Carotid Plaque In Men Research Articles

Sex and Age Influence the Relationship Between Serum Creatinine/Cystatin C and Carotid Plaque in Patients With Type 2 Diabetes Mellitus.

We investigated the effect of sex and age on the association between serum creatinine/cystatin C (CCR) ratio and carotid plaque in patients with type 2 diabetes mellitus (T2DM). The carotid plaque group and the non-plaque group were divided according to cervical vascular ultrasound; the general and biochemical data of the two groups were compared according to CCR, gender, and age. Binary logistic regression was used to analyze the factors influencing carotid plaque. A total of 1429 patients with T2DM were included in this study. On multivariate analysis, CCR was an independent predictor of carotid plaque with an adjusted odds ratio (OR) of 1.681 [1.250-2.260]. The risk of carotid plaque in men with T2DM increased significantly (P < .05) with decreasing levels of CCR. In addition, an association between CCR and carotid plaque was found in individuals with T2DM <65years of age (P < .05). CCR is strongly associated with the risk of carotid plaques in persons with T2DM and are an independent risk factor for carotid plaques in men and people aged <65years with T2DM.

Sex differences in cardiovascular and disease-related features in axial spondyloarthritis. A multicenter study of 912 patients

ObjectivesTo determine the potential impact of sex-specific disease-related characteristics on cardiovascular (CV) disease in axial spondyloarthritis (axSpA). MethodsCross-sectional study of the Spanish AtheSpAin cohort to study CV disease in axSpA. Data on carotid ultrasound and CV disease and disease-related features were collected. Results611 men and 301 women were recruited. Classic CV risk factors were significantly less prevalent in women, who also showed a lower frequency of carotid plaques (p = 0.001), lower carotid intima-media thickness (IMT) values ​​(p<0.001) and CV events (p = 0.008). However, after adjustment for classic CV risk factors, only the differences with respect to carotid IMT remained statistically significant. Women showed higher ESR at diagnosis (p = 0.038), and more active disease (ASDAS, p = 0.012, and BASDAI, p<0.001). They had shorter disease duration (p<0.001), lower prevalence of psoriasis (p = 0.008), less structural damage (mSASSS, p<0.001), and less mobility limitation (BASMI, p = 0.033). To establish whether these findings could lead to sex differences in CV disease burden, we compared the prevalence of carotid plaques in men and women with the same level of CV risk stratified according to the Systematic Coronary Risk Evaluation (SCORE). Men included in the low-moderate CV risk SCORE category had more carotid plaques (p = 0.050), along with longer disease duration (p = 0.004), higher mSASSS (p = 0.001) and psoriasis (p = 0.023). In contrast, in the high-very high-risk SCORE category, carotid plaques were observed more frequently in women (p = 0.028), who were characterized as having worse BASFI (p = 0.011), BASDAI (p<0.001) and ASDAS (p = 0.027). ConclusionDisease-related features may influence the expression of atherosclerosis in patients with axSpA. This may be especially applicable to women at high CV risk, characterized by greater disease severity and more severe subclinical atherosclerosis than men, suggesting a stronger interaction between disease activity and atherosclerosis in women with axSpA.

Current Smoking is a Risk Factor for the Irregular Surface and Calcification of Carotid Plaque in Men.

ObjectiveTo explore whether current smoking could influence plaque characteristics and determine its correlation to the irregular surface and calcification of carotid plaque.MethodsThree hundred and seventeen patients with severe carotid atherosclerosis stenosis (SCAS) detected by color duplex flow imaging (CDFI) and confirmed by CT angiography (CTA) were recruited. The results of laboratory parameters were collected by using electronic database of the hospital. Computerized tomography (CT) scanning and high-resolution ultrasonography were performed for assessment of plaque morphology, respectively.ResultsAll enrolled smokers and non-smokers had no significant difference among all characteristics not related to smoking. CT scanning could efficiently identify the difference among enrolled smokers and non-smokers not only for the characteristics related to smoking but also the onsets of carotid plaque. Surface morphology was also efficiently detected by ultrasonography. Further ridge trace analysis showed that ultrasonography is efficient for diagnosis of calcified plaque compared with gold standard for plaque diagnosis. Further correlation analysis showed that ultrasonography parameters could offer reliable evidence for plaque scores, which was associated with age index. Ultrasonography parameters could efficiently differentiate plaque morphologies among enrolled smokers and never-smokers.ConclusionCurrent smoking was positively associated with plaque calcification onsets, and smoking cessation could efficiently attenuate such injury. High-frequency ultrasound can clearly distinguish the details of calcification with promising clinical significance for current smoking patients.

Abstract P183: Contribution Of Childhood Risk Factors To Sex Differences In Adult Carotid Imt And Plaques: The Childhood Determinants Of Adult Health Study

Background: Understanding the origins of sex differences in cardiovascular diseases (CVD) may help with prevention. We examined sex differences in carotid artery IMT and plaques in adulthood including the contribution of childhood risk factors. Methods: Boys and girls aged 7-15 years old from the Australian Schools Health and Fitness Survey in 1985 were followed up in the Childhood Determinants of Adult Health study at ages 36-49 years between 2014-19. Sex differences in adult carotid IMT and plaques, identified with 2D ultrasound of left and right carotid arteries, were examined with linear and log binomial regression, respectively. Childhood sociodemographic, psychosocial, health-related behavioural and biomedical risk factors that might contribute to sex differences in carotid IMT/plaques were identified with purposeful model building. Results: Among 1,286 men and women with vascular measurements of carotid IMT (53% women, mean carotid IMT 0.63 mm ± 0.09 standard deviation) women had thinner carotid IMT measurements than men (β coefficients -0.053 95% CI -0.063, -0.043). Adjusting for age standardised waist circumference (WC), waist/hip ratio (WHR), waist/height ratio (WHtR) and systolic blood pressure (SBP) in childhood reduced the sex difference of carotid IMT in adulthood (see Figure), but a significant sex-difference in carotid IMT remained. Women had a 42% lower risk of plaques than men (Relative Risk 0.58 95% CI 0.42, 0.79). School achievement levels, endurance/power fitness and SBP in childhood partially explained the sex difference in the prevalence of plaques at adulthood (see Figure) as the sex difference decreased and became statistically insignificant. Conclusion: Various factors in childhood had contributed to thicker carotid IMT and higher prevalence of carotid plaques in men compared to women. These findings suggest that the origins of adult sex differences in CVD may begin in childhood. There may be benefits of sex-specific primary prevention programs starting in childhood.

Association of Tumor Necrosis Factor Inhibitor Treatment With Reduced Indices of Subclinical Atherosclerosis in Patients With Psoriatic Disease.

To assess the effect of tumor necrosis factor inhibitors (TNFi) on subclinical cardiovascular disease in patients with psoriatic disease. We performed a 2-stage study. In stage 1, carotid total plaque area was assessed in patients with psoriasis or psoriatic arthritis (PsA) (n = 319) by ultrasound at baseline and after 2-3 years. The annual progression rate of atherosclerosis was the outcome of interest. In stage 2, PsA patients receiving TNFi (n = 21) and age- and sex-matched PsA patients not receiving any biologic agent (n = 13) underwent 18 F-fluorodeoxyglucose-positron emission tomography/computed tomography at baseline and 1 year to assess vascular inflammation, measured as target-to-background ratio (TBR). In both stages, multivariable regression analyses adjusted for cardiovascular risk factors and use of statins were performed. In stage 1, men had significantly higher atherosclerosis progression than women (P < 0.001). TNFi was associated with reduced atherosclerosis progression in men after controlling for cardiovascular risk and use of statins (adjusted β = -2.20 [95% confidence interval -3.41, -1.00], P < 0.001). There was no association between TNFi and atherosclerosis progression in women (P = 0.74). In stage 2, patients receiving TNFi had reduced TBR at 1 year (P = 0.03). Those not receiving TNFi had no significant change in TBR (P = 0.32). The improvement in aortic vascular inflammation in the TNFi group was independent of cardiovascular risk factors (adjusted β = -0.41 [95% confidence interval -0.74, -0.08], P = 0.02). Our findings indicate that TNFi treatment is associated with reduced progression of carotid plaques in men and improvement in vascular inflammation in both men and women with psoriatic disease.

Sex Differences in Prevalence of and Risk Factors for Carotid Plaque among Adults: A Population-based Cross-Sectional Study in Rural China.

Although the associations between carotid plaque and cardiovascular disease risk factors have been identified in previous studies, there is limited information on sex-related differences in factors associated with the development of carotid plaque. We aimed to determine sex differences in the prevalence of carotid plaque and associated risk factors in rural China. A total of 3,789 subjects aged ≥45 years without history of stroke or cardiovascular disease were recruited to the study. B-mode ultrasonography was performed to determine the presence of carotid plaque. The mean age of male subjects was greater than that of female subjects. In addition, there was a higher prevalence of carotid plaque in men than in women (50.1% vs. 35.5%; P < 0.001) irrespective of age group, education level, and presence of risk factors. Older age, hypertension, diabetes mellitus, and high concentrations of low-density lipoprotein cholesterol were pronouncedly associated with the risk of carotid plaque in both men and women. These findings suggest that it is vital for physicians to be aware that conventional risk factors and other related factors are of equal importance among rural residents in China; patients should thus be treated accordingly so that reduce the burden of stroke and cardiovascular disease.

The relationship between blood pressure dipping status and carotid plaque in senior essential hypertensive individuals of different sexes: a cross-sectional study.

To investigate the associations of the blood pressure (BP) dipping status with carotid plaque in senior essential hypertensive patients of different sexes. A total of 512 patients (275 men and 237 women) with essential hypertension who underwent ambulatory BP monitoring and carotid ultrasound assessment were recruited in our study. Binary logistic regression was used to analyze the associations of multiple risk factors with carotid plaque. Abnormal dipping [odds ratio (OR)=2.138, 95% confidence interval (CI) 1.170-3.908, P<0.05] and circadian decline rate of systolic BP (SBP) (OR=0.925, 95% CI 0.884-0.968, P<0.01) were found to be associated with carotid plaque in men. The level of night-time SBP (OR=1.022, 95% CI 1.003-1.042, P<0.05) and carotid plaque were associated with each other in women. In addition, as for all the patients in our study, abnormal dipping (OR=1.743, 95% CI 1.114-2.725, P<0.05), circadian decline rate of SBP (OR=0.950, 95% CI 0.922-0.980, P<0.01), the level of night-time SBP (OR=1.030, 95% CI 1.014-1.047, P<0.001), and the level of daytime diastolic BP (OR=0.971, 95% CI 0.946-0.998, P<0.05) were associated with carotid plaque, respectively. Our results suggested that the abnormal dipping status of BP and circadian decline rate of SBP might serve as independent risk factors for carotid plaque, respectively, in men, as does night-time SBP in women. Therefore, personalized BP management may be necessary for hypertensive patients.

Testosterone, dihydrotestosterone and estradiol are differentially associated with carotid intima-media thickness and the presence of carotid plaque in men with and without coronary artery disease.

Clarifying the relationship of sex hormones to preclinical atherosclerosis could illuminate pathways by which androgens are associated with cardiovascular events and mortality. Our aim was to determine hormone profiles associated with carotid intima-media thickness (CIMT) and carotid atheroma, in men with and without known coronary artery disease (CAD). We included 492 community-based men aged 20-70 years (Group A) and 426 men with angiographically proven CAD aged <60 years (Group B). Fasting early morning sera were assayed for testosterone (T), dihydrotestosterone (DHT) and estradiol (E2) using mass spectrometry. CIMT and carotid plaque were assessed ultrasonographically. Mean (±SD) age was Group A: 53.8±12.6 and Group B: 49.6±5.1 years. Higher T was associated with reduced CIMT (-0.011 mm per 1-SD increase, p=0.042) and lower prevalence of carotid plaque (odds ratio [OR] per 1-SD increase, 0.68, p=0.012) in Group A, but not B. E2 was associated with increased CIMT in Group A (0.013 mm, p=0.011) but not B. Higher DHT and E2 were associated with reduced carotid plaque in Group B (DHT: OR=0.77, p=0.024; E2: OR=0.75, p=0.008), but not A. In community-dwelling men, higher T is associated with favourable CIMT and lower prevalence of carotid plaque, while higher E2 is associated with worse CIMT. In men with CAD, higher DHT or E2 are associated with less carotid plaque. T, DHT and E2 are differentially associated with preclinical carotid atherosclerosis in a cardiovascular phenotype-specific manner. Interventional studies are needed to examine effects of exogenous T and its metabolites DHT and E2, on atherogenesis.

Homocysteine and carotid plaque stability: a cross-sectional study in Chinese adults.

Background and PurposeThis study aimed to explore the possible association of plasma total homocysteine with carotid plaque stability.MethodsA cross-sectional study was conducted from 2010 to 2011. A stratified random sample of 2,919 Chinese participants aged 40 years or older was enrolled. Plasma total homocysteine levels were measured and carotid plaques were evaluated by ultrasonography. Logistic regression model was used to analyze the association of homocysteine levels to the progression of carotid plaque development, while adjusting for demographics and vascular risk factors.ResultsThe mean level of plasma homocysteine in the subjects was 14.9 µmol/l. Along with increase in homocysteine level, the risk of advanced carotid plaque elevated (odds ratio = 1.28; 95% confidence interval = 1.09–1.51) after adjusting for age, sex, and other potential confounders. Stratified by sex, higher homocysteine level was strongly associated with advanced carotid plaque in men (OR = 1.41; 95% confidence interval = 1.17–1.70), but not in women.ConclusionThe findings suggest that plasma level of homocysteine may be associated with advanced carotid plaque, which constitutes high risks of stroke, in male Chinese adults.

Sex-related differences in carotid plaque features and inflammation

Severe carotid stenosis is a frequent cause of stroke in both men and women. Whereas several sex-related comparisons are available on coronary atherosclerosis, there are few data appraising gender-specific features of carotid plaques. We aimed to systematically compare the pathology and inflammatory features of carotid plaques in men vs women. Carotid plaque specimens were collected from patients undergoing surgical endarterectomy for asymptomatic or symptomatic carotid stenosis. Histologic analysis was performed, as well as measurements of plaque composition and inflammation. A total of 457 patients were included (132 women, 325 men). Baseline analyses showed a greater prevalence of hypercholesterolemia, hypertension, and former smoking status in women, despite a higher Framingham Heart Score in men (all P < .05). Women had a lower prevalence of thrombotic plaques, smaller percentage area of necrotic core, and hemorrhage extension (all P < .05). Plaque inflammation analysis showed a lower concentration of inflammatory and, in particular, of macrophage foam cells in the plaque cap of women (both P < .05). These differences were, however, no longer significant at multivariable analysis, including several baseline features, such as symptom status and stenosis severity. Carotid plaques seem significantly different in women and men, but the main drivers of such pathologic differences are baseline features, including stenosis severity and symptom status.

Alcohol consumption and carotid artery structure in Korean adults aged 50 years and older.

BackgroundEpidemiologic studies of the association between alcohol consumption and carotid artery structure have reported conflicting results. We investigated the association between alcohol consumption and carotid atherosclerosis by evaluating the effects of alcohol intake on carotid artery enlargement.MethodsThe study population consisted of 4302 community-dwelling Koreans (1577 men and 2725 women) aged 50 years and over. All the subjects had participated in the baseline survey of the Dong-gu Study conducted between 2007 and 2008. Daily alcohol consumption was determined by the number and frequency of alcoholic beverages consumed. We measured common carotid artery intima-media thickness (CCA-IMT), common carotid and bulb IMT (CB-IMT), carotid plaques, and the diameter of the common carotid artery (CCA-diameter) using high-resolution B-mode ultrasonography. We used analysis of covariance and multiple logistic regressions to determine the relationship between alcohol consumption and carotid artery parameters.ResultsCCA-IMT and CB-IMT were negatively correlated with alcohol consumption after controlling for cardiovascular risk factors in men (p for linear trend = 0.009 and = 0.038, respectively). The multivariate-adjusted odds ratio (OR) for carotid plaques was significantly higher in men who consumed >40.0 g/d (OR = 1.81, 95% CI = 1.13-2.91), although a significant positive correlation was observed between alcohol consumption and carotid plaques (p for linear trend = 0.027). Neither carotid IMT nor carotid plaques were correlated with alcohol intake in women. Alcohol intake was positively correlated with CCA-diameter adjusted for carotid IMT and plaques in the multivariate-adjusted model in both sexes (p for linear trend <0.001 for men and 0.020 for women).ConclusionThe results of our study indicate that alcohol consumption is inversely related to carotid IMT and positively related to carotid plaques in men, but not women. However, alcohol intake is positively associated with CCA-diameter in both men and women. Additional large population-based prospective studies are needed to confirm the effects of alcohol consumption on carotid artery structure.

Tea Consumption Is Inversely Associated With Carotid Plaques in Women

The aim of this study was to assess the relationship of tea consumption with common carotid artery intima-media thickness (CCA-IMT) and carotid plaques. The study was performed on 6597 subjects aged > or = 65 years, recruited in the French population for the Three-City Study. Atherosclerotic plaques in the extracranial carotid arteries and CCA-IMT were measured using a standardized protocol. Results were tested for replication in another, younger, French population sample (EVA-Study, 1123 subjects). In the Three-City Study, increasing daily tea consumption was associated with a lower prevalence of carotid plaques in women: 44.0%, 42.5%, and 33.7% in women drinking no tea, 1 to 2 cups/d, and > or = 3 cups/d (P=0.0001). This association was independent of age, center, major vascular risk factors, educational level, and dietary habits (adjOR=0.68[95%CI:0.54 to 0.86] for women drinking > or = 3 cups/d compared with none). There was no association of tea consumption with carotid plaques in men, or CCA-IMT in both genders. In the EVA-Study, carotid plaque frequency was 18.8%, 18.5%, and 8.9% in women drinking no tea, 1 to 2 cups/d, and > or = 3 cups/d (P=0.08). In a large sample of elderly community subjects we showed for the first time that carotid plaques were less frequent with increasing tea consumption in women.

Alcohol Consumption and Carotid Artery Structure in Older French Adults

Several epidemiological studies have suggested a U-shaped association between alcohol consumption and cardiovascular risk. However, the modifications of vascular structure associated with alcohol consumption are largely unknown. The study population sample comprised 6216 subjects (3780 women and 2436 men) aged 65 years or older who were recruited from 3 French cities (Bordeaux, Dijon, and Montpellier, which are located in the 3 principal wine-growing regions). Usual alcohol consumption was assessed by a standardized questionnaire. Carotid ultrasound examination included measurements (at sites free of plaques) of intima-media thickness (IMT) at the common carotid arteries (CCA), CCA-lumen diameter, and assessment of atherosclerotic plaques in the extracranial carotid arteries. Neither CCA-IMT nor carotid plaques were associated with alcohol consumption categories in the overall population. Weak and marginal positive associations were observed between categories of alcohol consumption and carotid plaques in men (P=0.02 for linear trend). CCA-lumen diameter was positively and independently associated with alcohol consumption in overall population and in men and in women. Similar results were found between alcohol consumption and carotid measurements in subjects free of cardiovascular disease (90.1% of the population). This very large population sample of French older adults shows no marked relationships of alcohol consumption with atherosclerosis. The positive association of alcohol intake with carotid arterial diameter may reflect the ability of alcohol to maintain adaptive enlargement to preserve lumen area.

Serum ferritin and C282Y mutation of the hemochromatosis gene as predictors of asymptomatic carotid atherosclerosis in a community population.

Serum ferritin and heterozygosity for the C282Y mutation of the hemochromatosis gene have both been associated with an increased risk of cardiovascular events. The purpose of the study was to test whether either is a risk predictor for asymptomatic carotid atherosclerosis. We assessed carotid intima-media wall thickness (IMT) and focal plaque formation by high-resolution B-mode ultrasound, conventional risk factors, serum ferritin levels, and the C282Y mutation of the hemochromatosis gene in a randomly selected community population of 1098 subjects (545 women and 553 men) aged 27 to 77 years. After adjustment for conventional risk factors, serum ferritin was not associated with carotid mean IMT. Women with ferritin values over the first quartile (>34 microg/L) had an adjusted odds ratio of 2.1 (95% CI, 1. 3 to 3.4; P:=0.0016) for carotid plaque compared with the first quartile. Ferritin was not associated with carotid plaque in men. Subjects who were heterozygous for the C282Y mutation constituted 11. 4% of the population, and there was no independent association of this genotype with either carotid IMT or focal plaque formation. We conclude that in our community population, C282Y genotype status was not a risk predictor for either carotid mean IMT or plaque formation. Serum ferritin values in women were independently associated with carotid plaque.

Carotid Atherosclerosis in Relation to Systolic and Diastolic Blood Pressure: Kuopio Ischaemic Heart Disease Risk Factor Study

We investigated the association of systolic and diastolic blood pressure and hypertension with two different manifestations of carotid atherosclerosis in a random population sample of 1165 Eastern Finnish men aged 42, 48, 54 or 60 years, examined in the Kuopio Ischaemic Heart Disease Risk Factor Study. Carotid atherosclerosis was assessed with high-resolution B-mode ultrasonography. Men with a casual sitting systolic blood pressure of 175 mmHg or more had a 3.17-fold (95% confidence interval 1.79-5.61) prevalence of intima-media thickening--adjusted for age, smoking, S-LDL-cholesterol, IHD history and diabetes--compared to men with lower systolic pressures. The relative prevalence of carotid plaques in men with raised systolic pressures. The relative prevalence of carotid plaques in men with raised systolic blood pressure was 2.61 (95% confidence interval 1.44-4.72) in relation to men with no lesions. Our findings suggest that systolic but not diastolic hypertension is associated with an increased prevalence of both early and advanced atherosclerotic lesions in carotid arteries.