Increased carotid artery intima-media thickness may be associated with stroke in primary antiphospholipid syndrome (original) (raw)
Related papers
2011
Stroke is the second leading cause of mortality worldwide. Ischemic stroke is more prevalent than hemorrhagic stroke and atherosclerosis is the major cause of ischemic stroke. The increased carotid artery intima-media thickness (CIMT) is considered to be useful indicator of early atherosclerosis. So, this study was aimed to correlate the relationship between atherosclerotic risk factors and intima-media thickness of carotid artery in patients with acute ischemic stroke. Material and Methods: In this cross-sectional study, 100 consecutive patients of acute ischemic stroke and 50 healthy relatives of patients as control were studied for presence of atherosclerotic risk factors and carotid artery intima-media thickness by B-mode Doppler ultrasonography. Results: In this age and sex matched study, higher CIMT measurement was found among patients of acute ischemic stroke than healthy controls (0.849 ± 0.196 vs 0.602 ± 0.092; p < 0.001). The CIMT was well correlated with smoking (Beta = 0.295; t = 5.728; 95% CI 0.088 to 0.181; p < 0.001); hypertension (Beta = 0.387; t = 6.518; CI 0.112 to 0.209; p < 0.001); di abetes (Beta = 0.237; t = 4.848; CI 0.074 to 0.175; p < 0.001); hypercholesterolemia (Beta = 0.292; t = 5.840; CI 0.096 to 0.195; p < 0.001), but not with age (p = 0.153). The CIMT was also found to be higher among acute ischemic stroke patients who were smoker, hypertensive, diabetic and hypercholesterolemic than non-smoker, normotensive, non-diabetic and normo-cholesterolemic respectively. Conclusion: The CIMT being indicator of atherosclerosis can be used as future predictor of ischemic stroke.
Circulation, 1997
Background-It has been argued that lumen diameter of the common carotid artery should be taken into account in analyses on common carotid intima-media thickness (CIMT) and cardiovascular risk. Yet, no published report has dealt with this issue in detail. Methods-In the Rotterdam study baseline ultrasound images of the carotid arteries were made. During follow-up of 8.2 years, 656 new acute myocardial infarctions (AMI) occurred. Regression analysis was used to study myocardial infarction relation to right (or left) common CIMT with various adjustments for right-, or left-sided lumen diameter. Lumen adjustment was made by (1) a simple adjustment in a regression equation;
Incidence of stroke is related to carotid IMT even in the absence of plaque
Atherosclerosis, 2005
Background: The carotid intima-media thickness (IMT) has been associated with incidence of stroke. Whether this association is independent of carotid plaque is controversial. Methods and results: The associations among B-mode ultrasound determined common carotid IMT, carotid plaque (focal IMT > 1.2 mm) and incident stroke, were investigated in 5163 Swedish middle-aged men and women over a median follow-up of 7 years. Age and sex-adjusted carotid IMT, and carotid plaque were significantly (p < 0.05) related to future stroke. Adjustment for cardiovascular risk factors generally reduced the hazard rate ratios, however more prominently so with regard to the carotid measure of plaque than with IMT. The associations between carotid IMT and stroke remained after adjustment for presence of carotid plaque, and graded associations between carotid IMT and stroke was found both among those with and without carotid plaque. Conclusions: In this population-based study, common carotid IMT was associated with incidence of stroke. This relation was independent of presence of carotid plaque.
Atherosclerosis, 2009
The aim of the present study was to investigate the relationship between atherosclerotic progression rate as measured by carotid artery IMT during very long-term follow-up in clinically healthy men and a number of baseline risk factors of potential importance for atherosclerosis progression including apoA-I, apoB, apoB/apoA-I ratio, other lipid variables including LDL particle size, body composition variables, blood pressure, smoking, fasting blood glucose and insulin, and also hsCRP. Background: Low-density lipoprotein (LDL) is associated with increased carotid IMT progression rate during long-term follow-up, whereas the relationship between newer biomarkers such as apoB/apoA-I ratio and carotid artery IMT progression rate has been less investigated. Methods: 58-year-old men identified by screening in the community (n = 391) with varying degrees of obesity and insulin sensitivity were examined with high-resolution B-mode ultrasound at baseline and after 3, and 8.9 years of follow-up (n = 305 investigated after 8.9 years). The carotid arteries were examined bilaterally, and the mean intima-thickness was calculated for 10 mm sections of the composite of common carotid arteries and bulbs (IMT composite). Serum levels of apoB and apoA-I were measured using a turbidimetric method. Uni-and multi-variable analyses were performed to study the relationship between carotid IMT composite progression rate and risk factors. Results: In a multi-variable analysis including all baseline variables only the apoB/apoA-I ratio (p = 0.003; = 0.181, standard error = 0.003) and serum insulin (p = 0.026;ˇ= −0.133, standard error = 0.000) was significantly related to IMT composite progression rate. Conclusion: The results indicate that apoB/apoA-I ratio is an important risk factor for predicting atherosclerotic progression rate during very long-term follow-up in clinically healthy middle-aged men.
Diseases
Introduction: Antiphospholipid syndrome (APS) is an autoimmune disease characterised by arterious and venous thrombosis, miscarriage, and the presence of antiphospholipid antibodies (aPL) in the blood. As we know, APS is also characterised by accelerated atherosclerotic degeneration with an increased risk of thrombosis in all blood vessels, including the carotid arteries. Carotid artery stenosis can manifest in many different ways. The aim of this study is to present the results of our multidetector computerised tomography angiography (MDCTA) analysis of the carotid arteries in patients with primary and secondary APS compared with a control group. Materials and Methods: This study examined 50 patients with primary antiphospholipid syndrome (PAPS) and 50 patients with secondary antiphospholipid syndrome (SAPS). The results were compared with a control group also comprising 50 patients. The groups were analysed with respect to age, sex and the presence of well-established risk factors...
Is Common Carotid Intima Media Thickness an Independent Predictor for Coronary Artery Disease
2010
Introduction: Non-invasive measurement of carotid intima media thickness (IMT) has been noted as a marker for atherosclerosis and can serve as a predictor of cardiovascular events. This study investigates the relationship between carotid IMT and coronary artery disease (CAD). Method: This is a descriptive, analytical cross-sectional study of 300 individuals referring to Isfahan Cardiovascular Research Center (ICRC). Following history taking, clinical examinations, and measurement of body weight and height, the subjects' lipid profile and fasting blood sugar (FBS) were evaluated. The subjects were divided into two groups according to CAD risk factors. The two groups were adjusted based on coronary disease risk factors. Maximum common carotid IMT was measured via B-mode ultrasonography in all subjects. Those with atherosclerotic plaques were excluded from the study. Collected data were statistically analyzed by SPSS 10. Results: 65% of the subjects were male and 35% were female. They had a mean age of 50.72 years. 130 subjects (43%) were placed in the CAD group and 170 (56.7%) in the non-CAD group. There was no significant difference between the two groups in respect of risk factors such as age, total cholesterol, cigarette smoking, body mass index (BMI), hypertension, HDL-C, and LDL-C. Common carotid IMT was evaluated in the two groups. Mean IMT of the CAD group was found to be 0.8 millimeters more than that of the non-CAD group (P<0.05). Discussion: Different studies have shown varying relationships between carotid IMT and CAD. Based on the results of this study and in view of the safety and simplicity of ultrasonographic carotid IMT measurement, IMT can be used as a predictor of atherosclerosis in coronary arteries.
Stroke, 2013
A therosclerosis and cardiovascular disease are the leading causes of death and disability in industrialized nations. 1 Carotid intima-media thickness (cIMT) was a widely accepted imaging marker of subclinical atherosclerosis in the past; 2-4 however, it is increasingly clear that IMT is a separate phenotype from carotid plaque, which is a focal lesion most likely determined by a set of different biological and genetic factors. Early detection of risk factors of cIMT and their early modification may have a significant impact on the prevention of atherosclerotic disease. Traditional and common vascular risk factors, such as hypertension, diabetes mellitus, dyslipidemia, and smoking, have been associated with increased cIMT. 2,3,5,7-9 Although these traditional vascular risk factors account for <50% of the variance of atherosclerotic plaque burden, 10-13 they may not explain such a high proportion of the variance in IMT, especially when measured in plaque freelocations. 4,14 The contribution of other less traditional factors, such as homocysteine, 15,16 kidney function, 17,18 and adiponectin, 19 to cIMT is less clear. Furthermore, because atherosclerosis is considered an inflammatory disease, 20 factors involved in inflammatory processes may be important determinants of increased cIMT, including white blood cell count, 21 C-reactive protein, 22 interleukin-6, 23 serum amyloid A, 24 and others.
Transplantation, 2004
Background-The use of intima-media thickness (IMT) as an outcome measure in observational studies and intervention trials relies on the view that it reflects early stages of atherosclerosis and cardiovascular risk. There is little knowledge concerning the relation between IMT and brain infarction (BI). Methods and Results-We investigated the relation of IMT with BI and its subtypes in 470 cases and 463 controls. Cases with BI proven by MRI were consecutively recruited and classified into subtypes by cause of BI. Controls were recruited among individuals hospitalized at the same institutions and matched for age, sex, and center. IMT was measured at the far wall of both common carotid arteries (CCA) using an automatic detection system. Adventitia-to-adventitia diameters and CCA-IMT were measured on transverse views; lumen diameter was computed using these measures. Mean (ϮSEM) CCA-IMT was higher in cases (0.797Ϯ0.006 mm) than in controls (0.735Ϯ0.006 mm; PϽ0.0001). This difference remained after adjustment for lumen diameter and when analyses were restricted to subjects free of previous cardiovascular or cerebrovascular history. The difference in CCA-IMT between cases and controls was significant in the main subtypes. The risk of BI increased continuously with increasing CCA-IMT. The odds ratio per SD increase (0.150 mm) was 1.82 (95% confidence interval, 1.54 to 2.15); adjustment for cardiovascular risk factors slightly attenuated this relation (odds ratio, 1.73; 95% confidence interval, 1.45 to 2.07). Conclusions-An increased CCA-IMT was associated with BI, both overall and in the main subtypes. An increased IMT may help select patients at high risk for BI. (Circulation. 2000;102:313-318.)