Presence Of Atherosclerotic Plaques Research Articles

Subclinical atherosclerosis burden in carotid and femoral territories in HIV subjects: relationships with HIV and non-HIV related factors

BackgroundCardiovascular disease is a major cause of morbidity in an aging HIV population. However, risk estimation with the most frequent equations usually classifies HIV patients as having a low or moderate risk. Several studies have described a very high prevalence of subclinical atherosclerosis in a middle-aged, non-HIV population. There is insufficient body of knowledge to understand if this is the case in people living with HIV (PLWH). We aim to calculate the proportion of patients with subclinical atherosclerosis in a single site cohort of HIV-infected subjects.MethodsWe have analyzed chronically HIV infected adults (≥ 18 years) who were on active follow-up in an HIV unit specialized in the care of cardiovascular health. The most recent clinical visit and vascular ultrasonography were used to assess the objectives of our research. Our primary objective was to describe the proportion of participants with subclinical atherosclerosis (focal protrusion into the lumen > 0.5 mm or > 50% of the surrounding IMT or a diffuse thickness > 1.5 mm) in a single site cohort of PLWH. Carotid and iliofemoral territories were evaluated. As a secondary objective we have run a multivariate analysis to determine which HIV and non-HIV factors might be related with the presence of atherosclerotic plaques.FindingsWe included a total of 463 participants between November 2017 to October 2019. Subjects were predominantly male (84.2%) with a mean age of 48.8 years (SD 10.7). Hypercholesterolemia (36%) was the most prevalent comorbidity followed by Hypertension (18%) and Hypertriglyceridemia (16%). Mean duration of HIV infection is 12.3 years. Overall, participants had been receiving cART for a median of 9.5 years. Subclinical atherosclerosis was found in 197 subjects (42.5%; CI 95% [38.0–47.2]). The disease was found more frequently in the femoral arteries (37.8%) than in the carotid vascular bed (18.6%). Despite some HIV factors correlated with the presence of plaques in a univariate analysis (e.g., time with HIV-1 RNA > 50 copies/mL or time from HIV diagnosis), the only two explanatory factors that remained associated with the presence of atherosclerotic plaques in the multivariate analysis were smoking (OR 5.47, 95% CI 3.36 – 8.90) and age (OR 1.13, 95%CI 1.10 – 1.16).InterpretationWe have found a very high prevalence of subclinical atherosclerosis among our cohort of PLWH. Despite having analyzed several HIV factors, age and smoking have been found to be the only factors associated with the development of atherosclerotic plaques.

Associations between Adipose Tissue-Specific Insulin Resistance and Atherosclerotic Plaques and Burden in Community-Based Population.

We aimed to examine the association between adipose tissue-specific insulin resistance and atherosclerotic burden and plaques in intracranial, extracranial, and coronary arteries in community residents without diabetes. Adipose tissue-specific insulin resistance index (Adipo-IR) was calculated by fasting serum insulin and free fatty acids and categorized into 4 groups according to the quartiles. The 3.0 T magnetic resonance imaging scanner was used to assess intracranial and extracranial atherosclerotic plaques, while computed tomography angiography was used to assess coronary atherosclerotic plaques. Intracranial, extracranial, and coronary atherosclerotic burden was assessed by segmental stenosis segment scores of the corresponding arterial segments, respectively. Binary and ordinal logistic regression models were utilized to investigate the relationship of Adipo-IR with the presence of atherosclerotic plaques and atherosclerotic burden. Of 2,719 participants (mean [standard deviation] age, 60.9 [6.6] years; 1,441 [53.0%] women), the prevalence of intracranial atherosclerotic plaques, extracranial atherosclerotic plaques, and coronary plaques were 432 (15.9%), 975 (35.9%), and 1,160 (42.7%), respectively. Compared with individuals with the lowest quartile, participants with the fourth quartile of the Adipo-IR were associated with intracranial atherosclerotic burden (common odds ratio [cOR]: 1.35; 95% confidence interval [CI]: 0.99-1.82), coronary plaque (odds ratio [OR]: 1.45; 95% CI: 1.15-1.83), and segment stenosis score (cOR: 1.44; 95% CI: 1.15-1.81) after adjustment for age, sex, and current smoking. Adipose tissue-specific insulin resistance is associated with atherosclerotic burden and plaques in intracranial and coronary arteries in Chinese community nondiabetic residents.

Diagnosis and Vulnerability Risk Assessment of Atherosclerotic Plaques Using an Amino Acid-Assembled Near-Infrared Ratiometric Nanoprobe.

To reduce the risk of atherosclerotic disease, it is necessary to not only diagnose the presence of atherosclerotic plaques but also assess the vulnerability risk of plaques. Accurate detection of the reactive oxygen species (ROS) level at plaque sites represents a reliable way to assess the plaque vulnerability. Herein, through a simple one-pot reaction, two near-infrared (NIR) fluorescent dyes, one is ROS responsive and the other is inert to ROS, are coassembled in an amphiphilic amino acid-assembled nanoparticle. In the prepared NIR fluorescent amino acid nanoparticle (named FANP), the fluorescent properties and ROS-responsive behaviors of the two fluorescent dyes are well maintained. Surface camouflage through red blood cell membrane (RBCM) encapsulation endows the finally obtained FANP@RBCM nanoprobe with not only further reduced cytotoxicity and improved biocompatibility but also increased immune escape capability, prolonged blood circulation time, and thus enhanced accumulation at atherosclerotic plaque sites. In vitro and in vivo experiments demonstrate that FANP@RBCM not only works well in probing the occurrence of atherosclerotic plaques but also enables plaque vulnerability assessment through the accurate detection of the ROS level at plaque sites in a reliable ratiometric mode, thereby holding great promise as a versatile tool for the diagnosis and risk assessment of atherosclerotic disease.

UNATTENDED AUTOMATIC BLOOD PRESSURE MEASUREMENTS VS. CONVENTIONAL OFFICE READINGS IN PREDICTING HYPERTENSION-MEDIATED ORGAN DAMAGE

Objective: Hypertension, a major cardiovascular risk, requires accurate blood pressure measurement. Conventional office measurements (OBPM) are error-prone and systematically biased by the white coat effect. Unattended office blood pressure measurement (UOBPM) is emerging as an alternative to mitigate this bias. However, its ability to predict hypertension-mediated organ damage (HMOD), indicating disease progression, remains debated. This study compares UOBPM with OBPM in terms of their association with various HMODs, including left ventricular hypertrophy (LVH), left atrial enlargement (LAE), left ventricular systolic and diastolic dysfunction, intima-media complex (IMT) thickening, microalbuminuria and abnormal pulse wave velocity (PWV). Design and method: Hypertensive patients without overt cardiovascular disease were recruited, interviewed, and examined. Subsequently, blood pressure measurements were conducted in standard conditions in a randomized sequence in each patient: 1) UOBPM: After 5 minutes of solitary rest in the examination room, blood pressure was automatically measured three times at 1-minute intervals with OMRON HEM 907 device. 2) OBPM: After 5 minutes of rest, a physician performed three automated measurements at 1-minute intervals with the same device. Subsequent evaluations aimed to detect HMODs, including echocardiography, carotid artery ultrasound, PWV assessment, and laboratory tests. Receiver operating characteristic (ROC) analysis was performed for each HMOD in both measurement groups, and the areas under the ROC curves were compared. Results: The study enrolled 219 patients(55% females, mean age 55 ±14 years). The average systolic blood pressure in UOBPM was lower by 4,2 mmHg (p<0,001) compared to OBP while the difference in diastolic pressure was 1,9 mmHg (p<0,001). Both measurement methods were associated with the presence of the following HMODs: LAE, IMT thickening, and abnormal PWV. Neither method allowed for the prediction of LVH, systolic and diastolic dysfunction of the left ventricle, elevated ACR, or the presence of atherosclerotic plaques in the carotid arteries. Furthermore, ROC curve analyses revealed no difference between the two methods in predicting HMOD (Table 1). Conclusions: Both measurement techniques exhibited satisfactory predictive ability for the presence of certain HMOD. However, based on the study results, no significant differences could be inferred between the two methods with respect to their predictive performance.

Identification of microRNA biomarkers simultaneously expressed in circulating extracellular vesicles and atherosclerotic plaques.

Atherosclerosis is a widespread disorder of the cardiovascular system. The early detection of plaques by circulating biomarkers is highly clinically relevant to prevent the occurrence of major complications such as stroke or heart attacks. It is known that extracellular vesicles (EVs) are important in intercellular communication in atherosclerotic disorders and carry many components of their cells of origin, including microRNAs (miRNAs). In this study, we test the assumption that miRNAs present in material acquired from plaques in patients undergoing surgery for atherosclerotic carotid artery stenosis are also expressed in circulating EVs obtained from the identical patients. This would allow the adoption of a liquid biopsy approach for the detection of plaques. We studied 22 surgical patients with atherosclerotic carotid arterial stenosis and 28 healthy controls. EVs were isolated from serum by precipitation. miRNA expression profiles of serum-derived EVs were obtained by small RNA sequencing and in plaque material simultaneously acquired from patients. A comparative analysis was performed to identify circulating atherosclerosis-associated miRNAs that are also detectable in plaques. Seven miRNAs were found to be differentially regulated in patient serum compared with the serum of healthy controls. Of these, miR-193b-5p, miR-193a-5p, and miR-125a-3p were significantly upregulated in patients compared with that in healthy controls and present in both, circulating EVs and plaque material. An overrepresentation analysis of experimentally validated mRNA targets revealed an increased regulation of inflammation and vascular growth factors, key players in atherosclerosis and plaque formation. Our findings suggest that circulating EVs reflect plaque development in patients with symptomatic carotid artery stenosis, which can serve as biomarker candidates for detecting the presence of atherosclerotic plaques.

Examination of a cardiac patient, by using carotid artery ultrasound screening: possibilities of telemedicine

In clinical practice, there is a high workload of ultrasound (US) diagnostic rooms and a long waiting time for patients to be examined. For targeted selection of patients for expert US, it is possible for clinicians to conduct focus studies according to short protocols, which can be implemented using extramobile US devices. Objective. To assess the possibility of using telemedicine technologies to train cardiologists in an US-assisted primary examination of patients at an outpatient stage, as well as to evaluate the quality of this US by expert doctors. Material and methods. After briefly learning how to use a Philips Lumify handheld US device, two cardiologists independently examined the carotid arteries of patients, made conclusions about the presence of atherosclerotic plaques, and recorded the time spent on the examination. After each examination, the physician sent a video loop to an US expert, who assessed the quality of scanning. Results. The investigation enrolled 104 patients. The opinion of a cardiologist on the presence of an atherosclerotic plaque coincided with that of the expert in 66% of cases.

Dependency between local carotid arterial stiffness and the presence of atherosclerotic plaque in the carotid basin in hypertensive patients with type 2 diabetes mellitus

Aim. To assess the impact of atherosclerotic plaque (ASP) on the local arterial stiffness of the common carotid arteries (CCA) in patients with stage II hypertension (HTN) in combination with type 2 diabetes mellitus (T2DM). Materials and methods. The study included 37 patients with stage II HTN and T2DM (mean age 60.4 ± 10.7; 66.7 % male). Patients were divided into two groups: 20 individuals with ASP and <50 % stenosis in the carotid basin, 17 without ASP. The study involved a clinical examination, body weight and percentage of adipose tissue (AT) measurements, analysis of lipid and carbohydrate metabolism laboratory parameters, echocardiography, CCA ultrasound examination with the determination of local stiffness and intima-media complex thickness (IMT). Statistical analysis was performed, significant differences were considered at p < 0.05. Results. The whole-body AT percentage <39.51 % increases the odds ratio (OR) of ASP by 6 times (p = 0.02), an exceeding compliance coefficient (CC) over 0.68 mm2/kPa – by 12.7 times (p = 0.02), right CCA-IMT of over 639 µm – by 1.012 times (p = 0.001), and the factors are mutually reinforcing in the multivariate models and independent of age, sex, body mass index, and glycated hemoglobin level. Ascending aorta dilatation of over 3.34 cm increases the OR of ASP by 11.6 times (p = 0.0107); the factor is enhanced after adjusting for elevated total cholesterol levels over >6.35 mmol/l (p = 0.036) and independent of age and sex. A greater left CCA diameter of more than 8.59 mm (p < 0.019) and right CCA diameter of more than 8.1 mm (p < 0.0001) increases the OR of ASP by 3.7 times (p = 0.001) and 6.6 times (p = 0.0013), respectively, the factor influence increases after adjusting for elevated total cholesterol levels over >6.35 mmol/l (p = 0.031) and it is also unaffected by age and sex. Conclusions. In individuals with stage II HTN and T2DM, the presence of CA atherosclerosis with stenosis up to 50 % is associated with a significantly increased CCA and ascending aorta diameter, a decreased percentage of AT, and an increased compliance coefficient of plaque-free wall segments.

Association of left ventricular diastolic function with parameters of arterial stiffness and atherosclerotic plaques in the carotid basin in hypertensive patients

Aim. Тo assess changes in the left ventricular diastolic dysfunction (LVDD) indicators depending on the elastic properties of the common carotid arteries (CCA) and the presence of atherosclerotic plaque (ASP) in patients with stage II hypertension (HTS). Materials and methods. 48 patients with stage II HTS were involved in the study, the average age was 55.9 ± 11.2, 45.8 % men, among whom 14 did not have LVDD, 34 – had type I LVDD; 25 people did not have ASP, 23 people had ASP. Basic anthropometric data, echocardiographic indicators, QIMT, local stiffness indicators were studied: arterial diameter, distensibility, DC, CC, stiffness indices α, β, local PWV, augmentation pressure and index (using RF-QIMT, RF-QAS technologies). Statistical analysis was performed, the probability of differences is at the level of p < 0.05. Results. Significant differences in the stiffness parameters of the common carotid arteries were observed in patients with stage II HTS with LVDD: the diameter of the artery is higher by 6.5 % (p = 0.032), the stiffness index α – 28.3 % (р = 0.008), stiffness index β – 28.1 % (р = 0.009), PWV – 9.8 % (р = 0.004), DC is lower by 50.0 % (р = 0.021). A negative correlation of average strength was observed between e’med, e’lat, e’tv and stiffness indices α, β and PWV; E/e’, e’lat, e’tv had the average strength positive correlation with DC, CC indicators. The diameter of the carotid artery had a positive medium strength correlation with the thickness of the IVS (r = +0.38), LVFW (r = +0.47), RWT (r = +0.32), and LVMI (r = +0.57), diameter of the LA (r = +0.50) and had significant differences between 4 types of LV remodeling. The odds ratio of ASP in CCA increases by 1.32 times (p = 0.038) in the case of an excess of a’med more than 7 cm/c (sensitivity 95.7 %, specificity 28.0 %, p = 0.038); the influence of factor increases with a simultaneous increase in the diameter of the CCA over 7.94 mm (sensitivity 59.1 %, specificity 81.6 %, p = 0.005), and this prognostic model does not depend on age andgender. Conclusions. In persons with stage II HTS, the presence of type I LVDD is associated with an increase in the local stiffness and diameter of the CCA, just as the presence of ASP is associated with worse indicators of LVDD, in particular, a significant increase in a’med, regardless of age and gender.

Dependence of local carotid arterial stiffness on the presence of atherosclerotic plaque in the carotid basin in hypertensive patients

Aim. To evaluate the viscoelastic properties of the common carotid arteries (CCA) in patients with stage II hypertension (HTN) and to compare these indicators between groups with and without carotid artery (CA) stenosis <50 %. Materials and methods. The study included 48 patients with stage II HTN, mean age – 55.9 years, 45.8 % men. Basic anthropometric data, laboratory parameters of lipid and carbohydrate metabolism, creatinine, quality intima-media thickness (QIMT), local stiffness indicators: artery diameter, distensibility, distensibility coefficient (DC), compliance coefficient (CC), stiffness indices α, β, local pulse wave velocity (PWV), pressure and augmentation index (using RF-QIMT, RF-QAS technologies) were studied. Statistical analysis was performed, p values of < 0.05 were considered statistically significant. Results. CA atheromas with stenosis up to 50 % were found in 48 % of the examined, they were older with higher parameters of vessel diameter by 4.6 %, QIMT – by 12.5 %, α index – by 28.0 %, β index – by 27.7 %, and PWV – by 14.7 %. A medium-strength positive correlation has been revealed for age, QIMT, HDL, creatinine level and local stiffness parameters (distensibility, CC, PWV, indices α, β). The atherosclerotic plaque (ASP) presence in the CA was associated with the limit levels of the left CCA QIMT over 698 μm (sensitivity 65.2 %, specificity 86.6 %, p < 0.01), of the right – over 598 μm (sensitivity 73.9 %, specificity 66.6 %, p < 0.01). However, a greater dependence on age than on the presence of atheroma has been proven. At the same time, the odds ratio of the ASP presence was 2.99-fold higher (p = 0.0065) with an increase in the CCA diameter of more than 7.94 mm, and in the multivariate model incorporating age – 2.6-fold higher (p = 0.036), while age has not impacted significantly (p = 0.301) the prognosis. Conclusions. In individuals with stage II HTN, the presence of CA atherosclerosis with stenosis up to 50 % is associated with a significant increase in vessel diameter regardless of age. CCA intima media thickness depends more on the age of hypertensive patients.

Association Between Clonal Hematopoiesis Driver Mutations, Immune Cell Function, and the Vasculometabolic Complications of Obesity.

Obesity is accompanied by dysregulated inflammation, which can contribute to vasculometabolic complications including metabolic syndrome and atherosclerosis. Recently, clonal hematopoiesis of indeterminate potential (CHIP) has emerged as a risk factor for cardiovascular diseases. We aimed to determine how CHIP is related to immune cell function, systemic inflammation, and vasculometabolic complications in obese individuals. Two hundred ninety-seven individuals with overweight and obesity, between the ages of 54 and 81 years, were recruited in a cross-sectional study. Clonal hematopoiesis driver mutations (CHDMs) were identified with an ultrasensitive targeted assay. Assessment of carotid artery atherosclerosis was performed with ultrasound. Detailed immunological parameters, including cytokine production capacity of peripheral blood mononuclear cells, and targeted plasma proteomics analysis, were studied. Adipose tissue inflammation was determined in subcutaneous fat biopsies. Individuals with CHIP had higher concentrations of circulating IL (interleukin)-6. Total number of leukocytes and neutrophils were higher in individuals with CHIP. In contrast, exvivo cytokine production capacity of peripheral blood mononuclear cells was significantly lower in individuals with CHIP. Sex-stratified analysis showed that men with CHDMs had significantly higher leukocyte and neutrophil counts, and exvivo cytokine production capacity was lower in women with CHDMs. Surprisingly, the presence of atherosclerotic plaques was significantly lower in individuals with CHDMs. There was no relation between CHIP and metabolic syndrome. In individuals with overweight or obesity, CHDMs are not associated with vasculometabolic complications, but rather with a lower presence of carotid plaques. CHDMs associate with increased circulating inflammatory markers and leukocyte numbers, but a lower peripheral blood mononuclear cell cytokine production capacity.

Low-level exposure to lead and atherosclerosis in the carotid arteries: Results from the Swedish population-based cohort SCAPIS

BackgroundLead exposure is associated with cardiovascular disease. Atherosclerosis has been hypothesized to be one of the underlying mechanisms behind this association. AimTo investigate whether lead exposure is associated with an increased risk of atherosclerosis in the carotid arteries in a large Swedish population-based cohort. MethodsWe performed a cross-sectional study using data from the population-based Swedish CardioPulmonary bioImage Study (SCAPIS), including 5622 middle-aged men and women, enrolled 2013–2018. Blood lead (B–Pb), measured by inductively coupled plasma mass spectrometry, was used as exposure biomarker. The presence of atherosclerotic plaque in the carotid arteries (yes/no), total plaque area (mm2) and the presence of large plaques (>25 mm2) were determined by ultrasonography. Associations between B–Pb and the different outcomes were analysed using Poisson and linear regression models, adjusted for potential confounders. ResultsAtherosclerotic plaque was present in 57% of the individuals, for whom the median total plaque area was 16 mm2 (range: 0.2–222). The median B–Pb concentration was 14 μg/L (range: 0.75–203). After adjusting for potential confounders, individuals in the fourth quartile of B–Pb (Q4) had a prevalence ratio (PR) for plaque of 1.08 (95% CI: 1.01, 1.16) when compared with the first quartile (Q1). A 10 μg/L increase in B–Pb concentrations was associated with an increase of 0.92 mm2 (95% CI: 0.14, 1.71) in total plaque area. The PR for large plaque was 1.09 (95% CI: 0.84, 1.42 for Q4 vs Q1). ConclusionsThis study shows an association between B–Pb and atherosclerosis in the carotid arteries providing some support for the hypothesis that atherosclerosis is one of the mechanisms underlying the association between lead exposure and cardiovascular disease.

Abstract 16364: Presence of Ramus Intermedius Artery is Associated With Higher Atherosclerotic Plaque Burden in the Left Main Stem in Coronary CT Angiography

Introduction: Ramus intermedius (RI) is a variant vessel arising from left main (LM) bifurcation that supplies the lateral wall. It is thought that presence of RI would result in increased coronary turbulence in LM which in return could affect atherosclerotic plaque formation process. We aimed to investigate the association of presence of RI with presence of atherosclerotic plaque and stenosis in left main (LM). Hypothesis: Presence of RI artery associates with higher frequency of atherosclerotic plaque formation in LM Methods: We performed a large retrospective single-center study, including consecutive subjects who completed a CTA exam from October 2006 to December 2022 in Los Angeles, California to determine if presence of RI associated with higher LM coronary plaque burden. Chi-Square test was used to examine level of left main plaque burden and percent stenosis in subjects where the Ramus is present versus absent. Results: Among the 11,497 subjects, the average age was 62.0±12.4 years, 64% male, and 11% had the Ramus segment present. Those with a Ramus segment present were more likely to have mild, moderate or severe plaque burden (41% versus 26%, p=<0.0001) in their left main. (Table 1). Additionally, subjects with RI has higher prevalence of any degree of LM stenosis compared to those without RI (P-Value<0.0001). Conclusions: Our results suggest that the presence of RI is associated with higher prevalence of atherosclerotic plaques and higher degree of stenosis in LM stem.

The FCGR2A Is Associated with the Presence of Atherosclerotic Plaques in the Carotid Arteries-A Case-Control Study.

Atherosclerotic plaques in carotid arteries (APCA) are a prevalent condition with severe potential complications. Studies continuously search for innovative biomarkers for APCA, including those participating in cellular metabolic processes, cell adhesion, immune response, and complement activation. This study aimed to assess the relationship between APCA presence and a broad range of cardiometabolic biomarkers in the general population. The study group consisted of consecutive participants of the population study Bialystok PLUS. The proximity extension assay (PEA) technique from the Olink Laboratory (Uppsala, Sweden) was used to measure the levels of 92 cardiometabolic biomarkers. The study comprised 693 participants (mean age 48.78 ± 15.27 years, 43.4% males, N = 301). APCA was identified in 46.2% of the participants (N = 320). Of the 92 biomarkers that were investigated, 54 were found to be significantly linked to the diagnosis of APCA. After adjusting for the traditional risk factors for atherosclerosis in multivariate analysis, the only biomarker that remained significantly associated with APCA was FCGR2A. In the general population, the prevalence of APCA is very high. A range of biomarkers are linked with APCA. Nonetheless, the majority of these associations are explained by traditional risk factors for atherosclerosis. The only biomarker that was independently associated with APCA was the FCGR2A.

Prevalence of atherosclerosis in individuals with prediabetes and diabetes compared to normoglycaemic individuals—a Swedish population-based study

BackgroundPatients with type 2 diabetes have an increased risk of death and cardiovascular events and people with diabetes or prediabetes have been found to have increased atherosclerotic burden in the coronary and carotid arteries. This study will estimate the cross-sectional prevalence of atherosclerosis in the coronary and carotid arteries in individuals with prediabetes and diabetes, compared with normoglycaemic individuals in a large population-based cohort.MethodsThe 30,154 study participants, 50–64 years, were categorized according to their fasting glycaemic status or self-reported data as normoglycaemic, prediabetes, and previously undetected or known diabetes. Prevalence of affected coronary artery segments, severity of stenosis and coronary artery calcium score (CACS) were determined by coronary computed tomography angiography. Total atherosclerotic burden was assessed in the 11 clinically most relevant segments using the Segment Involvement Score and as the presence of any coronary atherosclerosis. The presence of atherosclerotic plaque in the carotid arteries was determined by ultrasound examination.ResultsStudy participants with prediabetes (n = 4804, 16.0%) or diabetes (n = 2282, 7.6%) had greater coronary artery plaque burden, more coronary stenosis and higher CACS than normoglycaemic participants (all, p < 0.01). Among male participants with diabetes 35.3% had CACS ≥ 100 compared to 16.1% among normoglycaemic participants. For women, the corresponding figures were 8.9% vs 6.1%. The prevalence of atherosclerosis in the coronary arteries was higher in participants with previously undetected diabetes than prediabetes, but lower than in patients with known diabetes. The prevalence of any plaque in the carotid arteries was higher in participants with prediabetes or diabetes than in normoglycaemic participants.ConclusionsIn this large population-based cohort of currently asymptomatic people, the atherosclerotic burden in the coronary and carotid arteries increased with increasing degree of dysglycaemia. The finding that the atherosclerotic burden in the coronary arteries in the undetected diabetes category was midway between the prediabetes category and patients with known diabetes may have implications for screening strategies and tailored prevention interventions for people with dysglycaemia in the future.

Low adherence to the Mediterranean diet is associated with increased prevalence and number of atherosclerotic plaques in the ILERVAS cohort

Background and aimsCurrent research on the association between dietary patterns and subclinical atherosclerotic disease (SAD) is still limited, and published results are inconsistent and often consist of small population sizes. We aimed to evaluate the association between the Mediterranean diet (MDiet) and SAD in a large cohort of Mediterranean individuals. MethodsThis was a cross-sectional study that included 8116 subjects from the ILERVAS cohort. The presence of atherosclerotic plaques (AP) was assessed by ultrasound examination. Adherence to the MDiet was assessed using the 14-item Mediterranean Diet Adherence Score (MEDAS). Inclusion criteria were subjects with at least one cardiovascular risk factor. Exclusion criteria were a clinical history of diabetes, chronic kidney disease, or a prior cardiovascular event. Bivariable and multivariable models were performed. ResultsCompared with subjects without SAD, participants with SAD were older and had a higher frequency of smoking habit, hypertension, dyslipidemia, HbA1c and waist circumference. The adjusted multivariable analysis showed that a higher MEDAS was associated with a lower risk of AP (incidence rate ratios [IRR] 0.97, 95% CI [0.96–0.98]; p<0.001). Furthermore, moderate or high adherence to the MDiet was associated with a lower number of AP compared with a low MDiet adherence (IRR 0.90, 95% CI [0.87–0.94]; p<0.001). In both models, female sex was associated with a lower risk of AP. ConclusionsOur findings point to a potentially protective role of MDiet for SAD in a Mediterranean population with low-to-moderate cardiovascular risk. Further research is needed to establish a causal relationship between both variables.

SERUM PROTEOMIC PROFILING OF CAROTID ATHEROSCLEROSIS: A POPULATION OUTCOME STUDY

Objective: Circulating proteins linked to atherosclerosis may improve cardiovascular (CV) disease prediction. Here, we applied proteomic profiling, feature selection and unbiased clustering to identify proteins associated with carotid atherosclerosis and integrate them in a protein-based classification system for prediction of future CV events. Design and method: 491 community-dwelling participants (mean age, 58±11 years; 51% women) underwent carotid ultrasonography and proteomic profiling (CVD II panel, Olink Proteomics) at baseline. Subsequently, we collected cardiovascular outcome for a median follow-up period of 10.2 years. We applied partial least squares (PLS) and a machine learning algorithm (Random Forest, RF) to identify proteins associated with carotid intima-media thickness (cIMT) and the presence of atherosclerotic plaques. Next, we assessed the association of future CV events with protein-based phenogroups defined by unbiased clustering (Gaussian Mixture modelling) based on influential proteins in PLS and RF. Results: Of 92 measured proteins, 13 were labelled as important by PLS and RF and were independently associated with cIMT and/or the presence of plaques after multivariable adjustment: pro-adrenomedullin, agouti-related protein, brother of CDO, CD40 ligand, CD84, GLO1, HB-EGF, HSP27, lipoprotein lipase, lymphotactin, PAR-1, PDGF subunit B and TGM2. Based on these proteins, the clustering algorithm subdivided the cohort into two distinct phenogroups. Compared to the first (n = 174), participants in the second phenogroup (n = 317) had: i) a more unfavourable lipid profile with higher total cholesterol and triglycerides and lower HDL cholesterol (P&lt;0.014 for all), but no differences in other CV risk factors such as age, blood pressure, smoking status and diabetes mellitus (P&gt;0.061 for all); ii) higher cIMT (P = 0.0020); and iii) a significantly higher risk for future CV events during follow-up (multivariable-adjusted hazard ratio (95% CI) versus cluster 1: 2.63 (1.25 to 5.56); P = 0.01). Conclusions: Carotid atherosclerosis was linked to proteins reflecting haemostasis, angiogenesis, blood pressure regulation and inflammation. Focused proteomic phenomapping adequately identified individuals at high risk for future CV events and may thus complement current CV risk stratification strategies.

The contribution of competing mechanisms in stroke despite anticoagulation in patients with atrial fibrillation.

For reasons poorly understood, strokes frequently occur in patients with atrial fibrillation (AF) despite oral anticoagulation. Better data are needed to inform randomised trials (RCTs) of new strategies to prevent recurrence in these patients. We investigate the relative contribution of competing stroke mechanisms in patients with AF who have stroke despite anticoagulation (OAC+) compared with those who are anticoagulant naïve (OAC-) at the time of their event. We performed a cross-sectional study leveraging data from a prospective stroke registry (2015-2022). Eligible patients had ischemic stroke and AF. Stroke classification was performed by a single stroke-specialist blinded to OAC status using TOAST criteria. The presence of atherosclerotic plaque was determined using duplex ultrasonography, computerised tomography (CT) or magnetic resonance (MR) angiography. Imaging was reviewed by a single reader. Logistic regression was used to identify independent predictors of stroke despite anticoagulation. Of 596 patients included, 198 (33.2%) were in the OAC+ group. A competing cause for stroke was more frequent in patients with OAC+ versus OAC- (69/198 (34.8%)) versus 77/398 (19.3%), p < 0.001). After adjustment, both small vessel occlusion (odds ratio (OR): 2.46, 95% CI: 1.20-5.06) and arterial atheroma (⩾50% stenosis) (OR: 1.78, 95% CI: 1.07-2.94) were independently associated with stroke despite anticoagulation. Patients with AF-associated stroke despite OAC are much more likely than patients who are OAC-naïve to have competing stroke mechanisms. Rigorous investigation for alternative stroke causes in stroke despite OAC has a high diagnostic yield. These data should be used to guide patient selection for future RCTs in this population.

Toraks BT'de mediastinal yağ dokusu ve aort ölçümleri: ateroskleroz ile ilişkisi var mı?

Aim: We aimed to investigate whether the mediastinal adipose tissue plays a role in thoracic aortic atherosclerosis with thoracic Computed Tomography (CT) imaging. We aimed to elucidate the relationship between the amount and density of mediastinal adipose tissue, age, sex, and the presence of atherosclerotic plaque in the aorta.&#x0D; Material and Method: In this retrospective study, the thoracic computed tomography (CT) images of 45 patients (21 men and 24 women) were examined in two groups. There were 23 patients aged &gt;60 years in group 1 and 22 patients aged 60 years (group 1) and

Desorption of cholesterol from model membranes by β-cyclodextrins: Characterizing plaque fighting compounds via quartz crystal microgravimetry with dissipation monitoring.

Atherosclerosis is induced by low-density lipoprotein cholesterol retention in arterial walls and is identifiable by the presence of atherosclerotic plaques. Supported lipid bilayers (SLBs) are model membrane interfaces that resemble biological cell membranes and can be constructed with various combinations of lipid compositions. Herein, we exploit the solvent-assisted lipid bilayer (SALB) formation method to construct SLB model membranes with varying cholesterol compositions to create a novel lipid-sterol interface atop of biosensors. Cholesterol-laden SLBs are utilized as surfaces where quantitative investigations of various molecules’ cholesterol-fighting competencies can occur. At constant flow, we introduced the cyclodextrins 2-hydroxypropyl-beta-cyclodextrin (HPBCD) and methyl-beta-cyclodextrin (MBCD) atop the membranes of varying cholesterol mol fractions and measured changes in relative areal mass and surface viscosity. Quartz crystal microgravimetry with dissipation monitoring allowed for the collection of these measurements in vitro, overtime. Aggregated experimental desorption data correlates as expected with the relative hydrophobicities and topological polar surface areas of the drug candidates. Data also supports a steady-state kinetic model mechanism for our lipid-cholesterol-drug interface. Overall, our findings demonstrate that MBCD not only removes a distinct quantity of cholesterol greater than that of HPBCD, but MBCD also outperforms the rate constant of cholesterol desorption of HPBCD by a factor of 8.

Assessment of the prevalence of target organ damage at various stages of the cardiometabolic continuum. According to the ESSE RF study

Objective: to assess the prevalence of target organ damage (TOD) at various stages of the cardiometabolic continuum, including abdominal obesity (AO) without metabolic syndrome (MS), MS, and type 2 diabetes mellitus (DM).Materials and methods: this study presents an analysis of data from a sample of residents of Tomsk (1,104 examined from an unorganized adult population of 25-64 years), performed within the framework of the ESSAY RF-2012 project (Epidemiology of Cardiovascular Diseases in the Regions of the Russian Federation). The analysis included the presence of LV hypertrophy (LVH), a decrease in glomerular filtration rate (GFR), an increase in the thickness of the intima-media complex (TIM), the presence of atherosclerotic plaques (ASP) in the common carotid arteries (CCA).Results: TODs were already reported among individuals with isolated AO (without MS), whose prevalence was statistically significantly higher compared to those with normal body weight. Atherosclerosis of CCA turned out to be the most frequent TOD phenotype, ASP was detected in 22% of individuals with isolated AO, in 33% patients with MS and 35% patients with type 2 DM, the second most common was LVH, which was detected in 0.8%, 4,7% and 17,5% of cases, respectively, the least common was a decrease in GFR – in 1,37%, 3,7% and 6,7% of patients, respectively. Differences in the frequency of TOD in all groups were statistically significant (p &lt; 0,01).Conclusions: Thus, the prevalence of TODs detected already at the stage of isolated AO progressively increased from group to group, as they moved along the cardiometabolic continuum.