Journal articles on the topic 'Subclinical atherosclerosi'
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1
Drapkina, O. M., O. N. Korneeva, and N. V. Mankova. "Subclinical atherosclerosis: The benefits of calcium antagonists." "Arterial’naya Gipertenziya" ("Arterial Hypertension") 18, no. 2 (April 28, 2012): 118–25. http://dx.doi.org/10.18705/1607-419x-2012-18-2-118-125.
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Recently the research has been focused on the earlier stages of the atherosclerotic process, i.e. subclinical atherosclerosis. Endothelial dysfunction is a suitable marker of subclinical atherosclerosis. In routine clinical practice, ultrasonography is the most useful and accessible non-invasive method for diagnosis of subclinical atherosclerosis. Carotid intimai media thickness (IMT) was shown to be predictive for the risk of cardiovascular events. Furthermore, vascular stiffness can be a helpful marker for assessment of the vascular wall state and blood flow. Calcium antagonists (CA) seem to be promising for the prevention of subclinical atherosclerosis progression, and amlodipine has the priority due to the metabolic neutralilty, vasodilation effect and favourable effects on renal hemodynamics. The data on IMT assessement showed that amlodipine slows down the development of atherosclerotic lesions in hypertensive patients.
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Казакова, М. И., and Н. П. Митьковская. "Subclinical Coronary Atherosclerosis: Significance in Cardiovascular Risk Stratification." Кардиология в Беларуси, no. 4 (September 26, 2022): 482–91. http://dx.doi.org/10.34883/pi.2022.14.4.010.
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Сердечно-сосудистые заболевания остаются ведущей причиной заболеваемости и смертности во всем мире и в системе здравоохранения обуславливают самую высокую долю затрат. Патоморфологической основой ишемической болезни сердца в подавляющем большинстве клинических ситуаций является атеросклероз коронарных артерий. В последнее время множество исследований посвящено изучению ранней стадии атеросклероза – субклинического атеросклероза. Дестабилизация гемодинамически незначимых, бессимптомных атеросклеротических бляшек может привести к развитию инфаркта миокарда. В статье обсуждается распространенность, клиническая значимость необструктивного атеросклероза коронарных артерий. Отдельное внимание уделено шкалам стратификации сердечно-сосудистого риска. Обозначены современные методы диагностики коронарного атеросклероза, методы визуализации «нестабильных» атеросклеротических бляшек. В реальной клинической практике оценить «нестабильность» атеросклеротической бляшки не представляется возможным, поэтому сам факт наличия субклинического атеросклероза коронарных артерий позволяет отнести пациента к категории высокого и очень высокого риска. Cardiovascular diseases remain the leading cause of mortality and morbidity worldwide and represent the highest proportion of costs in healthcare systems. In the vast majority of cases, the pathomorphological basis of coronary heart disease is coronary artery atherosclerosis. Many of the recent research have been devoted to the study of the early stage of atherosclerosis – subclinical atherosclerosis. Destabilization of hemodynamically insignificant, asymptomatic atherosclerotic plaques can lead to the development of myocardial infarction. The article discusses the prevalence and clinical significance of non- obstructive atherosclerosis of the coronary arteries. Special attention is devoted to the scales of cardiovascular risk stratification. Modern methods of coronary atherosclerosis diagnosis, methods of visualization of unstable atherosclerotic plaques are outlined. Considering that it is impossible to assess the instability of atherosclerotic plaque in real clinical practice, the presence of subclinical coronary atherosclerosis itself allows the patient to be classified as high and very high risk.
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Boytsov, S. A., V. V. Kukharchuk, Yu A. Karpov, I. V. Sergienko, O. M. Drapkina, A. E. Semenova, and S. Zh Urazalina. "Subclinical atherosclerosis as a risk factor of cardiovascular events." Cardiovascular Therapy and Prevention 11, no. 3 (June 20, 2012): 82–86. http://dx.doi.org/10.15829/1728-8800-2012-3-82-86.
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Subclinical atherosclerosis is an initial, latent stage of chronic progressing arterial inflammation. Destabilisation of asymptomatic, hemodynamically non-significant atherosclerotic plaques (AP) could lead to myocardial infarction, stroke, or sudden death. Since the assessment of AP stability is problematic in real-world clinical settings, the risk stratification should, at least, account for the presence of subclinical atherosclerosis. In 600 ambulatory patients from the Moscow City Western Administrative Okrug who had low and moderate SCORE-assessed cardiovascular risk levels, the prevalence of AP, based on the duplex carotid ultrasound results, was 59% (n=358). Presently, no standard guidelines exist on cardiovascular risk stratification which would include the assessment of subclinical atherosclerosis, despite the importance of the latter as a prognostic factor. Large clinical studies on prognosis in patients with subclinical atherosclerosis will clarify the role of this parameter as an independent cardiovascular risk factor and facilitate the development of respective clinical recommendations.
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Onalan, Orhan, Adem Adar, Hakan Keles, Goksen Ertugrul, Nurhayat Ozkan, Habibullah Aktas, and Ekrem Karakaya. "Onychomycosis is associated with subclinical atherosclerosis in patients with diabetes." Vasa 44, no. 1 (January 1, 2015): 59–64. http://dx.doi.org/10.1024/0301-1526/a000407.
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Background: We aimed to investigate the association of toenail onychomycosis with subclinical atherosclerosis in patients with diabetes mellitus. Patients and methods: Consecutive diabetic patients who were seen at our outpatient clinic were enrolled. The carotid intima-media thickness (CIMT) was assessed and toenail onychomycosis was diagnosed with microscopic evaluation. Results: We investigated 127 patients with diabetes melltus type 2. Overall, the prevalence of toenail onychomycosis was 37.8 % (48 of 127). Of the 127 patients, 60 (47.2 %) had subclinical atherosclerosis (CIMT ≥ 1 mm). Prevalence of male gender (43.3 % vs. 22.4 %, p = 0.012) and onychomycosis (53.3 % vs. 23.9 %, p = 0.001) was significantly higher in patients with subclinical atherosclerosis. Among biochemical parameters, low-density lipoprotein (122 ± 38 mg/dL vs. 108 ± 36 mg/dL, p = 0.039) and glycosylated hemoglobin levels (median 8.4 %, IQR: 2.1 % vs. median 7.5 %, IQR: 1.6 %, p = 0.002) were significantly higher in patients with subclinical atherosclerosis. Study groups were similar with respect to all other demographic, clinical, and laboratory parameters. After adjustment for all potential confounders, the presence of onychomycosis was independently associated with subclinical atherosclerosis (OR 2.77, 95 % CI 1.16 to 6.30) in multivariate logistic regression analysis. Conclusions: Presence of onychomycosis in patients with diabetes is associated with subclinical atherosclerosis. Onychomycosis may be a marker of atherosclerotic arterial involvement.
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Kousios, Andreas, Panayiotis Kouis, and Andrie G. Panayiotou. "Matrix Metalloproteinases and Subclinical Atherosclerosis in Chronic Kidney Disease: A Systematic Review." International Journal of Nephrology 2016 (2016): 1–11. http://dx.doi.org/10.1155/2016/9498013.
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Background.Cardiovascular disease (CVD) remains a significant problem in Chronic Kidney Disease (CKD). Subclinical atherosclerosis identified by noninvasive methods could improve CVD risk prediction in CKD but these methods are often unavailable. We therefore systematically reviewed whether circulating levels of Matrix Metalloproteinases (MMPs) and tissue inhibitors (TIMPs) are associated with subclinical atherosclerosis in CKD, as this would support their use as biomarkers or pharmacologic targets.Methods.All major electronic databases were systematically searched from inception until May 2015 using appropriate terms. Studies involving CKD patients with data on circulating MMPs levels and atherosclerosis were considered and subjected to quality assessment.Results.Overall, 16 studies were identified for qualitative synthesis and 9 studies were included in quantitative synthesis. MMP-2 and TIMP-1 were most frequently studied while most studies assessed carotid Intima-Media Thickness (cIMT) as a measure of subclinical atherosclerosis. Only MMP-2 demonstrated a consistent positive association with cIMT. Considerable variability in cIMT measurement methodology and poor plaque assessment was found.Conclusions.Although MMPs demonstrate great potential as biomarkers of subclinical atherosclerosis, they are understudied in CKD and not enough data existed for meta-analysis. Larger studies involving several MMPs, with more homogenized approaches in determining the atherosclerotic burden in CKD, are needed.
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Genkel, Vadim, Ilya Dolgushin, Irina Baturina, Albina Savochkina, Karina Nikushkina, Anna Minasova, Lubov Pykhova, Veronika Sumerkina, Alla Kuznetsova, and Igor Shaposhnik. "Circulating Ageing Neutrophils as a Marker of Asymptomatic Polyvascular Atherosclerosis in Statin-Naïve Patients without Established Cardiovascular Disease." International Journal of Molecular Sciences 23, no. 17 (September 5, 2022): 10195. http://dx.doi.org/10.3390/ijms231710195.
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Background: Current data on the possible involvement of aging neutrophils in atherogenesis are limited. This study aimed to research the diagnostic value of aging neutrophils in their relation to subclinical atherosclerosis in statin-naïve patients without established atherosclerotic cardiovascular diseases (ASCVD). Methods: The study was carried out on 151 statin-naïve patients aged 40–64 years old without ASCVD. All patients underwent duplex scanning of the carotid arteries, lower limb arteries and abdominal aorta. Phenotyping and differentiation of neutrophil subpopulations were performed through flow cytometry (Navios 6/2, Beckman Coulter, USA). Results: The number of CD62LloCXCR4hi-neutrophils is known to be significantly higher in patients with subclinical atherosclerosis compared with patients without atherosclerosis (p = 0.006). An increase in the number of CD62LloCXCR4hi-neutrophils above cut-off values makes it possible to predict atherosclerosis in at least one vascular bed with sensitivity of 35.4–50.5% and specificity of 80.0–92.1%, in two vascular beds with sensitivity of 44.7–84.4% and specificity of 80.8–33.3%. Conclusion: In statin-naïve patients 40–64 years old without established ASCVD with subclinical atherosclerosis, there is an increase in circulating CD62LloCXCR4hi-neutrophils. It was also concluded that the increase in the number of circulating CD62LloCXCR4hi-neutrophils demonstrated moderate diagnostic efficiency (AUC 0.617–0.656) in relation to the detection of subclinical atherosclerosis, including polyvascular atherosclerosis.
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Tsiogka, Aikaterini, Stamatios Gregoriou, Alexander Stratigos, Stergios Soulaidopoulos, Natalia Rompoti, Pantelis Panagakis, Marina Papoutsaki, et al. "The Impact of Treatment with IL-17/IL-23 Inhibitors on Subclinical Atherosclerosis in Patients with Plaque Psoriasis and/or Psoriatic Arthritis: A Systematic Review." Biomedicines 11, no. 2 (January 23, 2023): 318. http://dx.doi.org/10.3390/biomedicines11020318.
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Accumulating evidence considers psoriasis a systemic inflammatory disorder that is associated with comorbidities such as psoriatic arthritis, cardiovascular disease, and metabolic syndrome. Although the precise pathogenetic links between psoriasis and atherosclerosis warrants further investigation, it is believed that chronic systemic inflammation along with the T helper (Th)-1 and Th17 polarization are associated with endothelial dysfunction and subsequent acceleration of atherosclerosis. Considering the above, several studies have evaluated if optimal control of the inflammation in psoriasis by inhibiting interleukins targeting the Interleukin (IL)-23/Th17 axis could subsequently reduce the atherosclerotic process during anti-psoriatic treatment by using a variety of surrogate markers of subclinical atherosclerosis. This systematic review summarizes current knowledge on the pathogenetic mechanisms and diagnostic evaluation of atherosclerosis in the context of psoriasis and provides a systematic review of the literature on the impact of treatment with biologics targeting the IL-23/Th17 axis on subclinical atherosclerosis in patients with plaque psoriasis and/or psoriatic arthritis.
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Katamadze, N. O., L. L. Berstein, and Yu N. Grishkin. "Subclinical atherosclerosis diagnostics as a component of a modern strategy for cardiovascular risk stratification." Cardiovascular Therapy and Prevention 11, no. 2 (April 20, 2012): 76–84. http://dx.doi.org/10.15829/1728-8800-2012-2-76-84.
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Cardiovascular risk (CVR) stratification plays an important role in the primary prevention of atherosclerosis and associated disorders. The standard scales for CVR assessment (Framingham scale, SCORE scale, etc.) are focused on a limited number of traditional risk factors (RFs) and, therefore, neither produce precise individual risk estimates, nor increase the effectiveness of preventive interventions. One of the methods for CVR assessment optimisation is the diagnostics of subclinical atherosclerosis, based on the direct visualisation of preclinical atherosclerotic changes in arterial wall. Extracranial carotid artery (CA) ultrasound and assessment of the intima-media thickness (IMT) index or atherosclerotic plaque volume (PV) is an important method of the preclinical atherosclerosis diagnostics. The review discusses pathogenetic mechanisms of IMT increase, the standards of ultrasound IMT assessment and its interpretation, and the role of the information obtained for optimization of the CVR evaluation.
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Simerzin, V. V., O. V. Fatenkov, T. V. Malykhina, I. V. Gagloeva, M. A. Galkina, T. E. Molchanova, and Yu R. Yunusova. "THE VERIFICATION OF SUBCLINICAL CAROTID ATHEROSCLEROSIS IN THE RISK STRATIFICATION AT PRIMARY CARDIOVASCULAR PROPHYLAXIS." Morphological newsletter 25, no. 3 (September 30, 2017): 58–62. http://dx.doi.org/10.20340/mv-mn.17(25).03.58-62.
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In this review of literature present duplex scanning technology as modern noninvasive information technique of subclinical carotid atherosclerosis verification. The article gives assessment and description of intima-media complex thicknesses and atherosclerotic plaques in patients risk stratification within the scope of primary cardiovascular prophylaxis.
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Ahmad, Garg, Dhar, Srivastava, Biswas, P. Barthwal, Shirazi, and Srivastava. "Predictors of atherosclerosis in rheumatoid arthritis." Vasa 41, no. 5 (August 1, 2012): 353–59. http://dx.doi.org/10.1024/0301-1526/a000221.
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Background: Atherosclerosis is emerging as an important complication of rheumatoid arthritis (RA), with coronary artery disease being projected as the major cause of mortality in these patients.This study was undertaken to evaluate the presence of subclinical atherosclerosis and to identify the risk factors of atherosclerosis in patients with RA. Patients and methods: All consecutive in- and out-patients of rheumatoid arthritis (n = 100) irrespective of the disease duration were included in the study. A group of 100 age and sex matched controls were also studied. Increased carotid intima media thickness (beyond the 75th percentile for age and sex), presence of plaques, ankle brachial pressure index and QT dispersion were deemed as non-invasive measures of atherosclerotic burden. Results: Fifty patients (50.0 %) with RA had evidence of subclinical atherosclerosis as compared to the control group (n = 11, 11 %); plaques were observed in 26 patients. Eighteen (36 %) of these developed this evidence within 1 - 5 years of disease onset. Low HDL levels among the conventional risk factors and advanced patient age, longer disease duration, greater number of involved joint areas, steroid use and indices of inflammation in particular in RA, were associated with subclinical atherosclerosis. Sustained inflammation was observed throughout the sub-group with atherosclerosis irrespective of the disease duration. Conclusions: RA is a pro-atherogenic state with the process of atherosclerosis initiated in the early stage of the disease. Besides the traditional risk factors, sustained inflammation contributes to atherogenesis.
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Muljadi, Rusli, Bachtiar Murtala, Peter Kabo, and FX Budhianto Suhadi. "Comparison between Carotid Intima-Media Thickness and Coronary Artery Calcification in the Prediction of Atherosclerosis in Diabetic Patients." Indonesian Biomedical Journal 6, no. 1 (April 1, 2014): 45. http://dx.doi.org/10.18585/inabj.v6i1.42.
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BACKGROUND: Cardiovascular disease is one of the atherosclerosis etiologies that can lead to death. Diabetes mellitus increases the risk of atherosclerosis. Screening tool is very beneficial for detecting atherosclerotic plaque, especially in subclinical atherosclerotic cases. Carotid intima-media thickness (CIMT) and coronary artery calcification score (CACS) are two kinds of tools that are widely used, and each of these tools has its own superiority. This study was aimed to investigate the sensitivity and specificity of both of these tools as screening tools.METHODS: The study was conducted with a cross sectional design involving 43 diabetic and 68 non-diabetic male subjects aged above 45 years old. All subjects fulfilled inclusion criteria. Carotid artery ultrasonography and CACS measurement were performed.RESULTS: Fischer exact test was used to show a significant correlation between CIMT and CACS (p<0.05). Diagnostic test was used to assess the sensitivity of CIMT toward CACS in above 75 percentile. The left common carotid artery (LCCA) showed the highest sensitivity either in diabetic (76.4%) or non-diabetic male subjects (90%).CONCLUSION: CIMT has the same sensitivity with CACS. CIMT can be used as the preferred screening tool for high risk patients and as a substitution tool to CACS for low risk patients in subclinical atherosclerosis detection.KEYWORDS: atherosclerosis, diabetes mellitus, carotid intima-media thickness, coronary artery calciication score
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Siscovick, David, Frits Rosendaal, and Alexander Reiner. "Hemostatic Risk Factors and Arterial Thrombotic Disease." Thrombosis and Haemostasis 85, no. 04 (2001): 584–95. http://dx.doi.org/10.1055/s-0037-1615638.
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SummaryThe pathogenesis of arterial thrombotic disease involves multiple genetic and environmental factors related to atherosclerosis and thrombosis. Acute thrombosis at the site of a ruptured, lipid-rich atherosclerotic plaque is the usual precipitating event in the transition from stable or subclinical atherosclerotic disease to acute myocardial infarction (MI), stroke, or peripheral arterial occlusion (1). Pathologic studies of coronary arteries in acute MI suggest that the acute thrombosis likely involves activation of both platelets and the coagulation system.
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Awan, Sobia, Asma Kiyani, Pooner Fiaz Aman, Syeda Midhat Fatima, Abdul Hameed Siddiqui, and Farid-Ur Rehman. "Frequency of Subclinical Atherosclerosis in Patients of Psoriasis." Pakistan Armed Forces Medical Journal 72, SUPPL-3 (November 29, 2022): S683–87. http://dx.doi.org/10.51253/pafmj.v72isuppl-3.9607.
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Objective: To find out how common subclinical atherosclerosis is in psoriasis patients.
Study Design: Descriptive cross-sectional study
Place and Duration of Study: Dermatology unit of Fauji Foundation, Rawalpindi Pakistan, from Jan 2020 to Jun 2020.
Methodology: After receiving informed consent, 314 cases that met the selection criteria were enrolled. Psoriasis was diagnosed depending on physical examination the family history of patients. Ultrasonography high-resolution B mode was opted to assess carotid atherosclerosis (Xario color Doppler probe frequency 5 to 7mHZ.). If the (IMT) was less than 0.9mm, it was regarded normal; values greater than 0.9mm were termed thickened intima, while digits greater than 1.5mm were considered atherosclerotic plaque. SPSS version 21.0 was used for data analysis.
Results: Age of patients was from 18 to 70 years old, with a Mean±SD (44.00 ±12.12) years. Males made up 47(15%) of the population, while females made up 267(85%). There were 33(10.5%) smokers and 281(89.5%) non-smokers. The mean IMT was 0.84±0.61, with 0.1mm and 2.05mm as the minimum and maximum, respectively. Subclinical atherosclerosis was found in 96 patients (30.6%) (p<0.05). SPSS 21 was used to enter and evaluate the data. Age, BMI, IMT, and disease duration were all expressed as a Mean±SD. Other parameters like gender, smoking, subclinical atherosclerosis be measured by frequency and percentage.
Conclusion: Subclinical atherosclerosis is significantly higher in patients of psoriasis. Early detection and management can help to reduce risks of cardiovascular complications.
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Medina, J., F. Aramburu, C. González Montagut, D. Sánchez, and E. Loza. "OP0122 SUBCLINICAL ATHEROSCLEROSIS OF FEMORAL ARTERIES IN RHEUMATOID ARTHRITIS. AN ULTRASOUND STUDY." Annals of the Rheumatic Diseases 79, Suppl 1 (June 2020): 80.1–81. http://dx.doi.org/10.1136/annrheumdis-2020-eular.2378.
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Background:Cardiovascular morbidity and mortality is increased in patients with rheumatoid arthritis (RA). This cannot be entirely explained by traditional risk factors. Inflammation and autoimmunity may play a role in the cardiovascular risk excess. Subclinical atherosclerosis is associated with a risk comparable to established coronary heart disease. In RA it has been investigated by carotid artery ultrasound and carotid atherosclerotic plaques are more prevalent in RA patients than controls. EULAR recommendations for cardiovascular disease risk management consider that carotid ultrasound may be part of the risk evaluation in patients with RA. Recent studies in general population have shown that plaques in femoral arteries are more common and are associated with higher cardiovascular risk.Objectives:To study the usefulness of femoral artery ultrasound for the detection of subclinical atherosclerosis and its ability to improve cardiovascular risk assessment in RA patients.Methods:Cross-sectional observational study of prevalence in 140 RA patients aged 40 to 65 years. Subclinical atherosclerosis was evaluated by carotid and femoral artery ultrasound.Results:Atherosclerotic plaques were found in 86.4% of RA patients (60.7% in carotid arteries and 78.6% in femoral arteries). Patients with plaques were older and more frequently past or present tobacco users. Femoral plaques were larger and more numerous than the carotid plaques and people with plaques in both locations had more extensive subclinical atherosclerotic disease (table). Only 7.9% of RA patients were considered as having very high cardiovascular risk by clinical factors, after carotid ultrasound this increased to 57.1% and after femoral ultrasound to 86.4%.Conclusion:Ultrasound examinations of the femoral artery in addition to the carotid artery increased the detection of subclinical atherosclerosis and determine a group of patients with higher intensity of atherosclerotic disease. Examinations of both arteries allowed a greater number of RA patients previously considered to have low to moderate cardiovascular risk to be classified as very high cardiovascular risk.References:[1]Agca R, Heslinga SC, Rollefstad S, Heslinga M, McInnes IB, Peters MJL, et al. EULAR recommendations for cardiovascular disease risk management in patients with rheumatoid arthritis and other forms of inflammatory joint disorders: 2015/2016 update. Ann Rheum Dis. 2017 Jan;76(1):17–28.[2]Ambrosino P, Lupoli R, Di Minno A, Tasso M, Peluso R, Di Minno MND. Subclinical atherosclerosis in patients with rheumatoid arthritis. A meta-analysis of literature studies. Thromb Haemost. 2015 May;113(5):916–30.[3]Laclaustra M, Casasnovas JA, Fernández-Ortiz A, Fuster V, León-Latre M, Jiménez-Borreguero LJ, et al. Femoral and Carotid Subclinical Atherosclerosis Association With Risk Factors and Coronary Calcium: The AWHS Study. J Am Coll Cardiol. 2016 Mar 22;67(11):1263–74.TableOnly carotid plaquesn= 11Only femoral plaquesn= 36Femoral and carotid plaquesn= 74Number of carotid plaques per patient1,3 ± 0,5-2,5 ±2,0*Carotid plaques size (mm)1,63 ±0,20-2,08 ±0,69*Number of femoral plaques per patient-2,3 ±1,73,7 ± 2,9**Femoral plaque size (mm)-2,20 ± 0,593,10 ± 1,10**Total number of plaques per patient1,3 ± 0,52,3 ± 1,7*6,2 ± 4,3***†Results in mean ± sd. *p<0,05 vs only carotid plaques. **p<0,05 vs only femoral plaques. ***p<0,05 vs only carotid plaques and only femoral plaques.Disclosure of Interests:Julio Medina: None declared, Francisco Aramburu: None declared, Carmen González Montagut: None declared, Dolores Sánchez: None declared, Estíbaliz Loza Grant/research support from: Roche, Pfizer, Abbvie, MSD, Novartis, Gebro, Adacap, Astellas, BMS, Lylly, Sanofi, Eisai, Leo, Sobi
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Bergström, Göran, Margaretha Persson, Martin Adiels, Elias Björnson, Carl Bonander, Håkan Ahlström, Joakim Alfredsson, et al. "Prevalence of Subclinical Coronary Artery Atherosclerosis in the General Population." Circulation 144, no. 12 (September 21, 2021): 916–29. http://dx.doi.org/10.1161/circulationaha.121.055340.
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Background: Early detection of coronary atherosclerosis using coronary computed tomography angiography (CCTA), in addition to coronary artery calcification (CAC) scoring, may help inform prevention strategies. We used CCTA to determine the prevalence, severity, and characteristics of coronary atherosclerosis and its association with CAC scores in a general population. Methods: We recruited 30 154 randomly invited individuals age 50 to 64 years to SCAPIS (the Swedish Cardiopulmonary Bioimage Study). The study includes individuals without known coronary heart disease (ie, no previous myocardial infarctions or cardiac procedures) and with high-quality results from CCTA and CAC imaging performed using dedicated dual-source CT scanners. Noncontrast images were scored for CAC. CCTA images were visually read and scored for coronary atherosclerosis per segment (defined as no atherosclerosis, 1% to 49% stenosis, or ≥50% stenosis). External validity of prevalence estimates was evaluated using inverse probability for participation weighting and Swedish register data. Results: In total, 25 182 individuals without known coronary heart disease were included (50.6% women). Any CCTA-detected atherosclerosis was found in 42.1%; any significant stenosis (≥50%) in 5.2%; left main, proximal left anterior descending artery, or 3-vessel disease in 1.9%; and any noncalcified plaques in 8.3% of this population. Onset of atherosclerosis was delayed on average by 10 years in women. Atherosclerosis was more prevalent in older individuals and predominantly found in the proximal left anterior descending artery. Prevalence of CCTA-detected atherosclerosis increased with increasing CAC scores. Among those with a CAC score >400, all had atherosclerosis and 45.7% had significant stenosis. In those with 0 CAC, 5.5% had atherosclerosis and 0.4% had significant stenosis. In participants with 0 CAC and intermediate 10-year risk of atherosclerotic cardiovascular disease according to the pooled cohort equation, 9.2% had CCTA-verified atherosclerosis. Prevalence estimates had excellent external validity and changed marginally when adjusted to the age-matched Swedish background population. Conclusions: Using CCTA in a large, random sample of the general population without established disease, we showed that silent coronary atherosclerosis is common in this population. High CAC scores convey a significant probability of substantial stenosis, and 0 CAC does not exclude atherosclerosis, particularly in those at higher baseline risk.
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Tóth, Štefan, Peter Olexa, Zdenka Hertelyová, Peter Štefanič, Ivan Kopolovets, Peter Berek, Vladimir Filip, Ryan Chakravarty, Monika Široká, and Daniel Pella. "PCSK9 concentrations in different stages of subclinical atherosclerosis and their relationship with inflammation." Open Chemistry 18, no. 1 (August 7, 2020): 1011–19. http://dx.doi.org/10.1515/chem-2020-0147.
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AbstractThe aim of this study was to detect the concentrations of PCSK9 in various subclinical stages of atherosclerosis and to highlight its relationship with inflammation. One hundred and fifty-nine healthy patients were divided into three groups, based on the extent of atherosclerotic changes in the carotid artery: a group without identifiable atherosclerosis, cIMT>75‰ and an asymptomatic plaque group. The PCSK9 was measured by ELISA and hsCRP by the immunoturbidimetric method. Vascular changes were identified by a carotid ultrasound. PCSK9 was elevated, when comparing the healthy group with the cIMT>75‰ group; however, no significant increase was detected between cIMT>75‰ and the asymptomatic plaque group. A positive linear correlation of the PCSK9 concentration and atherosclerotic changes was found; however, after the re-analysis in each group, this correlation persisted only in the group with still normal values. Additionally, a significant linear correlation was found between the PCSK9 concentrations and lipid parameters. However, no significant association was found with hsCRP. PCSK9 was found to be elevated only in cIMT>75‰, but not in the later plaque stage. A linear correlation of PCSK9 values was detected only in the group with still reference values. Based on this fact, we assumed the direct linear role of PCSK9 in initiating atherosclerosis; however, in the later phases, the relationship, which highlights other risk factors such as inflammation, is not linear.
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Bielak, Lawrence F., Richard B. Horenstein, Kathleen A. Ryan, Patrick F. Sheedy, John A. Rumberger, Keith Tanner, Wendy Post, Braxton D. Mitchell, Alan R. Shuldiner, and Patricia A. Peyser. "Circulating CD34+ Cell Count is Associated with Extent of Subclinical Atherosclerosis in Asymptomatic Amish Men, Independent of 10-Year Framingham Risk." Clinical medicine. Cardiology 3 (January 2009): CMC.S2111. http://dx.doi.org/10.4137/cmc.s2111.
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Background Bone-marrow derived progenitor cells (PCs) may play a role in maintaining vascular health by actively repairing damaged endothelium. The purpose of this study in asymptomatic Old Order Amish men (n = 90) without hypertension or diabetes was to determine if PC count, as determined by CD34+ cell count in peripheral blood, was associated with 10-year risk of cardiovascular disease (CVD) and measures of subclinical atherosclerosis. Methods and Results CD34+ cell count by fluorescence-activated cell sorting, coronary artery calcification (CAC) by electron beam computed tomography, and CVD risk factors were obtained. Carotid intimal-medial thickness (CIMT) also was obtained in a subset of 57 men. After adjusting for 10-year CVD risk, CD34+ cell count was significantly associated with CAC quantity ( p =0.03) and CIMT ( p < 0.0001). A 1-unit increase in natural-log transformed CD34+ cell count was associated with an estimated 55.2% decrease (95% CI: −77.8% to −9.3%) in CAC quantity and an estimated 14.3% decrease (95% CI: −20.1% to −8.1%) in CIMT. Conclusions Increased CD34+ cell count was associated with a decrease in extent of subclinical atherosclerosis in multiple arterial beds, independent of 10-year CVD risk. Further investigations of associations of CD34+ cell count with subclinical atherosclerosis in asymptomatic individuals could provide mechanistic insights into the atherosclerotic process.
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Fowkes, F. G. R., J. F. Price, and G. C. Leng. "Targeting subclinical atherosclerosis." BMJ 316, no. 7147 (June 13, 1998): 1764–70. http://dx.doi.org/10.1136/bmj.316.7147.1764.
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Kolchina, М. А., O. V. Kosmatova, V. E. Novikov, and I. A. Skripnikova. "Early markers of athrosclerotic cardiovascular diseases and osteoporotic fractures in a postmenopausal woman (сlinical case)." Clinician 13, no. 3-4 (January 30, 2020): 53–58. http://dx.doi.org/10.17650/1818-8338-2019-13-3-4-53-58.
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The aim to demonstrate that subclinical atherosclerosis and vascular rigidity in a postmenopausal patient without clinical sings of cardiovascular disease and osteoporosis are connected with a decreased bone mass.Materials and methods. Patient O., 64 years old, was examined at the National Medical Research Center for Preventive Medicine within the program “Comprehensive assessment of total risks and early preclinical markers of osteoporosis and atherosclerosis complications”. No complaints during the examination were revealed. Laboratory tests were performed to evaluate blood lipids level, calcium-phosphorus metabolism, determine marker of bone resorption – CTX (β-crosslaps), measure levels of vitamin D and parathyroid hormone. Instrumental examinations included dual-energy x-ray absorptiometry of the spine and femoral neck, carotid ultrasound, applanation tonometry, multispiral computed tomography of coronary arteries with calcium score determination.Results. During outpatient examination, densitometry revealed decreased bone mineral density in the lumbar spine and in the femoral neck, corresponding to osteoporosis, carotid ultrasound identified atherosclerotic plaques, multispiral computed tomography of coronary arteries – coronary calcification, applanation tonometry – increased aortic stiffness.Conclusion. The clinical case is an example of early-detected preclinical signs of atherosclerosis and osteoporosis, as well as an increased risk of cardiovascular complications. Due to the high frequency of subclinical atherosclerosis, vessel wall state should be examined in women at the beginning of postmenopause. Signs of vascular stiffness and subclinical atherosclerosis give occasion to assess risk of fractures using the FRAX ® calculator and, if necessary, to diagnose bone mass loss using X-ray densitometry. Proposed algorithm can contribute to the early detection of cardiovascular diseases and at the same time improve fracture risk assessment.
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Kocyigit, Duygu, Kadri Murat Gurses, Muhammed Ulvi Yalcin, and Lale Tokgozoglu. "Role of Micronutrients on Subclinical Atherosclerosis Micronutrients in Subclinical Atherosclerosis." Current Pharmaceutical Design 22, no. 2 (December 21, 2015): 221–29. http://dx.doi.org/10.2174/1381612822666151112150020.
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Nasonov, E. L., and T. V. Popkova. "Role of interleukin 1 in the development of atherosclerosis." Rheumatology Science and Practice 56 (April 3, 2019): 28–34. http://dx.doi.org/10.14412/1995-4484-2018-28-34.
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Atherosclerosis is now considered as chronic inflammatory vascular disease connected to «pathological» activation of innate and adaptive immunity, characterized by lipid deposition, leukocyte infiltration and proliferation of vascular smooth muscle cells. Subclinical (low grade) inflammation plays fundamental role at all stages of atherosclerotic process progression and determines cardiovascular catastrophes development and mortality. Proinflammatory cytokines including interleukin (IL) 1, IL6, tumor necrosis factor α (TNFα), IL17, IL18, IL27, IL33, IL37 tightly interacting within cytokine network occupy an important place among numerous mediators participating in immunopathogenesis of atherosclerosis and rheumatoid arthritis. IL1β playing an important role in the development of many acute and chronic immunoinflammatory diseases attracts particular attention. IL1β significance in the development of atherosclerosis is determined by many mechanisms including procoagulant activity, enhancement of monocytes and leucocytes adhesion to vascular endothelium, vascular smooth muscle cells growth and others. Fundamental role of inflammation in the development of atherosclerosis is well proved in investigations of anti-atherosclerotic effect of canakinumab. Randomized placebo-controlled trial CANTOS (Canakinumab ANti-inflammatory Thrombosis Otcomes Study) assessing efficacy of canakinumab as new tool for secondary prophylaxis cardiovascular complications in general population of patients with severe atherosclerotic vascular damage. CANTOS results in combination with accumulated in rheumatology data on cardiovascular effects of anti-inflammatory drugs are of great importance for personification of approach to secondary prophylaxis of caused by atherosclerosis cardiovascular complications. They also contribute to the development of inflammatory theory of atherosclerosis pathogenesis in the whole.
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Dolgushi, I. I., V. V. Genkel, I. L. Baturina, A. Yu Savochkina, A. A. Minasova, K. V. Nikushkina, L. R. Pykhova, A. S. Kuznetcova, and I. I. Shaposhnik. "Interactions between immunosuppressor neutrophiles, innate and adaptive immunity indexes in the patients with subclinical atherosclerosis." Medical Immunology (Russia) 24, no. 2 (April 20, 2022): 283–94. http://dx.doi.org/10.15789/1563-0625-ibi-2463.
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The last fifteen years have been marked by rapid progress in the study of neutrophils. The discovery of transcriptional plasticity of neutrophils, their phenotypic and functional heterogeneity contributed to launching active interdisciplinary studies on the role of neutrophils in various chronic inflammatory diseases. Increased systemic circulation of immunosuppressive neutrophils can be observed not only in sepsis, but also in chronic systemic inflammation, which, along with disorders of lipid metabolism, is the major mechanism of atherosclerosis development and progression. Monocytes, dendritic cells, Tlymphocytes and neutrophils are key participants and modulators of inflammation in atherosclerosis. Potential significance of immunosuppressive neutrophils in atherogenesis and regulation of inflammatory response in atherosclerosis has not been currently established. However, taking into account their possible effects upon T lymphocytes and innate immunity cells, the study of immunosuppressive neutrophils seems promising in the context of atherosclerosis and atherosclerotic cardiovascular diseases. The purpose of this study was to evaluate relationship between the numbers of circulating immunosuppressive neutrophils and subpopulations of T cells and monocytes in the patients with subclinical atherosclerosis. The study enrolled patients aged 40-64 years with subclinical atherosclerosis of peripheral arteries. Subpopulations of neutrophils, lymphocytes and monocytes were phenotyped by flow cytometry using “Navios 6/2” (Beckman Coulter). 133 patients, 65 (48.8%) males and 68 (51.2%) females were included into the study. Correlation analysis showed that increased number of circulating CD16hiCD11bloCD62Lbr neutrophils was associated with increased number of regulatory T lymphocytes. The patients with subclinical atherosclerosis and absolute numbers of circulating immunosuppressive neutrophils within the first quartile (<136 cells/μL) had a statistically significantly lower number of regulatory T lymphocytes compared with patients in the 2-4 quartiles. An increase in immunosuppressive neutrophils was associated with decreased number of classical monocytes expressing TLR4 (r = -0.335; p = 0.004), and a decrease in TLR2 surface expression intensity (r = -0.268; p = 0.023) on the non-classical monocytes. In patients with subclinical atherosclerosis of 40-64 years old, an increase in immunosuppressive CD16hiCD11bloCD62Lbr neutrophils was associated with increase in regulatory T lymphocytes and nonclassical monocytes, as well as decrease in classic monocytes expressing TLR4, and lower intensity of TLR2 expression on the non-classical monocytes.
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Barakoti, Murari Prasad. "Carotid intima-media thickness and coronary artery Disease." Nepalese Heart Journal 15, no. 1 (May 8, 2018): 9–15. http://dx.doi.org/10.3126/njh.v15i1.19705.
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It is known from the post-mortem studies of accidental death that atherosclerotic process begins in childhood and gradually progresses over decades. Only when the process leads to flow limiting stenosis as a gradual narrowing or when a thrombus forms at a site of plaque due to rupture or erosion, then the clinical cardiovascular event is manifested. Although only a certain percentage of people with underlying atherosclerosis become manifest, the greater degree of subclinical atherosclerosis is associated with greater chance of future events. The event could be sudden cardiac death at its extreme. The ultrasound measurement of carotid intima-media thickness (CIMT) has withstood test of time as an important technique of measuring atherosclerotic burden. It has been more than three decades to know the value of CIMT in the risk prediction.NepaleseHeart Journal 2018; 15(1): 9-15
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Verma, Vijay Kumar. "Carotid artery intima media thickness in relation with atherosclerotic risk factors in patients with newly diagnosed type 2 diabetes mellitus in a rural tertiary care hospital in central India." International Journal of Research in Medical Sciences 6, no. 1 (December 23, 2017): 293. http://dx.doi.org/10.18203/2320-6012.ijrms20175737.
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Background: Vascular complications of atherosclerosis are major causes of morbidity and mortality in patients with type 2 diabetes mellitus (T2DM). The aim of the study was to study the correlation between carotid artery intima media thickness (CIMT) and risk factors for atherosclerosis and atherosclerotic vascular events in newly diagnosed type 2 diabetes mellitus patients with an objective to determine the predictive value of CIMT as an indicator of early atherosclerosis.Methods: The predictive value of CIMT as well as various atherosclerotic risk factors including ankle brachial index (ABI) were determined as an indicator of early atherosclerosis. Data were presented in form of percentage and proportions. Qualitative variables were tested using Chi square test and the p values were calculated between the groups having CIMT less than and more than 0.9 mm. p values of ≤0.05 were considered statistically significant. Averages were expressed between groups as mean ±standard deviation or as percentage. Multivariate analysis was done using the multiple linear regression model.Results: The study showed that though age, smoking and dyslipidemia did not show any association with CIMT; hypertension, ABI, glycosylated hemoglobin and urine albumin excretion rate had positive correlation with CIMT with statistically significant association between ABI and CIMT.Conclusions: Assessment of CIMT by B mode ultrasound is a relatively inexpensive means of measuring subclinical atherosclerosis. Present study showed that CIMT is significantly higher in those type 2 diabetic patients who had atherosclerotic events than in those type 2 diabetic patients who had only risk factors for atherosclerosis.
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Das, Apabrita Ayan, Devasmita Chakravarty, Debmalya Bhunia, Surajit Ghosh, Prakash C. Mandal, Khawer N. Siddiqui, and Arun Bandyopadhyay. "Elevated level of circulatory sTLT1 induces inflammation through SYK/MEK/ERK signalling in coronary artery disease." Clinical Science 133, no. 22 (November 2019): 2283–99. http://dx.doi.org/10.1042/cs20190999.
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Abstract The role of inflammation in all phases of atherosclerotic process is well established and soluble TREM-like transcript 1 (sTLT1) is reported to be associated with chronic inflammation. Yet, no information is available about the involvement of sTLT1 in atherosclerotic cardiovascular disease. Present study was undertaken to determine the pathophysiological significance of sTLT1 in atherosclerosis by employing an observational study on human subjects (n=117) followed by experiments in human macrophages and atherosclerotic apolipoprotein E (apoE)−/− mice. Plasma level of sTLT1 was found to be significantly (P<0.05) higher in clinical (2342 ± 184 pg/ml) and subclinical cases (1773 ± 118 pg/ml) than healthy controls (461 ± 57 pg/ml). Moreover, statistical analyses further indicated that sTLT1 was not only associated with common risk factors for Coronary Artery Disease (CAD) in both clinical and subclinical groups but also strongly correlated with disease severity. Ex vivo studies on macrophages showed that sTLT1 interacts with Fcɣ receptor I (FcɣRI) to activate spleen tyrosine kinase (SYK)-mediated downstream MAP kinase signalling cascade to activate nuclear factor-κ B (NF-kB). Activation of NF-kB induces secretion of tumour necrosis factor-α (TNF-α) from macrophage cells that plays pivotal role in governing the persistence of chronic inflammation. Atherosclerotic apoE−/− mice also showed high levels of sTLT1 and TNF-α in nearly occluded aortic stage indicating the contribution of sTLT1 in inflammation. Our results clearly demonstrate that sTLT1 is clinically related to the risk factors of CAD. We also showed that binding of sTLT1 with macrophage membrane receptor, FcɣR1 initiates inflammatory signals in macrophages suggesting its critical role in thrombus development and atherosclerosis.
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Lehtinen, Allison B., Kathryn P. Burdon, Joshua P. Lewis, Carl D. Langefeld, Julie T. Ziegler, Stephen S. Rich, Thomas C. Register, J. Jeffrey Carr, Barry I. Freedman, and Donald W. Bowden. "Association of α2-Heremans-Schmid Glycoprotein Polymorphisms with Subclinical Atherosclerosis." Journal of Clinical Endocrinology & Metabolism 92, no. 1 (January 1, 2007): 345–52. http://dx.doi.org/10.1210/jc.2006-0429.
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Abstract Context: Cardiovascular disease is significantly increased in individuals with type 2 diabetes mellitus (T2DM), especially in the presence of calcified atherosclerotic plaque. Fetuin A is an important mineralization inhibitor, and polymorphisms in the corresponding α2-Heremans-Schmid glycoprotein (AHSG) gene have been shown to be associated with serum fetuin A levels and free phosphate levels, as well as cardiovascular disease death. Objective: This study investigated whether polymorphisms in AHSG contribute to the development of calcified atherosclerotic plaque in the coronary and carotid arteries and to carotid artery intima-media thickness. Design: Eleven single nucleotide polymorphisms (SNPs) in AHSG were genotyped and evaluated for association with quantitative measures of subclinical atherosclerosis. Participants: Subjects were 829 T2DM-affected European Americans from 368 families in the Diabetes Heart Study. Main Outcome Measures: Participants were phenotyped for cardiovascular risk factors and atherosclerosis traits. The extent of coronary artery calcified plaque (CorCP) and carotid artery calcified plaque (CarCP) was measured using quantitative computed tomography, and carotid artery intima-media thickness was measured using high-resolution B mode ultrasonography. Results: Four SNPs in AHSG were nominally associated with CorCP in European Americans with T2DM (P < 0.05). Two 3-SNP haplotypes in the exon 6–7 region were associated with CorCP in European Americans with T2DM (P < 0.06). Conclusions: Sequence variants in the AHSG gene affect the extent of CorCP in T2DM-affected European Americans, consistent with the known biological role of AHSG in vascular calcification. These data implicate AHSG in the development of vascular calcified plaque in diabetic subjects.
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Henein, Michael Y., Sergio Vancheri, Gani Bajraktari, and Federico Vancheri. "Coronary Atherosclerosis Imaging." Diagnostics 10, no. 2 (January 24, 2020): 65. http://dx.doi.org/10.3390/diagnostics10020065.
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Identifying patients at increased risk of coronary artery disease, before the atherosclerotic complications become clinically evident, is the aim of cardiovascular prevention. Imaging techniques provide direct assessment of coronary atherosclerotic burden and pathological characteristics of atherosclerotic lesions which may predict the progression of disease. Atherosclerosis imaging has been traditionally based on the evaluation of coronary luminal narrowing and stenosis. However, the degree of arterial obstruction is a poor predictor of subsequent acute events. More recent techniques focus on the high-resolution visualization of the arterial wall and the coronary plaques. Most acute coronary events are triggered by plaque rupture or erosion. Hence, atherosclerotic plaque imaging has generally focused on the detection of vulnerable plaque prone to rupture. However, atherosclerosis is a dynamic process and the plaque morphology and composition may change over time. Most vulnerable plaques undergo progressive transformation from high-risk to more stable and heavily calcified lesions, while others undergo subclinical rupture and healing. Although extensive plaque calcification is often associated with stable atherosclerosis, the extent of coronary artery calcification strongly correlates with the degree of atherosclerosis and with the rate of future cardiac events. Inflammation has a central role in atherogenesis, from plaque formation to rupture, hence in the development of acute coronary events. Morphologic plaque assessment, both invasive and non-invasive, gives limited information as to the current activity of the atherosclerotic disease. The addition of nuclear imaging, based on radioactive tracers targeted to the inflammatory components of the plaques, provides a highly sensitive assessment of coronary disease activity, thus distinguishing those patients who have stable disease from those with active plaque inflammation.
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Saranchina, Yu V., S. V. Dutova, O. Yu Kilina, N. V. Khanarin, and T. S. Kulakova. "The role of neutrophils in the pathogenesis of atherosclerosis." Cardiovascular Therapy and Prevention 17, no. 6 (December 20, 2018): 110–16. http://dx.doi.org/10.15829/1728-8800-2018-6-110-116.
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Atherosclerosis (AS) is one of the causes of cardiovascular disease. The formation of atherosclerotic lesions of the arteries is a long process, and clinical symptoms appear already at the stage of atherosclerotic plaque (ASB), which prevents blood flow and can cause coronary heart disease, as well as acute coronary syndrome. The study of atherosclerosis mechanisms at the subclinical level is relevant. This article provides a summary of current data on the structure and functions of neutrophils (NF) in physiological processes. Particular attention is paid to the participation of neutrophils in the damage and formation of vascular endothelial dysfunction. Discusses several mechanisms of involvement of neutrophils in atherogenesis: the production of reactive oxygen species, which cause direct endothelial damage; the synthesis of cytokines that trigger the migration of leukocytes in inflammation; the formation of protein complexes with cholesterol, contributing to their deposition in the vessels, and neutrophil traps, triggering destructive-alterative reactions.
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Peñalvo, José L., Elly Mertens, Ainara Muñoz-Cabrejas, Montserrat León-Latre, Estíbaliz Jarauta, Martín Laclaustra, José M. Ordovás, José Antonio Casasnovas, Irina Uzhova, and Belén Moreno-Franco. "Work Shift, Lifestyle Factors, and Subclinical Atherosclerosis in Spanish Male Workers: A Mediation Analysis." Nutrients 13, no. 4 (March 26, 2021): 1077. http://dx.doi.org/10.3390/nu13041077.
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(1) Background: Working night shifts has been associated with altered circadian rhythms, lifestyle habits, and cardiometabolic risks. No information on the potential association of working shift and the presence of atherosclerosis is available. The aim of this study was to quantify the association between different work shifts and the presence of subclinical atherosclerosis objectively measured by imaging. (2) Methods: Analyses were conducted on the baseline data of the Aragon Workers Health Study (AWHS) cohort, including information on 2459 middle-aged men. Categories of shift work included central day shift, rotating morning-evening or morning-evening-night shift, and night shift. The presence of atherosclerotic plaques was assessed by 2D ultrasound in the carotid and femoral vascular territories. Multivariable logistic models and mediation analysis were conducted to characterize and quantify the association between study variables. (3) Results: Participants working night or rotating shifts presented an overall worse cardiometabolic risk profile, as well as more detrimental lifestyle habits. Workers in the most intense (morning-evening-night) rotating shift presented higher odds of subclinical atherosclerosis (odds ratio: 1.6; 95% confidence interval: 1.12 to 2.27) compared to workers in the central shift, independently of the presence of lifestyle and metabolic risk factors. A considerable (21%) proportion of this association was found to be mediated by smoking, indicating that altered sleep-wake cycles have a direct relationship with the early presence of atherosclerotic lesions. (4) Conclusions: Work shifts should be factored in during workers health examinations, and when developing effective workplace wellness programs.
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Cismaru, Gabriel, Teodora Serban, and Alexandru Tirpe. "Ultrasound Methods in the Evaluation of Atherosclerosis: From Pathophysiology to Clinic." Biomedicines 9, no. 4 (April 13, 2021): 418. http://dx.doi.org/10.3390/biomedicines9040418.
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Atherosclerosis is a key pathological process that causes a plethora of pathologies, including coronary artery disease, peripheral artery disease, and ischemic stroke. The silent progression of the atherosclerotic disease prompts for new surveillance tools that can visualize, characterize, and provide a risk evaluation of the atherosclerotic plaque. Conventional ultrasound methods—bright (B)-mode US plus Doppler mode—provide a rapid, cost-efficient way to visualize an established plaque and give a rapid risk stratification of the patient through the Gray–Weale standardization—echolucent plaques with ≥50% stenosis have a significantly greater risk of ipsilateral stroke. Although rather disputed, the measurement of carotid intima-media thickness (C-IMT) may prove useful in identifying subclinical atherosclerosis. In addition, contrast-enhanced ultrasonography (CEUS) allows for a better image resolution and the visualization and quantification of plaque neovascularization, which has been correlated with future cardiovascular events. Newly emerging elastography techniques such as strain elastography and shear-wave elastography add a new dimension to this evaluation—the biomechanics of the arterial wall, which is altered in atherosclerosis. The invasive counterpart, intravascular ultrasound (IVUS), enables an individualized assessment of the anti-atherosclerotic therapies, as well as a direct risk assessment of these lesions through virtual histology IVUS.
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PETERS, MIKE J. L., IZHAR C. van EIJK, YVO M. SMULDERS, ERIK SERNE, BEN A. C. DIJKMANS, IRENE E. van der HORST-BRUINSMA, and MICHAEL T. NURMOHAMED. "Signs of Accelerated Preclinical Atherosclerosis in Patients with Ankylosing Spondylitis." Journal of Rheumatology 37, no. 1 (December 1, 2009): 161–66. http://dx.doi.org/10.3899/jrheum.090667.
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Objective.Preliminary evidence suggests that ankylosing spondylitis (AS) is associated with an increased cardiovascular (CV) risk. We investigated subclinical atherosclerosis and arterial stiffness in patients with AS compared with controls, and identified CV and AS related risk factors for atherosclerotic disease.Methods.A total of 59 patients with AS who were scheduled for etanercept treatment according to the ASsessments in Ankylosing Spondylitis guidelines and 30 healthy controls were recruited. Subclinical atherosclerosis was assessed as the average intima-media thickness (IMT) of the common carotid artery. Arterial stiffness was determined by distensibility, compliance, and Young’s elastic modulus of the carotid artery.Results.AS patients had a greater IMT (0.62 ± 0.09 mm vs 0.57 ± 0.09 mm in controls; p = 0.02), a difference that remained after adjustment for traditional CV risk factors. AS was associated with higher carotid pulse pressure (47 ± 7 mm Hg vs 44 ± 8 mm Hg in controls; p = 0.04), but this was not due to local vessel wall properties. Among AS patients, age and body mass index (BMI) were determinants of IMT. Age, BMI, total cholesterol, triglycerides, and disease duration were identified as determinants of stiffness indices. No relationship was found between large-vessel properties and higher Bath AS disease indices or C-reactive protein values.Conclusion.AS was associated with subclinical atherosclerosis and arterial stiffness, supporting epidemiological evidence of an increased CV risk in these patients. Whether these differences are due to AS or to a higher prevalence of CV risk factors in patients with AS remains to be determined.
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Posadas-Romero, Carlos, Esteban Jorge-Galarza, Rosalinda Posadas-Sánchez, Jorge Acuña-Valerio, Juan G. Juárez-Rojas, Eric Kimura-Hayama, Aida Medina-Urrutia, and Guillermo C. Cardoso-Saldaña. "Fatty liver largely explains associations of subclinical hypothyroidism with insulin resistance, metabolic syndrome, and subclinical coronary atherosclerosis." European Journal of Endocrinology 171, no. 3 (September 2014): 319–25. http://dx.doi.org/10.1530/eje-14-0150.
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BackgroundThe association of subclinical hypothyroidism (SCH) with insulin resistance, metabolic syndrome (MS), and coronary atherosclerosis is uncertain.ObjectiveTo investigate the role of increased intrahepatic fat in the association of SCH with insulin resistance, MS, and coronary atherosclerosis.Design, patients, and methodsWe conducted a cross-sectional study in a sample of 753 subjects (46% males) aged 35–70 years with no history of diabetes, renal, hepatic, thyroid, or coronary heart disease, and were participants of the Genetics of Atherosclerotic Disease study. SCH was defined as a high serum TSH level with normal free thyroxine concentration. Fatty liver (FL), coronary artery calcification (CAC), and abdominal visceral adipose tissue were assessed by computed tomography. Cross-sectional associations of SCH with and without FL, with MS, insulin resistance, and subclinical atherosclerosis defined as a CAC score >0, were examined in logistic regression models.ResultsSCH was observed in 17.7% of the population studied. The prevalence of FL was similar in both euthyroid and SCH subjects (31.8 vs 27.8%,P=0.371). SCH plus FL subjects were heavier and had more metabolic abnormalities compared with SCH plus normal liver subjects. In multivariate-adjusted logistic regression analyses, SCH plus FL was associated with MS (odds ratio (OR): 2.73, 95% CI: 1.26–5.92), insulin resistance (OR: 4.91, 95% CI: 1.63–14.75), and CAC score >0 (OR: 3.05, 95% CI: 1.20–7.76). SCH without FL showed no associations.ConclusionSCH with FL is associated with increased odds of MS, insulin resistance, and CAC, independent of potential confounders.
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Skripnikova, I. A., N. A. Alikhanova, M. A. Kolchina, O. V. Kosmatova, V. E. Novikov, V. A. Vygodin, and O. M. Drapkina. "RELATIONSHIP OF BONE MINERAL DENSITY AND VASCULAR WALL CONDITION WITH BIOCHEMICAL MARKERS OF INFLAMMATION IN POSTMENOPAUSAL WOMEN." Rheumatology Science and Practice 58, no. 3 (June 24, 2020): 276–80. http://dx.doi.org/10.14412/1995-4484-2020-276-280.
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Objective: to investigate the correlation of bone mass, the parameters of vascular stiffness and subclinical atherosclerosis with biochemical markers of inflammation in postmenopausal women. Subjects and methods. The cross-sectional investigation included 98 patients aged 45–82 years who were followed up in the outpatient setting and signed an informed consent. The investigation did not include patients with any clinical manifestations of atherosclerosis, malignant neoplasms, with diseases causing secondary osteoporosis, as well as with the presence of symptoms of acute bacterial or viral infections and an exacerbation of chronic diseases, who took drugs affecting bone metabolism and vascular stiffness. C-reactive protein (CRP) level was determined by a high-sensitive immunoturbidimetric assay using carboxylated polystyrene particles. interleukin (IL)-6 concentration was measured by an enzyme immunoassay. The intima-media thickness (IMT), the presence and number of atherosclerotic plaques (ASP) were studied with duplex scanning. Pulse wave velocity (PWV) and augmentation index (AI) were measured by applanation tonometry using a SphygmoCor device (AtCor Medical Pty. Ltd., Sydney, Australia). Lumbar spine and hip bone mineral density (BMD) was determined using dual energy X-ray absorptiometry. Results and discussion. There was an increase in the parameters of vascular stiffness, subclinical atherosclerosis, and CRP level and a decrease in bone mass with a longer length of menopause. The vascular stiffness parameters, including IMT (r=0.26; p<0.05), AI (r=0.25; p<0.05), the presence of ASP (r=0.24; p<0.05), and PWV (r=0.23; p<0.05), directly correlated with CRP level. A negative correlation was found between LI–IV BMD and CRP (r=-0.31; p<0.05). The probability of detecting increased IMT with a high CRP level was increased by 2.64 times, ASP by 3.18 times, and low BMD by 2.4 times. There was no association of bone mass, and the parameters of subclinical atherosclerosis and vascular stiffness with IL-6. Conclusion. Lower bone mass and the development of osteoporosis in postmenopausal women were associated with increased vascular stiffness and the presence of signs of subclinical atherosclerosis, and with a high level of CRP, which allows one to discuss the common mechanisms for development of osteoporosis and atherosclerosis, as well as the involvement of chronic inflammation in them.
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Liu, Bo, Zhihao Chen, Xiaoqi Dong, and Guangming Qin. "Association of prehypertension and hyperhomocysteinemia with subclinical atherosclerosis in asymptomatic Chinese: a cross-sectional study." BMJ Open 8, no. 3 (March 2018): e019829. http://dx.doi.org/10.1136/bmjopen-2017-019829.
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ObjectivesComorbid hypertension and hyperhomocysteinemia is an important risk factor for carotid atherosclerotic plaque formation. We put forward the hypothesis that the subjects with comorbid prehypertension and hyperhomocysteinemia also had an increased risk of subclinical atherosclerosis, using carotid intima–media thickness (CIMT) as the marker of the atherosclerotic process.MethodsA total of 4102 asymptomatic Chinese subjects aged 18–60 years were divided into four groups according to blood pressure (BP) and homocysteine (HCY) level: the control group without prehypertension or hyperhomocysteinemia, isolated prehypertension group, simple hyperhomocysteinemia group and prehypertension with hyperhomocysteinemia group. Serum lipids, fasting blood glucose (FBG), HCY and CIMT were measured.ResultsThere was significant difference in the positive rates of increased CIMT among four groups. Compared with the controls, the subjects in the other three groups had a higher risk of increased CIMT (isolated prehypertension group, OR 2.049, 95% CI 1.525 to 2.754; simple hyperhomocysteinemia group, OR 2.145, 95% CI 1.472 to 3.125; prehypertension and hyperhomocysteinemia group, OR 3.199, 95% CI 2.362 to 4.332). However, by multiple logistic regression analysis, only comorbid prehypertension and hyperhomocysteinemia was independently associated with increased CIMT (OR 1.485, 95% CI 1.047 to 2.108, P<0.05).ConclusionsComorbid prehypertension and hyperhomocysteinemia was an independent risk factor of subclinical atherosclerosis in asymptomatic Chinese, but isolated prehypertension or hyperhomocysteinemia was not. Therefore, combined intervention for prehypertension and hyperhomocysteinemia may contribute to decrease the incident of cardiovascular disease.
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Adam, Cristina Andreea, Delia Lidia Șalaru, Cristina Prisacariu, Dragoș Traian Marius Marcu, Radu Andy Sascău, and Cristian Stătescu. "Novel Biomarkers of Atherosclerotic Vascular Disease—Latest Insights in the Research Field." International Journal of Molecular Sciences 23, no. 9 (April 30, 2022): 4998. http://dx.doi.org/10.3390/ijms23094998.
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The atherosclerotic vascular disease is a cardiovascular continuum in which the main role is attributed to atherosclerosis, from its appearance to its associated complications. The increasing prevalence of cardiovascular risk factors, population ageing, and burden on both the economy and the healthcare system have led to the development of new diagnostic and therapeutic strategies in the field. The better understanding or discovery of new pathophysiological mechanisms and molecules modulating various signaling pathways involved in atherosclerosis have led to the development of potential new biomarkers, with key role in early, subclinical diagnosis. The evolution of technological processes in medicine has shifted the attention of researchers from the profiling of classical risk factors to the identification of new biomarkers such as midregional pro-adrenomedullin, midkine, stromelysin-2, pentraxin 3, inflammasomes, or endothelial cell-derived extracellular vesicles. These molecules are seen as future therapeutic targets associated with decreased morbidity and mortality through early diagnosis of atherosclerotic lesions and future research directions.
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Orekhov, Alexander N., Andrey V. Grechko, Elena B. Romanenko, Dongwei Zhang, and Dimitry A. Chistiakov. "Novel Approaches to Anti-atherosclerotic Therapy: Cell-based Models and Herbal Preparations (Review of Our Own Data)." Current Drug Discovery Technologies 17, no. 3 (July 15, 2020): 278–85. http://dx.doi.org/10.2174/1570163816666190101112241.
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Atherosclerosis is a chronic arterial disease characterized by vascular inflammation, accumulation of lipids in the arterial wall, and formation and growth of atherosclerotic plaques followed by ischemia. In subclinical atherosclerosis, cholesterol retention in subendothelial cells leads to induction of local inflammation, generation of foam cells and lesion formation, followed by a chain of other pathogenic events. Atherosclerotic progression can frequently be fatal, since plaque rupture may lead to thrombosis and acute events, such as myocardial infarction, stroke and sudden death. Traditional anti-atherosclerotic therapy is mainly focused on improving the blood lipid profile and does not target various stages of plaque progression. Obviously, treating the disease at initial stages is better than beginning treatment at advanced stages and, in that regard, current atherosclerosis management can be improved. Cholesterol retention is an important component of atherogenesis that precedes plaque formation. Therapeutic targeting of cholesterol retention may be beneficial for preventing further atherogenic progression. For this purpose, we suggest using herbal preparations due to good tolerability and suitability for long-lasting treatment. We developed test systems based on cultured human intimal aortic cells for rapid screening of potential anti-atherogenic drugs. With the help of these test systems, we selected several natural substances with significant anti-atherogenic activity and further use these compounds to prepare herbal preparations for anti-atherosclerotic therapy. These preparations were clinically tested and showed good safety and a potent anti-atherogenic potential.
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Ammirati, Enrico, Francesco Moroni, Giuseppe Danilo Norata, Marco Magnoni, and Paolo G. Camici. "Markers of Inflammation Associated with Plaque Progression and Instability in Patients with Carotid Atherosclerosis." Mediators of Inflammation 2015 (2015): 1–15. http://dx.doi.org/10.1155/2015/718329.
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Atherosclerosis is the focal expression of a systemic disease affecting medium- and large-sized arteries, in which traditional cardiovascular risk factor and immune factors play a key role. It is well accepted that circulating biomarkers, including C-reactive protein and interleukin-6, reliably predict major cardiovascular events, including myocardial infarction or death. However, the relevance of biomarkers of systemic inflammation to atherosclerosis progression in the carotid artery is less established. The large majority of clinical studies focused on the association between biomarkers and subclinical atherosclerosis, that is, carotid intima-media thickening (cIMT), which represents an earlier stage of the disease. The aim of this work is to review inflammatory biomarkers that were associated with a higher atherosclerotic burden, a faster disease progression, and features of plaque instability, such as inflammation or neovascularization, in patients with carotid atherosclerotic plaque, which represents an advanced stage of disease compared with cIMT. The association of biomarkers with the occurrence of cerebrovascular events, secondary to carotid plaque rupture, will also be presented. Currently, the degree of carotid artery stenosis is used to predict the risk of future cerebrovascular events in patients affected by carotid atherosclerosis. However, this strategy appears suboptimal. The identification of suitable biomarkers could provide a useful adjunctive criterion to ensure better risk stratification and optimize management.
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Jiang, Yanfeng, Zehan Fan, Yingzhe Wang, Chen Suo, Mei Cui, Ziyu Yuan, Weizhong Tian, et al. "Low Bone Mineral Density Is Not Associated with Subclinical Atherosclerosis: A Population-Based Study in Rural China." Cardiology 141, no. 2 (2018): 78–87. http://dx.doi.org/10.1159/000493166.
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Objectives: Loss of bone mass may affect the progression of atherosclerosis. We investigated the relationship between low bone mineral density (BMD) and subclinical atherosclerosis in rural China. Methods: In total, 333 men and 421 postmenopausal women aged 55–65 years were enrolled. BMD was measured in the lumbar spine, femoral neck, and total hip using dual-energy X-ray absorptiometry. Subclinical atherosclerosis was defined as increased carotid artery intima-media thickness (CIMT ≥0.9 mm), the presence of carotid plaques, high brachial-ankle pulse wave velocity (baPWV ≥1,400 cm/s), and low ankle-brachial index (ABI ≤1). Binary logistic regression analyses were used to estimate the association between low BMD and subclinical atherosclerosis. Results: There was no significant difference in BMD between the normal group and the subclinical atherosclerosis group. After full adjustment for the relevant covariates, a boundary significant association was found between low BMD in the femoral neck and baPWV in postmenopausal women (odds ratio = 1.77, p = 0.049). After full adjustment, neither BMD nor low BMD were significantly associated with subclinical atherosclerosis in men or postmenopausal women. Conclusions: Low BMD is not associated with subclinical atherosclerosis in Chinese individuals aged 55–65 years resident in rural China.
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Orekhov, Alexander N., Igor A. Sobenin, Victor V. Revin, and Yuri V. Bobryshev. "Development of Antiatherosclerotic Drugs on the basis of Natural Products Using Cell Model Approach." Oxidative Medicine and Cellular Longevity 2015 (2015): 1–11. http://dx.doi.org/10.1155/2015/463797.
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Atherosclerosis including its subclinical form is one of the key medical and social problems. At present, there is no therapy available for widespread use against subclinical atherosclerosis. The use of synthetic drugs for the prevention of arteriosclerosis in its early stages is not sufficient because of the limited indications for severe side effects and high cost of treatment. Obviously, effective antiatherosclerotic drugs based on natural products would be a preferred alternative. Simple cell-based models for testing different natural products have been developed and the ability of natural products to prevent intracellular lipid accumulation in primary cell culture was evaluated. This approach utilizing cell models allowed to test effects of such direct antiatherosclerotic therapy, analyzing the effects mimicking those which can occur “at the level” of arterial wall via the inhibition of intracellular lipid deposition. The data from the carried out clinical trials support a point of view that the identification of antiatherosclerotic activity of natural products might offer a great opportunity for the prevention and treatment of atherosclerotic disease, reducing cardiovascular morbidity and mortality.
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Ramírez-Morros, Anna, Minerva Granado-Casas, Nuria Alcubierre, Montserrat Martinez-Alonso, Jordi Real, Esmeralda Castelblanco, Aureli Esquerda, et al. "Calcium Phosphate Product Is Associated with Subclinical Carotid Atherosclerosis in Type 2 Diabetes." Journal of Diabetes Research 2017 (2017): 1–8. http://dx.doi.org/10.1155/2017/3498368.
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Aims. To assess whether circulating 25-hydroxyvitamin D3(25OHD) and mineral metabolism-related factors (serum phosphate, calcium, and parathormone) are associated with subclinical carotid atherosclerosis (SCA), defined as the presence of carotid atherosclerotic plaques (main study outcome), in patients with type 2 diabetes mellitus (T2DM) without kidney disease or previous cardiovascular disease.Methods.We undertook a post hoc analysis of a cross-sectional study in adults with T2DM in whom we evaluated SCA. A total of 303 subjects with T2DM were included. Clinical variables and carotid ultrasound imaging were obtained.Results. We found no association of 25OHD with the presence of SCA. However, calcium phosphate (CaP; mg2/dL2) product was positively associated with the presence of carotid plaques (ORadj = 1.078; 95% CI: 1.017–1.142). An inverse association was observed between higher levels of 25OHD (≥30 ng/mL versus <20 ng/mL concentrations) and common carotid intima-media thickness (cIMT; mm) (βadj ± SE = −0.055 ± 0.024). We conclude that the CaP product is independently associated with the presence of established subclinical carotid atherosclerosis in patients with T2DM.
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Icli, Abdullah, Erkan Cure, Ali Ugur Uslu, Davut Sakiz, Medine Cumhur Cure, Miyase Ozucan, Rabia Aydogan Baykara, et al. "The Relationship Between Atherogenic Index and Carotid Artery Atherosclerosis in Familial Mediterranean Fever." Angiology 68, no. 4 (July 20, 2016): 315–21. http://dx.doi.org/10.1177/0003319716659220.
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Familial Mediterranean fever (FMF) is a disease characterized by chronic inflammation. Atherogenic index of plasma (AIP) is a logarithmic value of the triglyceride to high-density lipoprotein cholesterol ratio and it is a good marker for atherosclerotic heart disease and cardiac risk. In this study, we investigated subclinical atherosclerosis and cardiac risks in patients with FMF. Patients with FMF (78 men and 84 women) and healthy controls (74 men and 82 women) were included in this study. The AIP values of the patients were calculated and carotid intima–media thicknesses (cIMTs) were measured. The cIMT ( P < .001) and AIP ( P < .001) values of patients with FMF were higher than the values of the control group. There was a positive correlation between cIMT and AIP values ( r = .304, P < .001). In regression analysis, we detected an independent relationship between cIMT and AIP (β = .248, P = .001). Atherogenic index of plasma may be highly correlated with the subclinical atherosclerosis. Particularly, male patients with FMF may have a high cardiac risk.
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Seshadri, Sudha. "Indexes of Subclinical Atherosclerosis." JACC: Cardiovascular Imaging 7, no. 11 (November 2014): 1116–18. http://dx.doi.org/10.1016/j.jcmg.2014.09.004.
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Tepavčević, Brankica, and Sandra Radak. "Vascular age and carotid intima-media thickness." Medicinska istrazivanja 49, no. 3 (2015): 53–55. http://dx.doi.org/10.5937/medist1501053t.
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Measurement of carotid intima-media thickness with B-mode ultrasound is a noninvasive and highly reproducible technique for detecting and quantifying subclinical atherosclerosis. Several large, prospective, epidemiologic studies have shown that this method accurately identifies prevalence and incidence of cardiovascular disease, independently of traditional risk factors. The value of this method is that it can be used to determine patients' vascular age. Measurement of carotid intima-media thickness reveals current atherosclerotic burden, it is feasible in a clinical setting and it can be integrated into coronary heart disease risk assessment models. Vascular age is substitution for chronological age and it is used in order to improve coronary heart disease risk prediction taking current carotid atherosclerotic burden into account.
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Zamarrón-Licona, Erasmo, José Manuel Rodríguez-Pérez, Rosalinda Posadas-Sánchez, Gilberto Vargas-Alarcón, Manuel Alfonso Baños-González, Verónica Marusa Borgonio-Cuadra, and Nonanzit Pérez-Hernández. "Variants of PCSK9 Gene Are Associated with Subclinical Atherosclerosis and Cardiometabolic Parameters in Mexicans. The GEA Project." Diagnostics 11, no. 5 (April 26, 2021): 774. http://dx.doi.org/10.3390/diagnostics11050774.
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Background: Coronary artery disease (CAD) is a chronic, inflammatory, and complex disease associated with vascular risk factors. Nowadays, the coronary artery calcium (CAC) is a specific marker of the presence and extent of atherosclerosis. Additionally, CAC is a predictor of future coronary events in asymptomatic individuals diagnosed with subclinical atherosclerosis (CAC > 0). In this study, our aim is to evaluate the participation of two polymorphisms of the PCSK9 gene as genetic markers for developing subclinical atherosclerosis and cardiometabolic risk factors in asymptomatic individuals. Methods: We analyzed two PCSK9 polymorphisms (rs2479409 and rs615563) in 394 individuals with subclinical atherosclerosis and 1102 healthy controls using real time- polymerase chain reaction (PCR). Results: Under various inheritance models adjusted for different confounding factors, the rs2479409 polymorphism was associated with an increased risk of developing subclinical atherosclerosis (OR = 1.53, P recessive = 0.041). Both polymorphisms were significantly associated with several cardiometabolic parameters. Conclusions: Our data suggest that rs2479409 polymorphism could be envisaged as a risk marker for subclinical atherosclerosis.
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Szabóová, Eva, Alexandra Lisovszki, Eliška Fatľová, Peter Kolarčik, Peter Szabó, and Tomáš Molnár. "Prevalence of Microalbuminuria and Its Association with Subclinical Carotid Atherosclerosis in Middle Aged, Nondiabetic, Low to Moderate Cardiovascular Risk Individuals with or without Hypertension." Diagnostics 11, no. 9 (September 19, 2021): 1716. http://dx.doi.org/10.3390/diagnostics11091716.
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Microalbuminuria is closely associated with the risk of cardiovascular disease and all-cause mortality in the general population. Less is known about its relationship with subclinical atherosclerosis. We aimed to assess the prevalence of microalbuminuria and its relationship with subclinical atherosclerosis in middle-aged, nondiabetic, apparently healthy individuals (N = 187; 40.1% men, 59.9% women; aged 35–55 years) as well as to evaluate its potential associations with established risk modifiers, especially with the presence of carotid plaque. Clinical and laboratory parameters, the estimated 10-year fatal cardiovascular risk (SCORE), as well as circulating, functional (flow mediated vasodilation, ankle-brachial index, augmentation index, and pulse wave velocity), and morphological markers (mean carotid intima–media thickness, and carotid plaque) of subclinical atherosclerosis were analysed in group with vs. without microalbuminuria. Microalbuminuria was present in 3.8% of individuals with SCORE risk 0.43 ± 0.79%. Functional markers predominated in both groups. Carotid intima–media thickness (mean ± SD) in both groups was in range: 0.5–0.55 ± 0.09–0.14 mm. Carotid plaque was more frequent in group with (14.3%) vs. without (4.4%) microalbuminuria. Microalbuminuria had no statistically significant effect on most markers of subclinical atherosclerosis, but the increasing value of microalbuminuria was significantly associated with the occurrence of carotid plaque (p = 0.035; OR = 1.035; 95% CI = 1.002–1.07). Additional multiple logistic regression analysis, where variables belonged to microalbuminuria, number of risk factors, and family history, finally showed only two variables: microalbuminuria (p = 0.034; OR = 1.04; 95%CI = 1.003–1.09) and the number of risk factors (p = 0.006; OR = 2.15; 95% CI = 1.24–3.73) with independent and significant impact on the occurrence of carotid plaque. Our results may indicate an association of microalbuminuria with the presence of carotid atherosclerotic plaque; in addition, microalbuminuria and the number of risk factors appear to be possible predictors of the carotid plaque occurrence. Monitoring microalbuminuria may improve the personalized cardiovascular risk assessment in nondiabetic, low-to-moderate cardiovascular risk individuals with or without hypertension.
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Ershova, A. I., S. A. Boytsov, О. M. Drapkina, and Т. V. Balakhonova. "ULTRASOUND MARKERS OF PREMANIFEST ATHEROSCLEROSIS OF CAROTID AND FEMORAL ARTERIES IN ASSESSMENT OF CARDIOVASCULAR RISK." Russian Journal of Cardiology, no. 8 (September 9, 2018): 92–98. http://dx.doi.org/10.15829/1560-4071-2018-8-92-98.
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More than a half of cardiovascular events occur in low to moderate cardiovascular risk patients if assessed based on the traditional risk factors. At the same time, ultrasound examination of arteries makes it possible to reveal atherosclerosis even at early stages of its development. High prevalence of subclinical atherosclerosis in low to moderate risk patients, which is a realization of traditional and “unknown” risk factors, makes ultrasound examination a useful method for risk stratification. The review is focused on ultrasound markers of atherosclerosis with association to traditional risk factors, on the possibility to improve predictive role of current scores and influence on outcomes. Predictive significance of the markers is regarded for primary prevention in general population, in high risk persons and from the perspective of quantitative indicator of atherosclerotic lesion grade or plausibility as a surrogate cardiovascular diseases marker.
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Zhatkina, M. V., N. E. Gavrilova, V. A. Metelskaya, E. B. Yarovaya, B. A. Rudenko, and O. M. Drapkina. "Visual Scale as a Non-Invasive Method for Evaluation of Risk and Severity of Coronary Atherosclerosis." Kardiologiia 61, no. 4 (May 6, 2021): 46–52. http://dx.doi.org/10.18087/cardio.2021.4.n1481.
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Aim To evaluate quantitative and qualitative characteristics of atherosclerotic plaques (ASP) in carotid arteries (CA) and femoral arteries (FA) and to use these data for developing a visual scale (VS) for noninvasive diagnosis and determination of severity of coronary atherosclerosis.Material and methods This study included 216 patients (115 men and 101 women) aged 24 to 87 years (mean age, 61.5±10.73 years). All patients underwent coronary angiography (CAG) for detecting and determining severity of CA atherosclerosis and duplex scanning (DS) for detecting atherosclerosis of CA and FA.Results Analysis of ultrasound parameters of ASP in CA and FA showed that the maximal ASP height, moderate stenosis and maximal stenosis of the arterial bed had higher predictive values than other ultrasound parameters. These parameters were used for forming diagnostic complexes, on the basis of which two individual VSs for CA and FA were developed. Based on the high prognostic value of both scales, they were combined into one that was named VSCOMB. A ROC analysis determined cut-off points of the VSCOMB for diagnosis of CA atherosclerosis of various severity. VSCOMB scores >4 indicated pronounced CA atherosclerosis with sensitivity of 86.1 % and specificity of 87.5 % whereas VSCOMB scores ≤4 excluded it. Thus, VSCOMB score 0–1 indicated the absence of CA atherosclerosis; score 2–4 indicated the presence of subclinical CA atherosclerosis; and score >4 indicated severe CA atherosclerosis.Conclusion A VSCOMB was developed that includes a set of ultrasound parameters for CA and FA and is useful for noninvasive diagnosis of CA atherosclerosis of various severity. Simple and convenient use of VSCOMB allows it to be used at the screening stage to detect subclinical CA atherosclerosis and to prevent its progression.
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Aguilar-Palacio, Isabel, Sara Malo, Estibaliz Jarauta, Belén Moreno-Franco, Lina Maldonado, Luisa Compés, Mª José Rabanaque, and José Antonio Casasnovas. "Pharmacological Primary Cardiovascular Prevention and Subclinical Atherosclerosis in Men: Evidence from the Aragon Workers’ Health Study." Journal of Clinical Medicine 10, no. 5 (March 1, 2021): 945. http://dx.doi.org/10.3390/jcm10050945.
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The objective of this study is to describe the profile of primary preventive treatment for cardiovascular disease in adult males and to analyze the association between treatment profile and subclinical atherosclerosis. We selected male workers who had undergone ultrasound imaging and had no previous history of cardiovascular disease (n = 2138). Data on the consumption of primary cardiovascular drugs from the previous year were obtained. We performed bivariate analyses to compare patient characteristics according to cardiovascular treatment and the presence of subclinical atherosclerosis, and logistic regression models to explore the association between these two variables. Among participants with no personal history of cardiovascular disease, subclinical atherosclerosis was present in 77.7% and 31.2% had received some form of preventive treatment. Of those who received no preventive treatment, 73.6% had subclinical atherosclerosis. Cardiovascular preventive treatment was associated only with CACS > 0 (odds ratio (OR), 1.37; 95% confidence interval (95% CI), 1.06–1.78). Statin treatment was associated with a greater risk of any type of subclinical atherosclerosis (OR, 1.73) and with CACS > 0 (OR, 1.72). Subclinical atherosclerosis existed in almost 75% of men who had no personal history of cardiovascular disease and had not received preventive treatment for cardiovascular disease.
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Sheridan, Sinead E., Paul L. O’Connor, and Niall M. Moyna. "Cardiorespiratory Fitness, Atherosclerotic Cardiovascular Disease Risk Factors and Subclinical Atherosclerosis in Adolescent Boys." Medicine & Science in Sports & Exercise 46 (May 2014): 592–93. http://dx.doi.org/10.1249/01.mss.0000495250.43821.27.
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Hashimoto, Yoshitaka, Fuyuko Takahashi, Takuro Okamura, Takafumi Osaka, Hiroshi Okada, Takafumi Senmaru, Saori Majima, et al. "Relationship between serum creatinine to cystatin C ratio and subclinical atherosclerosis in patients with type 2 diabetes." BMJ Open Diabetes Research & Care 10, no. 3 (June 2022): e002910. http://dx.doi.org/10.1136/bmjdrc-2022-002910.
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IntroductionSarcopenia index (SI), calculated by (serum creatinine/cystatin C)×100, is reported to be associated with sarcopenia. Few studies reported the association between SI and subclinical atherosclerosis. We evaluated the association between SI and subclinical atherosclerosis, assessed by brachial-ankle pulse wave velocity (baPWV).Research design and methodsOne hundred seventy-four patients with type 2 diabetes were included in this cross-sectional study. The relationship between SI and baPWV was assessed by Pearson’s correlation coefficient. To calculate area under the receiver operator characteristic (ROC) curve (AUC) of SI for the presence of subclinical atherosclerosis, which was defined as baPWV >1800 cm/s, ROC analysis was performed. Logistic regression analyses were performed to assess the effect of SI on the prevalence of subclinical atherosclerosis adjusting for covariates.ResultsMean age, duration of diabetes, baPWV, and SI were 66.9 (10.1) years, 17.7 (11.6) years, 1802 (372) cm/s, and 77.6 (15.8), respectively. There was an association between SI and baPWV (men; r=−0.25, p=0.001, and women; r=−0.37, p=0.015). The optimal cut-off point of SI for the presence of subclinical atherosclerosis was 77.4 (sensitivity=0.72, specificity=0.58, p<0.001, AUC 0.66 (95% CI: 0.57 to 0.74)). In addition, SI was associated with the prevalence of subclinical atherosclerosis (adjusted OR 0.95, 95% CI: 0.91 to 0.99, p=0.015).ConclusionsSI is associated with the prevalence of subclinical atherosclerosis in patients with type 2 diabetes.