Mean Intima-media Thickness Research Articles

Correlation between Carotid Artery Intima-Media Thickness and Luminal Diameter with Body Mass Index and Other Cardiovascular Risk Factors in Adults.

This study aimed to examine the correlation between carotid artery intima-media thickness (IMT) and luminal diameter (LD) with body mass index (BMI) and other cardiovascular risk factors. This observational cross-sectional study took place between June 2013 and March 2014 in the Radiology Department of Rizgary Teaching Hospital in Erbil, Iraq. Non-randomly selected subjects ≥20 years old (n = 140) were divided into BMI groups and evaluated for the following cardiovascular risk factors: gender, age, hypertension (HTN), diabetes (DM), smoking, alcohol consumption, blood pressure, serum total cholesterol and triglyceride (TG) levels. IMT and LD of the extracranial carotid arteries were measured by B-mode ultrasonography. The mean IMT was 0.8 ± 0.3 mm, ranging from a total mean of 0.7 mm in the normal BMI group to 1.0 mm in the extremely obese group. A significant correlation was found between IMT and BMI (P = 0.04), but not between BMI and LD (P = 0.3). No significant difference in mean IMT or LD was seen between genders. Significant correlations were found between IMT and age, HTN, DM, high serum cholesterol and TG levels (P <0.001). An increase of one BMI unit caused a 0.009 mm increase in IMT and an increase of one year in age caused a 0.011 mm increase in IMT. Age, obesity, HTN, DM, high serum cholesterol and TG levels were found to have an impact on carotid IMT, which is a strong marker for the early development of atherosclerosis.

New Insights on the Role of SERCA During Vessel Remodeling in Metabolic Syndrome

The prevalence of metabolic syndrome in the adult population in developing countries, as it is currently conceived by the current definitions, has been estimated to range from 22 to 39% and varies depending on the definition used and on ethnicity (1–3). Metabolic syndrome is associated with future coronary heart disease events (4), and this forms the underlying basis for the study by Dineen et al. in this issue of Diabetes (5). Patients with metabolic syndrome have been shown to have an increased mean intimal-medial thickness (0.98 vs. 0.92 mm, P < 0.01) of the common carotid and an increase in the number of components of metabolic syndrome, which is associated with an increasing trend in the mean intimal-medial thickness, suggesting that metabolic syndrome can effect vessel wall modeling (6). Defining the biology of these early mural changes should allow for a better delineation of how metabolic syndrome influences the response to injury after coronary intervention. Individuals with metabolic syndrome and a Framingham risk score greater than 20% have an increased risk of major coronary events over the next 10 years compared with people without metabolic syndrome and the same risk score (7). Metabolic syndrome is associated with an increased risk of myocardial infarction with a corresponding population-attributable risk of 14.5%. The clustering of greater than three risk factors with subthreshold values is also associated with an increased risk of myocardial infarction (odds ratio 1.50 [95% CI 1.24–1.81]) compared with component factors with values in a normal range (8). The presence of metabolic syndrome increases the risk of mortality by 1.6-fold and cardiovascular death by 2.4-fold in patients who present with an acute coronary syndrome (9). The presence of metabolic syndrome correlates with a heightened inflammatory …

Pulse waveform analysis of optic nerve head circulation for predicting carotid atherosclerotic changes.

To evaluate the relationship between the parameters of pulse waveform analysis in the optic nerve head using laser speckle flowgraphy (LSFG) and intima-media thickness (IMT) and severity of carotid arterial plaque. Prospective and cross-sectional study. One hundred seventy-six subjects were studied. Mean IMT and plaque score obtained from high-resolution B-mode ultrasound were evaluated. If mean IMT was 1mm or greater, abnormal carotid artery thickening was diagnosed; if the plaque score exceeded 10, severe atherosclerosis was diagnosed. Blowout time and blowout score, which are parameters of pulse waveform analysis using LSFG, were evaluated. Logistic regression analyses determined the independent factors for abnormal carotid artery thickening and severe atherosclerosis. The cutoff levels for abnormal carotid artery thickening and severe atherosclerosis were analyzed using a conventional receiver operating characteristic (ROC) curve. Logistic regression analysis showed that blowout time and body mass index contributed independently to abnormal carotid artery thickening, and blowout score contributed independently to severe atherosclerosis. The ROC curve showed that sensitivity and specificity of the blowout time and blowout score were equivalent to or greater than those of other factors. The cutoff level of the blowout time for abnormal carotid artery thickening was 46.4; the cutoff level of the blowout score for severe atherosclerosis was 71.8. Measurement of blowout time and blowout score in the optic nerve head by LSFG can be useful for evaluating mean IMT and plaque score, which are parameters of carotid atherosclerosis.

Metabolically Healthy Obesity and Carotid Intima-Media Thickness: Effects of Cardiorespiratory Fitness

ObjectiveTo test the hypothesis that cardiorespiratory fitness modifies the association between metabolically healthy obesity (MHO) phenotype and carotid intima-media thickness. Patients and MethodsWe evaluated 3838 men (mean age, 51±6 years) who participated in the general health examination program at Samsung Medical Center, Seoul, South Korea, between January 2, 2008, and December 31, 2008. Participants were divided into 4 groups on the basis of body habitus and metabolic health status using the Asia-Pacific criteria. On the basis of Asian criteria, MHO was defined as body mass index greater than or equal to 25 kg/m2 with less than 3 metabolic abnormalities. Cardiorespiratory fitness (fitness) was directly measured by using peak oxygen uptake and divided into unfit (lower tertile of fitness) and fit (middle and upper tertiles of fitness) categories on the basis of age-specific peak oxygen uptake percentiles. The prevalence of subclinical carotid atherosclerosis was defined as a mean carotid intima-media thickness greater than the 75th percentile. ResultsCompared with metabolically healthy normal weight (MHNW), MHO was associated with a higher prevalence of subclinical carotid atherosclerosis (odds ratio, 1.39; 95% CI, 1.12-1.72) after adjusting for potential confounding variables. Using multivariate logistic regression analysis, we found that the MHO unfit group had 2.00 times (95% CI, 1.48-2.73) and the metabolically unhealthy obesity unfit group had 1.84 times (95% CI, 1.26-2.67) higher risk of subclinical carotid atherosclerosis as compared with the MHNW fit group (reference group). However, MHO fit (OR, 1.25; 95% CI, 0.97-1.62) and metabolically unhealthy obesity fit (OR, 1.31; 95% CI, 0.90-1.92) groups had odds ratios for subclinical carotid atherosclerosis similar to those of the MHNW fit group. ConclusionMetabolically healthy obesity was associated with a higher prevalence of subclinical carotid atherosclerosis, but this association was attenuated by increasing levels of cardiorespiratory fitness.

Inconsistent Correlation Between Carotid Artery Intima-Media Thickness and Peripheral Arterial Tonometry: Brazilian Longitudinal Study of Adult Health (ELSA-Brasil).

To estimate the association between 2 markers for atherosclerosis, measurements of carotid artery intima-media thickness (IMT) and of peripheral arterial tonometry (PAT), and to evaluate the role of traditional cardiovascular risk factors in this association.We applied the 2 diagnostic tests to 588 participants from the ELSA-Brazil longitudinal study cohort. The PAT measurements, obtained with the EndoPAT2000, were the reactive hyperemia index (RHI), the Framingham RHI (F-RHI), and the mean basal pulse amplitude (BPA). We used the mean of the mean scores of carotid IMT of the distal layers of the left and right common carotids obtained by ultrasonography after 3 cardiac cycles. We used linear regression and the Spearman correlation coefficient to test the relationship between the 2 markers, and multiple linear regressions to exam the relationship between the RHI/F-RHI scores and the mean BPA and IMT scores after adjusting for cardiovascular risk factors.In the multivariate analysis, RHI (but not F-RHI) was positively correlated with the mean of the means of the IMT values after adjusting for sex and risk factors connected with both measures (β = 0.05, P = 0.02). Mean BPA did not remain significantly associated with IMT after adjusting for common risk factors.We found that the higher the IMT (or the worse the IMT), the higher the RHI (or the better the endothelial function). F-RHI was not associated with IMT. These 2 results are against the direction that one would expect and may imply that digital endothelial function (RHI and F-RHI) and IMT correspond to distinct and independent stages of the complex atherosclerosis process and represent different pathways in the disease's progression. Therefore, IMT and PAT measures may be considered complementary and not interchangeable.

Effect of Plasma Fibrinogen, High-Sensitive C-Reactive Protein, and Cigarette Smoking on Carotid Atherosclerosis: The Suita Study

Few studies have reported on the association between inflammatory markers and atherosclerosis by smoking status. We investigated the effect of plasma levels of fibrinogen and high-sensitive C-reactive protein (hsCRP) on subclinical atherosclerosis stratified by smoking in a general urban population. From participants of the Suita study without a history of cardiovascular diseases, a total of 2502 subjects (805 men, median age 64 years) who underwent carotid ultrasonography were enrolled. Subjects were divided into current smokers (n = 566) and never-smokers. Ex-smokers were not included in the study. Each group was subdivided according to the median levels of markers (plasma fibrinogen [2.99 g/L] and hsCRP [.51 mg/L]) and the smoking amounts. We compare the adjusted maximum and mean intima-media thickness (IMT). In men and women, maximum IMT and mean IMT of the high fibrinogen and high hsCRP (Fib(H)CRP(H)) with smoking were thicker than those of the low fibrinogen and low hsCRP (Fib(L)CRP(L)) without smoking, the Fib(L)CRP(L) with smoking, and the Fib(H)CRP(H) without smoking after adjusting for covariates. The Fib(L)CRP(L) with smoking had thicker IMTs than the Fib(L)CRP(L) without smoking. There was a dose-dependent smoking effect on IMT in men. These trends were similar in age 60, 65, and 70. Plasma fibrinogen and hsCRP levels were related to multivariate-adjusted IMT, and smoking was associated with IMT in men. The combination of plasma fibrinogen and hsCRP levels could be a potential marker on subclinical carotid atherosclerosis in urban people.

Increased carotid artery intima-media thickness and myeloperoxidase level in children with newly diagnosed juvenile idiopathic arthritis.

IntroductionJuvenile idiopathic arthritis (JIA) is a frequent childhood rheumatic disease characterized by chronic inflammation. The latter has been related to impairment of arterial functional-structural properties, atherogenesis and later cardiovascular events. The objective of this study was to examine intima-media thickness (IMT) and the parameters of arterial stiffness in children with JIA at diagnosis and their correlation with JIA subtype and markers of inflammation and atherosclerosis.MethodsThirty-nine newly diagnosed patients with JIA (26 girls; mean age, 13.2 ± 2.6 years) and 27 healthy controls (9 girls; mean age, 13.6 ± 3.4 years) were included in the study. Twelve patients had oligoarthritis, fifteen had extended oligoarthritis and twelve had rheumatoid factor–negative polyarthritis. IMT of the common carotid artery was determined by ultrasonography, carotid-femoral pulse wave velocity (cfPWV) and augmentation index adjusted to a heart rate of 75 beats/min (AIx@75) were determined by applanation tonometry. The serum levels of atherosclerosis-related biomarkers, such as asymmetric dimethylarginine (ADMA), myeloperoxidase (MPO) and adiponectin, were measured by enzyme-linked immunosorbent assay.ResultsMean IMT (0.46 ± 0.04 vs. 0.42 ± 0.04 mm; p = 0.0003) and MPO concentration (115.2 [95 % confidence interval {95 % CI}, 97.4–136.3] vs. 57.6 [95 % CI, 47.1–70.3] ng/ml; p < 0.0001) were higher in the patients with JIA than in the control subjects. The cfPWV, AIx@75 and serum ADMA and adiponectin levels did not significantly differ between the groups and JIA subtypes. Serum adiponectin level correlated negatively with AIx@75 in patients with JIA (r = −0.38; p < 0.05).ConclusionsPatients with JIA have increased mean IMT and elevated MPO levels at early stages of the disease. AIx@75 was inversely independently associated with adiponectin level in the patients, suggesting that lower adiponectin levels might influence arterial subclinical stiffening in patients with newly diagnosed JIA.

Carotid plaque calcification predicts future cardiovascular events in type 2 diabetes.

The presence of carotid plaques is associated with future cardiovascular events, with local plaque composition being an independent outcome predictor. We examined the association between ultrasonographically determined carotid plaque calcification and incident major adverse cardiovascular events (MACE) and death in type 2 diabetes (T2D). We enrolled 581 patients with T2D who underwent routine carotid ultrasonography. Plaques were classified as echolucent (lipid rich), heterogenous, and echogenic (calcific). We collected demographic, anthropometric, and clinical data at baseline and followed the patients for up to 9 years. Plaques were detected in 81.8% of the patients (echolucent in 16.4%, heterogenous in 43.2%, and echogenic in 22.2%). During follow-up (4.3 ± 0.1 years), 58 deaths (27 cardiovascular) and 236 fatal and nonfatal MACE occurred. In univariate analyses, presence versus absence of any carotid plaque was associated with incident MACE, and the hazard ratio (95% CI) progressively increased from echolucent (1.97 [0.93-3.44]), to heterogeneous (3.10 [2.09-4.23]), to echogenic (3.71 [2.09-5.59]) plaques. Compared with echolucent plaques, echogenic plaques were associated with incident MACE independently from confounders. This association was attenuated after adjusting for the degree of stenosis, but in patients with stenosis ≤30%, echogenic plaque type still predicted total and atherosclerotic MACE, even after further adjusting for mean intima-media thickness. In T2D, carotid plaque calcification predicts MACE, especially in patients with a low degree of stenosis. The biology of atherosclerotic calcification in diabetes needs to be further elucidated to understand the basis of this association.

Ambient air pollution and racial/ethnic differences in carotid intima-media thickness in the Multi-Ethnic Study of Atherosclerosis (MESA)

BackgroundIn the USA, ethnic disparities in atherosclerosis persist after accounting for known risk factors. Ambient air pollution is associated with increased levels of atherosclerosis and differs in the USA by...

Eight-Year Outcomes of a Program for Early Prevention of Cardiovascular Events

Early identification of cardiovascular diseases allows us to prevent the progression of these diseases. The Bale/Doneen Method, a prevention and treatment program for heart attacks and ischemic strokes, has been adopted nationally in primary care and specialty clinics. The main purpose of this study was to evaluate the effect of the Bale/Doneen Method on lipoproteins and carotid intima-media thickness (IMT) for cardiovascular disease prevention and reduction. A secondary purpose was to illustrate the use of latent growth-curve analysis in studying trajectories of clinical outcomes and biomarkers in individual patients over time. This retrospective analysis is based on 576 patients at a nurse-managed ambulatory clinic who received the heart attack prevention and treatment program from 2000 to 2008. All patients were white; 61% were men; mean age was 55.5 years. Outcome measures include hemoglobin A1c, fasting blood sugar, plaque burden score (PBS), high-density lipoprotein, low-density lipoprotein (LDL), mean carotid artery IMT, and lipoprotein-associated phospholipase A2 test results. Latent growth-curve analysis was used in modeling changes in these outcome measures. On average, mean IMT score decreased by 0.01 per year (P < .001), PBS decreased by 0.17 per year (P < .001), LDL decreased by 5.19 per year (P < .001), and lipoprotein-associated phospholipase A2 decreased by 3.6 per year (P < .05). Hemoglobin A1c increased by 0.04 per year (P < .001). Significant sex and age differences in the initial level and/or rate of change of mean IMT, PBS, fasting blood sugar, high-density lipoprotein, and LDL scores were found. The current findings suggest that the Bale/Doneen Method is effective in generating a positive effect on the atherosclerotic disease process by achieving regression of disease in the carotid arteries.

Correlation between vascular endothelial growth factor and subclinical atherosclerosis in patients with psoriasis.

Psoriasis is associated with increased risk of atherosclerotic disorders. Vascular endothelial growth factor (VEGF) is an angiogenic factor that was overexpressed in both psoriatic and atherosclerotic lesions. In a prospective controlled study, we investigated the correlation between serum levels of VEGF and subclinical atherosclerosis in patients with moderate to severe psoriasis. Sixty patients with moderate to severe psoriasis and 60 age- and gender-matched healthy controls were recruited to the study. Mean intima-media thickness of the common carotid artery (MIMT-CCA) and serum VEGF levels of all subjects were measured. Subclinical atherosclerosis was defined as having an MIMT-CCA ≥0.8mm. Serum VEGF levels in psoriatic patients were significantly higher compared with healthy controls (P<0.0001). Psoriatic patients had significantly greater MIMT-CCA than healthy controls (P<0.0001). Forty-five percent of patients and 6.7% of the healthy controls had subclinical atherosclerosis (P<0.0001). In the patient group, subclinical atherosclerosis was significantly associated with serum VEGF levels, age, disease duration, and psoriasis area and severity index (PASI). This study supported the possible role of VEGF in the pathogenesis of subclinical atherosclerosis in psoriatic patients.

Inflammatory and vascular markers and olfactory impairment in older adults.

the incidence of olfactory impairment increases sharply in the eighth and ninth decades of life but the aetiology of age-related olfactory decline is not well understood. Inflammation and atherosclerosis are associated with many age-related conditions and atherosclerosis has been associated with olfactory decline in middle-aged adults. to determine if inflammatory markers and atherosclerosis are associated with the development of olfactory impairment in older adults. longitudinal, population-based study. a total of 1,611 participants, aged 53-97 years in the Epidemiology of Hearing Loss Study without olfactory impairment at the 1998-2000 examination and with follow-up at a subsequent examination 5 and/or 10 years later. the San Diego Odor Identification Test was used to measure olfaction. High sensitivity C-reactive protein, interleukin-6 and tumour necrosis factor-α were measured in serum and carotid ultrasound images were obtained for the measurement of carotid intima media thickness (IMT) and plaque assessment. Medical history, behavioural and lifestyle information were obtained by interview. inflammatory markers, IMT and plaque were not associated with the 10-year cumulative incidence of olfactory impairment in adjusted Cox proportional hazard models. Among those <60 years, the mean IMT [hazard ratio (HR) = 4.35, 95% confidence interval (CI) = 1.69-11.21, tertile 3 versus tertile 1] and the number of sites with plaque (HR = 1.56, 95% CI = 1.17-2.08, per site) were associated with an increased risk of developing an olfactory impairment at follow-up. subclinical atherosclerosis at a younger age may be a risk factor for the development of olfactory impairment.

Suppression of Remodeling Behaviors with Arachidonic Acid Modification for Enhanced in vivo Antiatherogenic Efficacies of Lovastatin-loaded Discoidal Recombinant High Density Lipoprotein.

A series of in vitro evaluation in our previous studies had proved that arachidonic acid (AA) modification could suppress the remodeling behaviors of lovastatin-loaded discoidal reconstituted high density lipoprotein (LT-d-rHDL) by restraining the reactivity with lecithin cholesterol acyltransferase (LCAT) for reducing undesired drug leakage. This study focuses on the investigation of AA-modified LT-d-rHDL (AA-LT-d-rHDL) in atherosclerotic New Zealand White (NZW) rabbit models to explore whether AA modification could enhance drug targeting delivery and improve antiatherogenic efficacies in vivo. After pharmacokinetics of AA-LT-d-rHDL modified with different AA amount were investigated in atherosclerotic NZW rabbits, atherosclerotic lesions targeting property was assessed by ex vivo imaging of aortic tree and drug distribution. Furthermore, their antiatherogenic efficacies were elaborately evaluated and compared by typical biochemical indices. With AA modification amount augmenting, circulation time of AA-LT-d-rHDL was prolonged, and drug accumulation in the target locus was increased, eventually the significant appreciation in antiatherogenic efficacies were further supported by lower level of bad cholesterol, decreased atherosclerotic lesions areas and mean intima-media thickness (MIT), markedly attenuated matrix metalloproteinase-9 (MMP-9) protein expression and macrophage infiltration. This proof-of-concept study demonstrated that AA-LT-d-rHDL could enhance drug accumulation in atherosclerotic lesion and impede atherosclerosis progression more effectively.

Carotid Intima-Media Thickness in Master Athletes.

Background:Carotid Intima Media Thickness (IMT) is currently used to assess the relationship between progression of coronary and systemic atherosclerosis. To date, however, the possible impact of regular physical activity (PA) on this parameter has not been well estimated.Objectives:Our study aims to examine this aspect especially in the absence of cardiovascular (CV) risk factors.Patients and Methods:100 master athletes (MA) and 51 sedentary controls (SC) were enrolled. They were evaluated by echo test with dedicated software (QIMT-Esaote) for IMT, and Bruce protocol and 2D echocardiography for cardiac hemodynamic parameters.Results:All values were within normal range. Left IMT mean values were significantly higher than right IMT values in both MA and SC groups (MA: IMT left 635 ± 104 µ, IMT right 614 ± 104 µ and mean IMT 624 ± 91.9 µ; SC: IMT left 633 ± 78 µ, IMT right 622 ± 90 µ and mean IMT 627 ± 78.1 µ). A positive relationship was found in both groups between IMT mean values and age (P < 0.01) and between IMT mean values and peak systolic blood pressure (MA: 0.28 R, P < 0.01; SC: 0.32 R, P < 0.05). At rest, only in MA was a significant relationship evident, between mean arterial pressure value and IMT (P < 0.01).Conclusions:In the absence of CV risk factors, only age is associated with a slight increase of wall carotid thickening. The data are indicative of a physiological increase in IMT, as a consequence of increased peak effort systolic pressure after regular PA in athletes.

PP.20.10

Objective: Carotid-femoral pulse wave velocity (cfPWV) is currently the standard measure of aortic stiffness. Brachial-ankle PWV (baPWV) can be more conveniently measured with an oscillometric cuff technique. We investigated the interrelationship between baPWV and cfPWV and their associations with cardiovascular risk factors and target organ damage. Design and method: Our study was conducted in the framework of comprehensive cardiovascular examinations in a workplace population living in a coast area, 300 kilometers south of Shanghai. BaPWV and cfPWV was measured using the Colin VP1000 (OMRON, Japan) and SphygmoCor (AtCor, Australia) devices, respectively. Mean intima-media thickness (IMT) at the right carotid artery was determined by an echotracking system (Esaote, Italy). Echocardiography was performed with a Mylab 30 CV machine (Esaote, Italy). Pearson's correlation and single and multiple regressions were applied for analyses. Results: The 954 participants (630 [66.0%] men, mean [±standard deviation] age 42.6 ± 14.2 years) included 203 (21.3%) hypertensive patients, of whom 89 (9.4%) took antihypertensive medication. BaPWV and cfPWV averaged 13.4 ± 2.7 and 7.3 ± 1.6 m/s, respectively. In unadjusted analysis, baPWV was significantly (P < 0.001) associated with cfPWV in all subjects (r = 0.75) and in men (r = 0.72) and women (r = 0.80). BaPWV and cfPWV shared similar major determinants, such as age (both partial r2 = 0.11) and systolic blood pressure (partial r2 = 0.51 and 0.44 for baPWV and cfPWV respectively). BaPWV and cfPWV were significantly (P < 0.001) and similarly (P > 0.29) associated with carotid IMT (r = 0.53 and 0.50, respectively), left ventricular mass index (r = 0.19 and 0.15), E/A ratio (r = -0.56 and -0.53) and deceleration time of E velocity (DTE, r = 0.43 and 0.39). After adjustment for other common cardiovascular risk factors, all above associations became non-significant (P > 0.15), except for both PWVs with DTE (partial r2 = 0.19 and 0.16, P < 0.02). Conclusions: BaPWV and cfPWV were closely correlated, and had similar major determinants and associations with cardiovascular target organ damage, indicating that baPWV can be an alternative measure of arterial stiffness and surrogate of cardiovascular damage.

PP.34.15

Objective: Assessment between the relation of 189 patients (132 women and 57 men) bearers of dyslipidemia and depressive syndrome (DS) for at least 3 years, with familiar priors of metabolic and cardiovascular risk. Design and method: This study comprises 132 (69,84%) women, with ages between 20–55 years, (mean age: 37,5 years), and 57 (30,16%) men with ages between 25–55 years (mean age: 40 years). All patients involved in this study had a previous anthropometric, biochemical, clinical and vascular evaluation. Therapeutic response was initiated, with serotonin reuptake inhibitors (SRI) and statin, associated to a modification in lifestyle. In 67 (50,75%) women between 20–30 years, an important correlation was found, between the clinical condition and hypotension. After 24 months, the realization of an auto evaluation (15D and SF-36 surveys) was proposed to all patients. Results: The mean values of cholesterol in the women's group was of HDLc: 38 mg/dl, LDLc: 135.5 mg/dl; and in the men's group was of HDLc: 33 mg/dl, and LDLc: 163 mg/dl. In 75 (39,68%) patients with ages comprised between 35–55 years, augmented values of the Intima Media Thickness (IMT) were found during carotid vascular assessment (mean: 2,3 mm), without differentiation of sexes. There was an excellent response to treatment after 24 months, with 98% complying with the therapeutic proposed, as well as changing lifestyle. Subsequent biochemical evaluation of the women's group showed mean values of HDLc: 53 mg/dl and LDLc: 93 mg/dl, whereas the men's group had a mean HDLc: 44 mg/dl and LDLc: 90,5 mg/dl. In the group of 75 patients with ages comprised between 35–55 years, there was a significant decrease of the mean IMT: 1,75 mm. The women's group with ages between 20–30 years kept a hypotension profile. Conclusions: DS is predictive of cardiovascular disease! Precocious metabolic compensation with introduction of statins and appropriate SRI is relevant to clinical evolution and to improve lifestyle quality.

Glycated albumin and the risk of micro- and macrovascular complications in subjects with type 1 diabetes.

BackgroundWe investigated the relationship between the glycemic indices glycated albumin (GA) and glycated hemoglobin (HbA1c) and the progression of diabetic vascular complications [diabetic nephropathy (DN) and carotid artery atherosclerosis (CAA)] in subjects with type 1 diabetes (T1D).MethodsA total of 154 participants with a median follow-up of 2.8 years were enrolled in this retrospective longitudinal study. We recruited T1D subjects who had regularly measured urine albumin-creatinine ratios and estimated glomerular filtration rates, as well as tested HbA1c and GA levels consecutively every 3 or 6 months. A subgroup of 54 subjects was measured repeated carotid intima-media thickness (IMT).ResultsWe classified subjects into the DN progression (Group I; n = 30) with either deteriorated stages of chronic kidney disease (n = 18) or albuminuria progression (n = 17), and the non-progression (Group II; n = 124). In multiple logistic regression analyses, baseline albuminuria (odds ratio [OR] = 2.64, 95 % confidence interval [CI] = 1.03–6.74), mean GA levels (OR = 2.03, 95 % CI = 1.27–3.26) were significantly associated with progression of DN. However, there was no association with mean HbA1c (OR = 0.98, 95 % CI = 0.62–1.54). In a subgroup analysis for follow-up measurements of carotid IMT, age was independently associated with the presence of plaque and the mean IMT. However glycemic indices were not significantly associated with CAA.ConclusionsMean GA levels were more closely associated with DN progression than mean HbA1c in subjects with T1D. However, they were not associated with the CAA.Electronic supplementary materialThe online version of this article (doi:10.1186/s12933-015-0219-y) contains supplementary material, which is available to authorized users.

Associations of Coronary Heart Disease with Common Carotid Artery Near and Far Wall Intima-Media Thickness: The Multi-Ethnic Study of Atherosclerosis.

Intima-media thickness (IMT) measured on ultrasound images of the common carotid artery (CCA) is associated with cardiovascular risk factors and events. Given the physics of ultrasound, CCA far wall IMT measurements are favored over near wall measurements, but this theoretical advantage is not well studied. A total of 6,606 members of the Multi-Ethnic Study of Atherosclerosis, a longitudinal cohort study (mean age, 62.1years; 52.7% women) who had near wall and far wall CCA IMT measurements. Multivariate linear regression models were used to estimate model goodness of fit of Framingham risk factors with near wall IMT, far wall IMT, and combined mean IMT. Multivariate Cox proportional hazards models were used to estimate hazard ratios for incident coronary heart disease events for each IMT variable. Change in Harrell's C statistic was used to compare the incremental value of each IMT variable when added to Framingham risk factors. Mean IMT had the strongest association with risk factors (R(2)=0.31), followed by near wall (R(2)=0.26) and far wall (R(2)=0.22) IMT. Far wall IMT improved the prediction of coronary artery disease events over the Framingham risk factors (change in C statistic, 0.012; 95% CI, 0.006-0.017; P<.001), as did mean IMT (P=.004), but near wall IMT did not. Far wall CCA IMT showed the strongest association with incident coronary heart disease, whereas mean IMT had the strongest associations with risk factors. This difference might affect the selection of appropriate IMT variables in different studies.

Abstract 577: Medical Marijuana Use: Effect on Lipid Metabolism and Atherosclerosis

Background: Dyslipidemia and aortic (Ao) and carotid (Ca) atherosclerosis are common in systemic lupus erythematosus (SLE) and are associated with increased morbidity and mortality. Medical use of Marijuana is common in SLE. Marijuana use has been associated with stroke and myocardial infarction in isolated case reports and limited and retrospective series. In contrast, Marijuana in atherogenic animal models has resulted in favorable lipid metabolism and inhibition of atherosclerosis. However, there are limited data on the effect of medical Marijuana on the lipid profile and atherosclerosis in humans. Methods: 76 SLE patients (69 women, age 38 ± 12 years) underwent laboratory evaluations including lipid profile [total cholesterol, LDL, HDL, and triglycerides levels in mg/dL] and Ca ultrasonography and transesophageal echocardiography for assessment of Ca and Ao atherosclerosis, respectively. Atherosclerosis was defined as intima-media thickening (mean intima-media thickness in 26 healthy controls+2SD) or plaques (as &gt;50% focal intima-media thickening as compared with surrounding walls). Fifteen (20%) patients were regular users of medical Marijuana (≥3 times per week for ≥1 year). Results: As shown in Table 1, Marijuana users versus non-users had lower total and LDL cholesterol (both p ≤0.006) and triglycerides (p=0.13). Also, Ao and Ca intima media thickness, intima-media thickening, or plaques were similar in users and non-users. Conclusions: Medical Marijuana use in SLE patients may not have a detrimental effect on lipid metabolism or atherogenesis. These findings are preliminary and need confirmation in a larger controlled study.

Specific Lipoprotein(a) apheresis attenuates progression of carotid intima-media thickness in coronary heart disease patients with high lipoprotein(a) levels

BackgroundTo date, there have been no studies evaluating the effect of isolated lipoprotein(a) (Lp(a)) lowering therapy on carotid atherosclerosis progression. MethodsWe enrolled 30 patients who had coronary heart disease (CHD) verified by angiography, Lp(a) level ≥50 mg/dL, and low density lipoprotein cholesterol (LDL-C) level ≤2.6 mmol/L (100 mg/dL) on chronic statin therapy. Subjects were allocated in a 1:1 ratio to receive apheresis treatment on a weekly basis with immunoadsorption columns (“Lp(a) Lipopak”®, POCARD Ltd., Russia) added to atorvastatin, or atorvastatin monotherapy. The primary efficacy end-point was the change from baseline in the mean intima-media thickness (IMT) of the common carotid arteries. ResultsAfter one month run-in period with stable atorvastatin dose, LDL-C level was 2.3 ± 0.3 mmol/L and Lp(a) – 105 ± 37 mg/dL. As a result of acute effect of specific Lp(a) apheresis procedures, Lp(a) level decreased by an average of 73 ± 12% to a mean of 29 ± 16 mg/dL, and mean LDL-C decreased by 17 ± 3% to a mean of 1.8 ± 0.2 mmol/L. In the apheresis group, changes in carotid IMT at 9 and 18 months from baseline were −0.03 ± 0.09 mm (p = 0.05) and −0.07 ± 0.15 mm (p = 0.01), respectively. In the atorvastatin group no significant changes in lipid and lipoprotein parameters as well as in carotid IMT were received over 18-month period. Two years after study termination carotid IMT increased by an average of 0.02 ± 0.08 mm in apheresis group and by 0.06 ± 0.10 mm in the control group (p = 0.033). ConclusionIsolated extracorporeal Lp(a) elimination over an 18 months period produced regression of carotid intima–media thickness in stable CHD patients with high Lp(a) levels. This effect was maintained for two years after the end of study.Trial Registration: Clinicaltrials.gov (NCT02133807).