scholarly journals Focused screening for occult carotid artery disease: patients with known heart disease are at high risk

2004 ◽  
Vol 39 (1) ◽  
pp. 44-50 ◽  
Author(s):  
Caron B Rockman ◽  
Glenn R Jacobowitz ◽  
Paul J Gagne ◽  
Mark A Adelman ◽  
Patrick J Lamparello ◽  
...  
Keyword(s):  
Heart Disease ◽  
High Risk ◽  
Carotid Artery ◽  
Carotid Artery Disease ◽  
Artery Disease

Angioplasty and stenting for carotid artery stenosis: indications, techniques, results, and complications

1998 ◽  
Vol 5 (6) ◽  
pp. E5 ◽  
Author(s):  
Giuseppe Lanzino ◽  
Richard D. Fessler ◽  
Robert A. Mericle ◽  
Ajay K. Wakhloo ◽  
Lee R. Guterman ◽  
...  
Keyword(s):  
High Risk ◽  
Carotid Artery ◽  
Carotid Artery Stenosis ◽  
Carotid Artery Disease ◽  
Artery Stenosis ◽  
High Risk Patients ◽  
Clinical Series ◽  
Risk Patients ◽  
Artery Disease ◽  
Angioplasty And Stenting

Following the favorable results obtained in the treatment of coronary artery disease, combined angioplasty and stenting has been advocated for the treatment of carotid artery stenosis as well. Although widespread application of angioplasty and stenting for carotid artery disease is neither indicated nor recommended, it may be a viable alternative therapy for select patients who are high-risk patients for surgery. The results of early series have suggested that endoluminal revascularization in these high-risk patients can be performed with an acceptable degree of safety. Although the incidence of death and major stroke rates following angioplasty and stenting procedures compares favorably with surgery, results of more recent clinical series have suggested that the incidence of perioperative transient neurological events and minor strokes may be higher than suggested by earlier reports, especially in patients with recent neurological symptoms and “unstable” plaques. In this article, the authors review the current potential indications for and preliminary results of angioplasty and stenting and describe their procedural technique. In addition, potential applications of stenting to intracranial thromboocclusive carotid artery disease are reviewed.

Abstract 13769: Assessing the Risk for Cardiovascular Diseases According to Lipoprotein(a) Levels

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Narek A Tmoyan ◽  
Marat V Ezhov ◽  
Olga I Afanasieva ◽  
Uliana V Chubykina ◽  
Elena A Klesareva ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Cardiovascular Diseases ◽  
Carotid Artery ◽  
Lower Extremity ◽  
Carotid Artery Disease ◽  
Lipoprotein A ◽  
Artery Disease ◽  
Lower Extremity Artery Disease

Introduction: There is no common opinion about threshold lipoprotein(a) [Lp(a)] concentration for atherosclerotic cardiovascular diseases (ASCVD) risk. Different clinical guidelines and consensus documents postulated cut-off Lp(a) level as 30 mg/dL or 50 mg/dL. We assessed the concentration of Lp(a) that associated with ASCVD of different locations. Methods: The study included 1224 patients with ASCVD. Lp(a) concentration was measured by enzyme-linked immunosorbent assay in serum. Patients were divided into 3 groups: group I - Lp(a)<30 mg/dL, group II - 30≤Lp(a)<50 mg/dL, group III - Lp(a)≥50 mg/dL (table). Results: Coronary heart disease, carotid artery disease, lower extremity artery disease, myocardial infarction and ischemic stroke were diagnosed in 61%; 34%; 23%; 42% and 11% patients, respectively. Lower extremity artery disease, carotid artery disease and myocardial infarction were more frequent in patients with Lp(a) concentration from 30 to 50 mg/dL compared to patients with Lp(a) <30 mg/dL: 36%, 41%, 48% vs. 17%, 30%, 36% respectively, p<0.01 for all. Subjects with Lp(a) 30-50 mg/dL (n=182, 15%) had a greater odds ratio of lower extremity artery disease, carotid artery disease and myocardial infarction compared to patients with Lp(a) <30 mg/dL (table). ROC analysis demonstrated that Lp(a) cut-off levels for lower extremity artery disease, carotid artery disease, coronary heart disease and myocardial infarction were 26; 21; 37 and 36 mg/dL, respectively. Conclusions: Our results demonstrate that in case of Lp(a) cut-off level of 50 mg/dL about 15% of patients are underestimated for the risk of ASCVD. Lp(a) cut-off level for ASCVD is between 20 and 40 mg/dL regarding the atherosclerosis location.

scholarly journals Plasma Homocysteine in Patients with Coronary and Carotid Artery Disease: A Case Control Study

PRILOZI ◽  
2020 ◽  
Vol 41 (1) ◽  
pp. 15-22
Author(s):  
Marijan Bosevski ◽  
Nenad Zlatanovikj ◽  
Danica Petkoska ◽  
Atanas Gjorgievski ◽  
Emilija Lazarova ◽  
...  
Keyword(s):  
High Risk ◽  
Carotid Artery ◽  
Plasma Levels ◽  
Carotid Artery Disease ◽  
Case Control ◽  
Plasma Homocysteine ◽  
Control Analysis ◽  
Significant Difference ◽  
Artery Disease ◽  
Cad Risk

AbstractIntroduction: Homocystein (Hcy) is an amino acid and elevated plasma cause endothelial damage, followed with inflammation in the blood vessels and its progression in atherosclerosis. We aimed to evaluate the correlation between cardiovascular disease and serum homocysteine levels..Methods: We performed a case control analysis of 212 patients, either for cardiovascular risk stratification or for invasive diagnostics and treatment of cardiovascular ischemic disease (CAD). Patients were divided into 4 groups: Group 1. Patients with low risk for CAD, with no symptoms of CAD and total of 10 years risk <10%. Group 2. High-risk patients with no symptoms of CAD, but 10 years total CAD risk of >20%. Group 3. Patients with symptomatic CAD, where angiography was performed and >50% occlusion of at least one coronary vessel was found. Group 4. Patients with carotid artery disease and documented CAD.Results: Group 1 consists of 56 subjects, of whom 33 (60%) males and 22 (40%) females. Their mean age was 52.18±8.07 years and their average CAD risk was 5.Group 2 included 60 patients, with average CAD risk of 23.73. There was a statistically significant difference between plasma homocysteine levels between the control and high CAD risk group, as well as between those with CAD and both CAD and CARD (p=0.001). In the high-risk subjects group, the level of homocysteine correlates albeit weak with the total CAD risk (p=0.04). Homocysteine levels correlate with the WBC count (p=0.02). In the subgroup of smokers with high CAD risk, homocysteine correlates with age, total CAD risk, total cholesterol, BUN (define BUN) and creatinine.Group 3 consisted of 49 subjects with manifested and angiographically proven CAD, out of whom 80% were males and 20% females, mean age 56.06±9.7 years, with average 2 coronary vessels affected. There were significantly higher homocysteine plasma levels between the control group and the group with manifested CAD (p=0.008).There is no significant difference of homocysteine plasma levels between the high risk group and the group with manifested coronary artery disease (15.03□mol/l vs. 16.38□mol/l). In this group, plasma levels of homocysteine correlate only with the highest level of vessel stenosis (>95%) with (p=0.04).The study population in group 4 showed a mean of IMT 0.9 +..09 mm and mean Hcy plasma levels of 21 + 11 µmol/L. From the evaluated patients with CAD, 82.9% of patients had elevated level of Hcy. From those, one showed elevated Hcy, 79.4 % had hypertension, 58.9 % had hyperlipidemia, 28.2% had diabetes mellitus as additional risk factors for atherosclerosis. 76.9 % of the patients had increased intima-media thickness; in 58.9 % plaques were detected, while 23 % of the patients had significant stenosis: 10.2 % with intermediate–grade stenosis (50-69%) and 12.8 % with high-grade stenosis (70-99 %). 17.1 % of the patients had normal level of Hcy, and in those ones 62.5 % only had increased IMT. We found linear correlation between IMT and HCy levels (r 0.7, p 0.05).Case control analysis showed significant higher level of Hcy in the group with CAD and carotid artery disease vs. CAD group (p 0.001).Conclusion:High plasma homocysteine concentrations are associated with high risk for vascular disease and consequently CAD itself and carotid artery disease, as well, proving its likely role in the development of atherosclerosis on inflammatory and metabolic levels.

scholarly journals Serum Biomarkers in Carotid Artery Disease

Diagnostics ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. 2143
Author(s):  
Vassiliki I. Kigka ◽  
Vassiliki Potsika ◽  
Michalis Mantzaris ◽  
Vassilis Tsakanikas ◽  
Igor Koncar ◽  
...  
Keyword(s):  
High Risk ◽  
Carotid Artery ◽  
Carotid Artery Disease ◽  
Imaging Techniques ◽  
Standard Of Care ◽  
Patient Specific ◽  
Circulating Biomarkers ◽  
Early Disease Detection ◽  
Asymptomatic Patients ◽  
Artery Disease

Carotid artery disease is considered a major cause of strokes and there is a need for early disease detection and management. Although imaging techniques have been developed for the diagnosis of carotid artery disease and different imaging-based markers have been proposed for the characterization of atherosclerotic plaques, there is still need for a definition of high-risk plaques in asymptomatic patients who may benefit from surgical intervention. Measurement of circulating biomarkers is a promising method to assist in patient-specific disease management, but the lack of robust clinical evidence limits their use as a standard of care. The purpose of this review paper is to present circulating biomarkers related to carotid artery diagnosis and prognosis, which are mainly provided by statistical-based clinical studies. The result of our investigation showed that typical well-established inflammatory biomarkers and biomarkers related to patient lipid profiles are associated with carotid artery disease. In addition to this, more specialized types of biomarkers, such as endothelial and cell adhesion, matrix degrading, and metabolic biomarkers seem to be associated with different carotid artery disease outputs, assisting vascular specialists in selecting patients at high risk for stroke and in need of intervention.

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