosclerosis. Multivariate analysis showed that the increased levels of Cys C were associated with a maximum carotid plaque thickness (MCPT) �2 mm (OR: 2.86, 95% C.I.: 1.13-7.97). The serum Cys C cut-off level for the diagnosis of atherosclerosis determined by ROC (receiver operating characteristic) curve was 0.73 mg/dL.

The Role of Monocyte to High-Density Lipoprotein Cholesterol Ratio in Prediction of Carotid Intima-Media Thickness in Patients With Type 2 Diabetes.

Background: Chronic inflammatory disorders and dyslipidemia in type 2 diabetes mellitus (T2DM) are essential contributors to the development of atherosclerotic cardiovascular disease. Monocyte to high-density lipoprotein cholesterol (HDL-C) ratio (MHR) is a novel and simple measure associated positively with the body inflammatory and oxidative stress status. However, little is known regarding the role of MHR in evaluating carotid intima-media thickness (CIMT), a surrogate predictor of subsequent vascular events, especially in diabetic patients.Methods: A total of 494 patients with T2DM and 1,848 non-diabetic subjects were consecutively enrolled in study 1. Correlation between MHR and CIMT was compared between diabetic and non-diabetic subjects. In study 2, a total of 110 T2DM patients from study 1 with normal basal CIMT and a follow-up ultrasonography at 12 months were enrolled. The predictive role of MHR on CIMT progression in diabetic patients was analyzed.Results: In study 1, MHR was higher in patients with T2DM than non-diabetic subjects (p < 0.001). After adjustment for confounding risk factors, MHR remained correlated significantly with CIMT in diabetic (r = 0.172, p = 0.001) but not non-diabetic (r = 0.006, p = 0.813) subjects. Logistic regression analyses demonstrated that MHR is superior to traditional lipid parameters in association with elevated CIMT in diabetic patients. In study 2, MHR at baseline was positively correlated with change in CIMT (r = 0.313, p = 0.001). Basal MHR was independently associated with change in CIMT [β = 0.059, (95% CI: 0.012–0.105), p = 0.014] in multivariate linear regression analysis.Conclusions: Our study suggests that MHR is a convenient and effective measure in prediction of the presence and progression of subclinical carotid atherosclerosis in patients with T2DM.

Preclinical Carotid Atherosclerosis in Patients With Juvenile-Onset Mixed Connective Tissue Disease

BackgroundThis study investigated preclinical atherosclerosis in patients with juvenile mixed connective tissue disease (JMCTD), which is a chronic inflammatory disease with a varied phenotype. Mixed connective tissue disease (MCTD) has well known associations with other autoimmune diseases known to have increased risk of cardiovascular disease. However, the cardiovascular risk for patients with the juvenile form remains unclear. Materials and methodsForty-nine patients with JMCTD and 45 age-and sex-matched controls took part in this study. They underwent blood tests, clinical examination, and ultrasound measurement of the carotid arteries. ResultsWe found that patients had significantly higher average carotid intima-media thickness (IMT) as compared to controls (mean 0.57 ± 0.09 versus 0.53 ± 0.06, P = .03). IMT also increased with both increasing disease duration (years from diagnosis), and severity as assessed by the physicians global assessment score, after adjustment for age. ConclusionsThis is the first study to demonstrate increased preclinical atherosclerosis in juvenile MCTD. Our findings suggest that the atherosclerotic burden in this patient group, which was independent of traditional cardiovascular risk factors, might be secondary to the underlying connective tissue disease.

400.02 Polymorphisms of Selected Genes of Inflammatory Process as Genetic Markers of Progression of Carotid Atherosclerosis in Patients with Type 2 Diabetes

Type 2 diabetes mellitus (T2DM) is chronic metabolic disorder associated with micro- and macrovascular disorders. One of the most important macrovascular disorders is carotid atherosclerosis (CA). 595 subjects with T2DM and 200 subjects without T2DM were enrolled in the study. DNA was analyzed with

Abstract TP454: Decision Tree Model for Carotid Atherosclerotic Risks

Background: Carotid atherosclerosis is strongly associated with stroke risk. However, we do not know of the severity of the risk in carotid atherosclerosis patients before their ultrasonic evaluations. Purposes: The purpose of this study is to verify the risk factors that influence carotid atherosclerosis and develop a decision tree model. Methods: In this retrospective correlational and methodological study, all 509 adults (329 men and 180 women) who underwent carotid ultrasound at a hospital in Seoul, Korea, for 6 months were enrolled. Baseline data and the results of carotid ultrasound were collected from electronic medical records. Data analyses were performed with SPSS 23 software. Results: A decision tree model for carotid atherosclerotic risks with age, duration of diabetes and hypertension, and LDL values was developed. Various predictive prevalence rates according to 6 subgroups are presented in the model (Figure 1). Misclassification rate, sensitivity, specificity, and area under the curve of this model were 16.6%, 75.6%, 65.2%, and 0.77, respectively. Conclusions: We developed a decision tree model that may be useful for predicting the prevalence rate of carotid atherosclerosis according to individual patient risk factors. Furthermore, nursing management focus on patients in the high-risk group could help prevent stroke.

Prediction of carotid atherosclerosis in patients with impaired glucose tolerance - a performance analysis of machine learning techniques

The focus of this paper is to examine factors associated with carotid atherosclerosis in patients with impaired glucose tolerance (IGT), and to predict the rapid progression of carotid intima-media thickness (IMT). The proposed machine learning methods performed well and accurately predicted the progression of carotid IMT. The linear support vector machine, nonlinear support vector machine with a radial basis kernel function, multilayer perceptron (MLP), and the Naive Bayes method were employed. A comparison of these methods was conducted using the Brier score, and the accuracy was tested using a confusion matrix.

Prediction of carotid atherosclerosis in patients with impaired glucose tolerance - a performance analysis of machine learning techniques

Prediction of carotid atherosclerosis in patients with impaired glucose tolerance - a performance analysis of machine learning techniques

Malnutrition assessed by controlling nutritional status is correlated to carotid atherosclerosis in patients with type 2 diabetes.

Diabetes and malnutrition sometimes overlap. Little is known about the relationship between malnutrition and subclinical atherosclerosis in patients with type 2 diabetes. This cross-sectional study investigated this relationship in patients with type 2 diabetes. We evaluated the relationships between malnutrition assessed by controlling nutritional status (CONUT) score and subclinical atherosclerosis assessed by carotid intima-media thickness (IMT) and carotid plaque scores in 461 consecutive patients with type 2 diabetes. Nutritional assessment indicated that 38% of patients were malnourished (CONUT ≥3). Carotid IMT and carotid plaque scores were significantly higher in patients with malnutrition. Multivariate linear regression analyses revealed that a high CONUT score (CONUT ≥3) was correlated with mean IMT (β = 0.196, p = 0.043) and max IMT (β = 0.243, p = 0.011) in patients taking statins and was also correlated with mean IMT (β = 0.287, p = 0.004), max IMT (β = 0.308, p = 0.002), and plaque score (β = 0.190, p = 0.044) in patients not taking statins after adjusting for age, sex, duration of diabetes, body mass index, hemoglobin A1c, creatine, smoking, and hypertension. Our results demonstrate a relationship between malnutrition and subclinical atherosclerosis in patients with type 2 diabetes.