Carotid Intima-media Wall Thickness Research Articles

Monocyte Chemoattractant Protein-1 and Large Artery Structure and Function in Young Individuals: The African-PREDICT Study.

To better understand hypertension development, the authors determined whether monocyte chemoattractant protein-1 (MCP-1) is associated with arterial stiffness (pulse wave velocity [PWV]) and carotid intima-media wall thickness (cIMT) in a young apparently healthy black and white population (N=403, aged 20-30years). Carotid-femoral PWV, central systolic blood pressure, and cIMT were measured, and MCP-1, reactive oxygen species, inflammatory markers (interleukin 6, tumor necrosis factor α), and endothelial activation (intercellular adhesion molecule, vascular cell adhesion molecule) were determined from blood samples. Although carotid-femoral PWV and cIMT were similar between blacks and whites, black men and women showed higher central systolic blood pressure, MCP-1, and reactive oxygen species than whites (all P<.05). In addition, black women had higher brachial blood pressure and interleukin 6 (all P<.001). A consistent positive association only in black women between cIMT and MCP-1 in multiple regression analyses was found (R²=0.151, β=0.248; P=.021). In this model, cIMT was also independently associated with vascular cell adhesion molecule (β=0.251; P=.022). The authors found elevated central systolic blood pressure and MCP-1 in young blacks, where cIMT was independently associated with MCP-1 in black women.

Coronary atherosclerosis burden is not advanced in patients with β-thalassemia despite premature extracardiac atherosclerosis: a coronary artery calcium score and carotid intima-media thickness study.

BackgroundThalassemic patients demonstrate an increased rate of extracardiac vascular complications and increased carotid wall intima-media thickness (cIMT), but very low prevalence of coronary artery disease (CAD). We investigated the atheroma burden by assessing the coronary artery calcium (CAC) and cIMT in these patients.MethodsWe examined 37 patients with β-thalassemia and 150 healthy control volunteers with multi-detector computer tomography (CT) and ultrasonography to determine CAC score and cIMT, respectively.ResultsPropensity score matching (C-statistic: 0.88; 95% CI: 0.83–0.93) resulted in 27 pairs of patients; severe CAC was observed in 2 (7.4%) and 0 of β-thalassemia patients and healthy volunteers respectively (P = 0.5). Median calcium score was 0 (0–0) in β-thalassemia patients and 0 (0–4) in healthy volunteers (P = 0.8). Median intima-media thickness was higher in β-thalassemia patients compared to control group [0.45 (0.06–0.65) vs. 0.062 (0.054–0.086); P = 0.04].ConclusionsPatients with β–thalassemia in comparison with healthy control subjects exhibit similar CAC score and increased cIMT. Our findings indicate a disparate rate of progression of atherosclerosis between coronary and extracardiac arteries in these patients lending support to the epidemiological evidence.

Population Study of Urban, Rural, and Semiurban Regions for the Detection of Endovascular Disease and Prevalence of Risk Factors and Holistic Intervention Study: Rationale, Study Design, and Baseline Characteristics of PURSE-HIS.

We designed and implemented the PURSE-HIS (Population Study of Urban, Rural and Semiurban Regions for the Detection of Endovascular Disease and Prevalence of Risk Factors and Holistic Intervention Study) to understand the prevalence and progression of subclinical and overt endovascular disease (EVD) and its risk factors in urban, semiurban, and rural communities in South India. The study is also designed to generate clinical evidence for effective, affordable, and sustainable community-specific intervention strategies to control risks factors for EVD. As of June 2012, 8,080 (urban: 2,221; semiurban: 2,821; rural: 3,038) participants >20 years of age were recruited using 2-stage cluster sampling. Baseline measurements included standard cardiovascular disease risk factors, sociodemographic factors, lifestyle habits, psychosocial factors, and nutritional assessment. Fasting blood samples were assayed for putative biochemical risk factors and urine samples for microalbuminuria. All nondiabetic participants underwent oral glucose tolerance test with blood and urine samples collected every 30 min for 2 h. Additional baseline measurements included flow-mediated brachial artery endothelial vasodilation, assessment of carotid intimal medial wall thickness using ultrasonography, screening for peripheral vascular disease using ankle and brachial blood pressures, hemodynamic screening using a high-fidelity applanation tonometry to measure central blood pressure parameters, and aortic pulse wave velocity. To assess prevalence of coronary artery disease, all participants underwent surface electrocardiography and documentation of ventricular wall motion abnormality and function using echocardiography imaging. To detect subclinical lesions, all eligible participants completed an exercise treadmill test. Prospectively, the study will assess progression of subclinical and overt EVD, including risk factor-outcome relation differences across communities. The study will also evaluate community-specific EVD prevention using traditional Indian system of medicine versus recognized allopathic (mainstream) systems of medicine.

Association between serum vitamin D levels and subclinical coronary atherosclerosis and plaque burden/composition in young adult population.

Evidence suggests that low 25-OH vitamin D 25(OH)D concentrations may increase the risk of several cardiovascular diseases such as hypertension, peripheral vascular disease, diabetes mellitus, obesity, myocardial infarction, heart failure and cardiovascular mortality. Recent studies suggested a possible relationship between vitamin D deficiency and increased carotid intima-media wall thickness and vascular calcification. We hypothesized that low 25(OH)D may be associated with coronary atherosclerosis and coronary plaque burden and composition, and investigated the relationship between serum vitamin D levels and coronary atherosclerosis, plaque burden or structure, in young adult patients by using dual-source 128x2 slice coronary computed tomography angiography (CCTA). We included 98 patients with coronary atherosclerosis and 110, age and gender matched, subjects with normal findings on CCTA examinations. Patients with subclinical atherosclerosis had significantly higher serum total cholesterol, triglycerides, hs-CRP, uric acid, HbA1c and creatinine levels and lower serum 25(OH)D levels in comparison with controls. There was no significant correlation between 25(OH)D and plaque morphology. There was also a positive relationship between 25(OH)D and plaque burden of coronary atherosclerosis. In multivariate analysis, coronary atherosclerosis was associated high hs-CRP (adjusted OR: 2.832), uric acid (adjusted OR: 3.671) and low 25(OH)D (adjusted OR: 0.689). Low levels of 25(OH)D were associated with coronary atherosclerosis and plaque burden, but there was no significant correlation between 25(OH)D and plaque morphology.

Asymptomatic atherosclerosis in egyptian rheumatoid arthritis patients and its relation to disease activity.

Aim. To detect the frequency of subclinical atherosclerosis in rheumatoid arthritis patients without clinically evident atherosclerosis and to correlate its presence with the disease activity. Patients and Methods. Our study includes 112 RA patients (group 1) and 40 healthy controls (group 11). All patients and controls were subjected to full history taking, clinical examination, and laboratory investigations. Carotid intima media wall thickness (IMT) and carotid plaques were measured in both groups by B-mode ultrasonography; also color duplex Doppler ultrasound of the brachial artery was done to detect endothelial function. Results. There is atherosclerosis in 31.3% of asymptomatic RA patients compared with only 5% in controls (P = 0.003**). A significant difference was detected in patients with and without atherosclerosis regarding duration of the disease (P = 0.0001***) and patient's age (P = 0.01*). There is highly statistical significant correlation between atherosclerosis and disease activity index. Conclusion. The frequency of subclinical atherosclerosis was high in long-term active RA patients.

Clinical Significance of Arterial Stiffness and Thickness Biomarkers in Type 2 Diabetes Mellitus: An Up-To-Date Meta-Analysis.

BackgroundType 2 Diabetes mellitus (T2DM) is associated with increased risk of cardiovascular disease (CVD). Previous studies explored the association of T2DM with arterial stiffness and thickness biomarkers including the augmentation index (AIX), aortic pulse wave velocity (aPWV), brachial-ankle PWV (baPWV), carotid intima-media wall thickness (IMT) as well as blood pressure (BP), low density lipoprotein cholesterol (LDL-C); however the conclusions are either inconsistent or incomprehensive.Material/MethodsThe average differences of each included trial were expressed as the standardized mean difference (SMD) with 95% confidence interval (CI). Analyses of carotid IMT, aPWV, baPWV and AIX Systolic BP (SBP), diastolic BP (DBP), LDL-C and HDL-C were independently performed. Furthermore, subgroup analyses by ethnicity (Caucasian or Asian) were conducted. Begg’s and Egger’s tests were performed for potential publication biases detection.ResultsA total of 14 case-control eligible studies with 1222 T2DM patients and 1094 control subjects were included. In the overall analysis, significant associations were observed between the carotid IMT, aPWV, baPWV, LDL-C, HDL-C, SBP, and DBP with T2DM (IMT: p=1.1*10−12; aPWV: p=1.1*10−7; baPWV: p=1.8*10−33; LDL-C: p=3.1*10−8; HDL-C: p=6.1*10−18; SBP: p=3.9*10−21; DBP: p=4.8*10−5). No association was detected for AIX (p=0.09). Subgroup analyses indicated that aPWV, baPWV, SBP, LDL-C, and HDL-C were associated with T2DM in both white and Asian populations (p<0.05). The significant associations of IMT, AIX and DBP with T2DM were only observed in the Asian subgroup.ConclusionsCarotid IMT, aPWV, baPWV, as well as LDL-C, HDL-C, SBP, and DBP but not AIX were useful noninvasive early markers for T2DM vascular dysfunction detection.

Predictors of carotid thickness and plaque progression during a decade: the Multi-Ethnic Study of Atherosclerosis.

Carotid artery intima-media thickness (IMT) and plaque are noninvasive markers of subclinical arterial injury that predict incident cardiovascular disease. We evaluated predictors of longitudinal changes in IMT and new plaque during a decade in a longitudinal multiethnic cohort. Carotid IMT and plaque were evaluated in Multi-Ethnic Study of Atherosclerosis (MESA) participants at exams 1 and 5, a mean (standard deviation) of 9.4 (0.5) years later. Far wall carotid IMT was measured in both common and internal carotid arteries. A plaque score was calculated from all carotid segments. Mixed-effects longitudinal and multivariate regression models evaluated associations of baseline risk factors and time-updated medication use with IMT progression and plaque formation. The 3441 MESA participants were aged 60.3 (9.4) years (53% women; 26% blacks, 22% Hispanic, 13% Chinese); 1620 (47%) had carotid plaque. Mean common carotid artery IMT progression was 11.8 (12.8) μm/year, and 1923 (56%) subjects developed new plaque. IMT progressed more slowly in Chinese (β=-2.89; P=0.001) and Hispanic participants (β=-1.81; P=0.02), and with higher baseline high-density lipoprotein cholesterol (per 5 mg/dL; β=-0.22; P=0.03), antihypertensive use (β=-2.06; P=0.0004), and time on antihypertensive medications (years; β=-0.29; P<0.0001). Traditional risk factors were associated with new plaque formation, with strong associations for cigarette use (odds ratio, 2.31; P<0.0001) and protection by black ethnicity (odds ratio, 0.68; P<0.0001). In a large, multiethnic cohort with a decade of follow-up, ethnicity was a strong, independent predictor of carotid IMT and plaque progression. Antihypertensive medication use was associated with less subclinical disease progression.

Increased serum leptin and resistin levels and increased carotid intima-media wall thickness in patients with psoriasis: Is psoriasis associated with atherosclerosis?

Patients with psoriasis may have an increased risk of cardiovascular disease. We sought to evaluate the potential association between subclinical atherosclerosis and psoriasis by measuring the intima-media wall thickness (IMT) of the common carotid artery (CCA) in patients with psoriasis and evaluating its correlation with serum leptin and resistin levels. The mean IMT (MIMT) of the CCA and leptin, resistin, triglyceride (TG), and total cholesterol levels in serum were determined in 60 patients and 60 healthy sex- and age-matched control subjects. Compared with the healthy control subjects, patients with psoriasis had significantly higher MIMT of the CCA and higher levels of serum leptin, resistin, TG, and total cholesterol. In addition, MIMT of the CCA was positively correlated with serum leptin, resistin, TG, and total cholesterol levels in patients with psoriasis. This was a cross-sectional single-center study, and we could not evaluate additional biomarkers such as adipokine or adiponectin because of our restricted facilities. Although serum leptin, resistin, TG, and total cholesterol levels and MIMT of the CCA were significantly increased in patients with psoriasis, MIMT of the CCA was also positively correlated with thesebiomarkers. Therefore, psoriasis could be an independent risk factor for subclinical atherosclerosis.

Carotid intima-media thickness is associated with incident heart failure among middle-aged whites and blacks: the Atherosclerosis Risk in Communities study.

BackgroundIncreased carotid intima‐media thickness (IMT) is associated with subclinical left ventricular myocardial dysfunction, suggesting a possible role of carotid IMT in heart failure (HF) risk determination.Methods and ResultsMean far wall carotid IMT, measured by B‐mode ultrasound, was available for 13 590 Atherosclerosis Risk in Communities study participants aged 45 to 64 years and free of HF at baseline. HF was defined using ICD‐9 428 and ICD‐10 I‐50 codes from hospitalization records and death certificates. The association between carotid IMT and incident HF was assessed using Cox proportional hazards analysis with models adjusted for demographic variables, major CVD risk factors, and interim CHD. There were 2008 incident HF cases over a median follow‐up of 20.6 years (8.1 cases per 1000 person‐years). Mean IMT was higher in those with HF than in those without (0.81 mm±0.23 versus 0.71 mm±0.17, P<0.001). Unadjusted rate of HF for the fourth compared with the first quartile of IMT was 15.4 versus 3.9 per 1000 person‐years; P<0.001. In multivariable analysis, after adjustment, each standard deviation increase in IMT was associated with incident HF (HR 1.20 [95% CI: 1.16 to 1.25]). After adjustment, the top quartile of IMT was associated with HF (HR 1.60 [95% CI: 1.37 to 1.87]). Results were similar across race and gender groups.ConclusionsIncreasing carotid IMT is associated with incident HF in middle‐aged whites and blacks, beyond risks explained by major CVD risk factors and CHD. This suggests that carotid IMT may be associated with HF through mechanisms different from myocardial ischemia or infarction.

The effects of treatment with Liraglutide on atherothrombotic risk in obese young women with polycystic ovary syndrome and controls

Background: Polycystic ovary syndrome (PCOS) is associated with obesity and increased cardiovascular (CV) risk markers. In this study our aim was to assess the effects of six months treatment with liraglutide 1.8 mg od on obesity, and CV risk markers, particularly platelet function, in young obese women with PCOS compared to controls of similar age and weight. Methods: Carotid intima-media wall thickness (cIMT) was measured by B-mode ultrasonography, platelet function by flow cytometry, clot structure/lysis by turbidimetric assays and endothelial function by ELISA and post-ischaemic reactive hyperemia (RHI). Data presented as mean change (6-month – baseline) ± standard deviation. Results: Nineteen obese women with PCOS and 17 controls, of similar age and weight, were recruited; baseline atherothrombotic risk markers did not differ between the two groups. Twenty five (69.4%) participants completed the study (13 PCOS, 12 controls). At six months, weight was significantly reduced by 3.0 ± 4.2 and 3.8 ± 3.4 kg in the PCOS and control groups, respectively; with no significant difference between the two groups, P = 0.56. Similarly, HOMA-IR, triglyceride, hsCRP, urinary isoprostanes, serum endothelial adhesion markers (sP-selectin, sICAM and sVCAM), and clot lysis area were equally significantly reduced in both groups compared to baseline. Basal platelet P-selectin expression was significantly reduced at six months in controls �0.17 ± 0.26 but not PCOS �0.12 ± 0.28; between groups difference, 95% confidence interval = �0.14 – 0.26, P = 0.41. No significant changes were noted in cIMT or RHI. Conclusions: Six months treatment with liraglutide (1.8 mg od) equally affected young obese women with PCOS and controls. In both groups, liraglutide treatment was associated with 3–4% weight loss and significant reduction in atherothrombosis markers including inflammation, endothelial function and clotting. Our data support the use of liraglutide as weight loss medication in simple obesity and suggest a potential beneficial effect on platelet function and atherothrombotic risk at 6 months of treatment.

Harmful and beneficial relationships between alcohol consumption and subclinical atherosclerosis

Background and aimsArterial stiffness and increased intima-media wall thickness are two of the main predictors of cardiovascular disease (CVD). We evaluated whether brachial-ankle pulse wave velocity (baPWV) and common carotid artery intima-media wall thickness (CCA-IMT) are correlated with alcohol consumption in a cross-sectional study among Korean men and women aged 40 years and over. Methods and resultsAll 5539 subjects (2121 men and 3418 women) were participants in the Multi-Rural Communities cohort (MRcohort) study, a part of the Korean Genome Epidemiology Study (KoGES). The baPWV was positively correlated with alcohol consumption in men (p for trend <0.0001). Age (middle-aged versus elderly) modified the effect of alcohol consumption on PWV. On the other hand CCA-IMT decreased with alcohol consumption in men. There was no favorable zone of alcohol consumption in terms of baPWV and CCA-IMT. Adjustment for lipid profiles substantially attenuated the relationship between alcohol consumption and CCA-IMT. There was no clear relation between alcohol consumption and baPWV/CCA-IMT in women. ConclusionsAlong with a linear harmful relationship between alcohol consumption and arterial stiffness in men there may also be a beneficial relationship between alcohol consumption and carotid intima-wall thickness. The effect of alcohol on arterial stiffness may be slightly stronger in elderly men, and the effect of alcohol on CCA-IMT may be mediated by lipid factors.

Abstract W MP66: Are Carotid Artery Stenosis-Isolated and Carotid Artery-Plus Two Distinct Entities?

Objective: To test the hypothesis that isolated carotid artery stenosis (CAS-isolated) and CAS as part of concurrent coronary artery disease (CAD) and/or peripheral arterial disease (PAD) are two distinct entities. Methods: We used the data from Multi-Ethnic Study of Atherosclerosis (MESA) which is a population-based sample of 6,814 men and women aged 44-84 years recruited from six US field centers. Baseline measurements include measurement of coronary calcium using computed tomography; carotid intimal-medial wall thickness and stenosis severity using ultrasonography; and measurement of peripheral vascular disease using ankle and brachial blood pressures. Participants were followed for identification and characterization of cardiovascular events. We defined CAS-isolated based on presence of CAS without any CAD (calcium score of 0 with no history of angina/myocardial infarction) or PAD (arm-brachial index 1.0-1.4). Results: Of the 858 persons with CAS ranging in severity from 25 to 100%, 155 (18%) and 703 (82%) were classified as CAS-isolated and CAS-plus, respectively. Persons with CAS-isolated were younger (mean age ±SD; 61±8 versus 70±8, p=0.001) and more likely to be women (63.2% versus 41.8%, p=&lt;.0001). The proportion of persons with hypertension (51.6% versus 66.3%, p=0.0006) and family history of heart attack (37.2% versus 51.1%, p=0.003) were lower among those with CAS-isolated. The proportion of persons with current cigarette smoking (19.6% versus 14.5%, p=0.01) and current alcohol abuse (73.4% versus 62.8%, p=0.03) were higher among CAS-isolated. Persons with CAS-isolated were more likely to have smooth carotid lesions (80.6% versus 69.3%, p=0.004). The relative risk for ischemic stroke was similar among patients with CAS-plus compared with CAS-isolated (RR, 1.1 95% CI 0.3-4.1) after adjustment for age and gender. Conclusions: CAS-isolated and CAS-plus appear to be two distinct entities with unique demographic and clinical attributes.

Central artery stiffness, neuropsychological function, and cerebral perfusion in sedentary and endurance-trained middle-aged adults

Midlife vascular disease risk is a strong risk factor for late-life dementia. Central arterial stiffness, a hallmark of vascular aging, is associated with accelerated brain aging and cognitive decline. Habitual aerobic exercise is an effective lifestyle strategy to reduce central arterial stiffness and is related to lower risk of cognitive impairment. To determine the associations among cardiopulmonary fitness, neuropsychological function, central arterial stiffness, and cerebral perfusion in the sedentary and endurance-trained middle-aged adults. Twenty-six sedentary and 32 endurance-trained middle-aged adults were measured for maximal oxygen consumption, central arterial stiffness determined by aortic pulse wave velocity and carotid ultrasound, neuropsychological function, and regional cerebral blood flow assessed by MRI. There were no group differences in age, sex, ethnicity, education, blood pressure, and carotid intima-media wall thickness (all P>0.05). Neuropsychological performance and occipitoparietal perfusion were greater, and central arterial stiffness was lower in endurance-trained individuals than in sedentary individuals (all P<0.05). Greater cardiopulmonary fitness was related to better cognitive composite scores, including memory and attention-executive function (r=0.28-0.40, P<0.05). Lower carotid arterial stiffness was associated with better neuropsychological outcome independent of age, sex, and education (r=-0.32 to -0.35, P<0.05), and correlated with greater occipitoparietal blood flow (r= -0.37 to -0.51, P<0.05). Lower carotid artery stiffness in endurance-trained adults is associated with better neuropsychological outcome and greater occipitoparietal perfusion.

Abstract 9559: Serum Uric Acid and the Vulnerability of Carotid Atherosclerotic Plaque Measured by Magnetic Resonance Imaging

Carotid-wall intima-media thickness (IMT) is a surrogate marker of atherosclerosis associated with cardiovascular risk factors and with cardiovascular outcomes. MR imaging of carotid plaque has been shown to be superior to the diagnostic assessment of plaque vulnerability at high risk of rupture, and to provide information useful to the choice of treatment. Regression of plaque has been reported by intensive statin therapy (IST). The effect of IST on the characteristics of carotid plaques, especially on the instability of plaques was determined using a combination of ultrasonography and MR imaging. In the present investigation, 572 patients having max IMT over 1.5mm were included. Among them, 445 patients (234 males and 211 females, average age was 70 ± 9.9 and 70 ± 10.1, respectively ) had been treated on IST for more than 1 year before the study(IST group). On the other hand, 117 patients (49 males and 68 females) had not been treated on IST before the study(non-IST group). Serum levels of LDL-C, HDL-C, LDL-C/HDL-C and uric acid of IST group and non-IST group are 68 ± 15 vs 133 ± 29, 52 ± 13 vs 53 ± 12, 1.39 ± 0.4 vs 2.6 ± 0.5 and 5.4 ± 1.4 vs 5.1 ± 1.2, respectively. The black-blood method was used, and a horizontal cross-sectional image of plaque was taken with T1- and T2-weighted mode. Finally, the ratio of the lesion and the submandibular gland was determined. Plaques having the ratio of T1 evaluation more than 1.25 were defined as intraplaque hemorrhage (IPH), while those below 1.25 were defined as stable. Plaques having the ratio of T2 evaluation more than 1.25 were defined as lipid core (LC), while those below 1.25 were defined as stable. In IST group, 58% of the patients have stable plaque, 6% have IPH, 24% have LC and 11% have IPH+LC. On the other hand, 50% of the patients of non-IST group have stable plaque, 4% have IPH, 33% have LC and 12% have IPH+LC. In IST group, among various parameters, only serum uric acid has strong and significant correlation with the presence of LC in carotid plaque in male (p=0.0030). Odds ratio of uric acid in the presence of LC in carotid plaque is 1.530. No such correlation was observed in female patients. Thus the present investigation provides a new insight into the role of uric acid in the vulnerability of carotid atherosclerotic plaque.

Mediators of Atherosclerosis in South Asians Living in America (MASALA) Study: Objectives, Methods, and Cohort Description

South Asians (individuals from India, Pakistan, Bangladesh, Nepal, and Sri Lanka) have high rates of cardiovascular disease (CVD) that cannot be explained by traditional risk factors. There are few prospective cohort studies investigating antecedents of CVD in South Asians. The Mediators of Atherosclerosis in South Asians Living in America (MASALA) study is investigating the prevalence, correlates, and outcomes associated with subclinical CVD in a population-based sample of South Asian men and women age 40-79 years at 2 US clinical field centers. This cohort is similar in methods and measures to the Multi-Ethnic Study of Atherosclerosis (MESA) to allow for efficient cross-ethnic comparisons. Measurements obtained at the baseline examination include sociodemographic information, lifestyle and psychosocial factors, standard CVD risk factors, oral glucose tolerance testing, electrocardiography, assessment of microalbuminuria, ankle and brachial blood pressures, carotid intima-media wall thickness using ultrasonography, coronary artery calcium measurement, and abdominal visceral fat measurement using computed tomography. Blood samples will be assayed for biochemical risk factors. Between October 2010 and March 2013, we enrolled 906 South Asians with mean age of 55 ± 9 years (46% women; 98% immigrants who have lived 27 ± 11 years in the United States). The sociodemographic characteristics of this cohort are representative of US South Asians. Participants are being followed with annual telephone calls for identification of CVD events including acute myocardial infarction and other coronary heart disease, stroke, peripheral vascular disease, congestive heart failure, therapeutic interventions for CVD, and mortality. The MASALA study will provide novel data on the prevalence and associations of cardiovascular risk factors and subclinical atherosclerosis in South Asians living in the United States.

Hyperhomocysteinemia is an independent predictor of sub-clinical carotid vascular damage in subjects with grade-1 hypertension

Although the role of homocysteinemia (Hcy) as a coronary risk factor (RF) has been scaled down, hyper-Hcy and carotid vascular damage (CVD) are still considered as RFs for cerebrovascular events. In 276 grade-1 hypertensives (160 men and 116 women aged 59.6 ± 15.0 years) without known cardiovascular disease and having hyper-Hcy (≥15 μM/L), subclinical CVD was evaluated by ultrasonographic carotid-wall intima media thickness (IMT). Hcy was divided into quartiles and C667→T polymorphism codifying for methylenetetrahydrofolate reductase (MTHFR) was determined. According to the genotype, subjects were divided into CC (wild), CT (heterozygote) and TT (homozygous mutation). Differences between continuous variables were evaluated by analysis of variance, while gender specific odds ratio (OR) and 95 % confidence intervals (CI) of CVD (IMT >0.9 mm or plaque) were calculated by multivariate logistic regression analysis. Blood pressure (BP) values were not different across the quartiles of Hcy. In 46.4 % of cases, sub-clinical CVD was found, with a prevalence increasingly distributed in the quartiles of Hcy (31.9, 42, 52.2, 59.4 %, p < 0.001). Prevalence of TT allele of the MTHFR genotype was also significantly distributed in the quartiles of Hcy (13.6, 12.3, 23.5 and 50.6 %, p < 0.0001), whereas no relationship was found between genotype and CVD. The last quartile of Hcy predicted CVD (OR 1.32, CI 1.12-2.2, p = 0.02) independent of age (OR 1.23, CI 1.002-1.56, p = 0.0001), systolic BP (OR 1.52, CI 1.24-2.10), diabetes (OR 2.11, CI 1:32-2.88, p = 0.01) and smoking (OR 1.45, CI 1.14-1.98, p = 0.04). Adding gender did not modify the model. In hypertensives, Hcy values >36.5 μM/L independently predict CVD and in those who are also diabetic and smokers, Hcy assessment without MTHFR genotype should be recommended to obtain a better stratification of global cerebrovascular risk.

Neck Circumference, Carotid Wall Intima-Media Thickness, and Incident Stroke

Locally acting fat depots may contribute to obesity complications, in particular vascular disease, through direct paracrine effects (1,2). The carotid arteries are encased in fat, and total upper-body subcutaneous fat is estimated by neck circumference (NC). NC has been independently correlated with cardiometabolic risk factors above and beyond that of other adiposity measures (3,4). Carotid wall intima-media thickness (IMT) is a surrogate marker of subclinical atherosclerosis and has been associated with cardiovascular and stroke outcomes (5). The aim of this study was to evaluate the association of NC and carotid wall IMT above and beyond traditional cardiovascular risk factors and generalized adiposity. Framingham Heart Study offspring participants who underwent carotid ultrasonography and NC measurements were included ( n = 3,274; mean age 59 years; 52% women); NC, internal carotid artery (ICA) IMT, and common carotid artery (CCA) IMT were determined as previously described (4,5). Linear regression models evaluated the association between adiposity exposures and IMT. NC, BMI, and …

AB0031 Lack of association between CXCL12 RS501120 polymorphism and cardiovascular disease in spanish patients with rheumatoid arthritis

BackgroundRheumatoid arthritis (RA) is an autoimmune inflammatory disease associated with accelerated atherosclerosis [1]. Both a chronic inflammatory response [2]and genetic factors have been implicated in the augmented cardiovascular (CV) mortality...

FRI0304 Incidence of and risk factors for a first cardiovascular event among german patients with systemic lupus erythematosus (SLE)

BackgroundCardiovascular disease remains a major cause of morbidity and mortality in SLE. Despite much research in this area, epidemiologic studies in specific populations are lacking.ObjectivesWe assessed the rate of a...

FRI0108 Serum osteoprotegerin levels, aortic stiffness and carotid intima-media thickness as cardiovascular risk factors in patients with rheumatoid arthritis

BackgroundOsteoprotegerin (OPG) is implicated in the pathogenesis of atherosclerosis. Recent studies have shown that arterial stiffness, carotid intima-media thickness (CIMT) and OPG are independent risk factors of cardiovascular (CV) disease....