PL EN


Preferencje help
Widoczny [Schowaj] Abstrakt
Liczba wyników

Czasopismo

2004 | 63 | 3 |

Tytuł artykułu

Carotid intima-media thickness better differentiates between groups of stroke patients and persons without cerebrovascular disease than other conventional and novel risk factors

Warianty tytułu

Języki publikacji

EN

Abstrakty

EN
When measured by ultrasound, the morphological markers of carotid atherosclerosis such as intima-media thickness (IMT) and cross-sectional plaque area have been associated with the risk of ischaemic stroke. We set out to determine whether the morphological parameters of the carotid arteries made it possible to better differentiate between groups of older atherothrombotic stroke patients and persons without cerebrovascular disease than conventional and novel risk factors of stroke. Of the total number of 623 persons examined, 54 stroke patients (mean age 63.3 years) and 74 controls without cerebrovascular disease (mean age 66.3 years) fulfilled the inclusion criteria for this investigation and were enrolled in the case-control study. After adjustment for age, gender and education level, the strongest associations were found between stroke and carotid IMT [odds ratio (OR) = 10.6; 95% confidence interval (CI): 4.3–26.9] and plaque area (OR = 5.4; 95%CI: 2.3–13.1). Other risk factors showed weaker associations with stroke occurrence. Of the clinical risk factors, a significant association was found between stroke and coronary heart disease (OR = 3.5; 95%CI: 1.2–10.2), hypertension (OR = 3.2; 95%CI: 1.5–7.2) and smoking (OR = 2.7; 95%CI: 1.1– –6.4). From the laboratory-derived risk factors a significant association was found between stroke and triglyceride levels (OR = 4.4; 95%CI: 1.9–10.0), and an inverse correlation was observed between stroke occurrence and HDL-cholesterol level (OR = 0.4; 95%CI: 0.2–0.8). The carotid IMT and plaque area, measured with the use of ultrasonography, showed a better correlation with stroke occurrence than currently recognised clinical and biochemical risk factors. The intima-media thickness and plaque area of the carotid arteries could be useful parameters in the development of strategies to identify patients at high risk of atherothrombotic ischaemic stroke.

Wydawca

-

Czasopismo

Rocznik

Tom

63

Numer

3

Opis fizyczny

p.253-260,fig.,ref.

Twórcy

autor
  • University of Medical Sciences, Przybyszewskiego 49, 60-355 Poznan, Poland
autor
autor
autor

Bibliografia

  • 1. Accinni R, Bartesaghi S, De Leo G, Cursano CF, Achilli G, Loaldi A, Cellerino C, Parodi O (2000) Screening of homocysteine from newborn blood spots by high-performance liquid chromatography with coulometric array detection. J Chromatogr A, 869: 183–189.
  • 2. Adams HP Jr, Bendixen BH, Kappelle LJ, Biller J, Love BB, Gordon DL, Marsh 3rd EE (1993) Classification of subtype of acute ischemic stroke. Definitions for use in a multicenter clinical trial. TOAST. Trial of Org 10172 in Acute Stroke Treatment. Stroke, 24: 35–41.
  • 3. Bamford J, Sandercock P, Dennis M, Burn J, Warlow C (1991) Classification and natural history of clinically identifiable subtypes of cerebral infarction. Lancet, 337: 1521–1526.
  • 4. Beamer NB, Coull BM, Clark WM, Briley DP, Wynn M, Sexton G (1998) Persistent inflammatory response in stroke survivors. Neurology, 50: 1722–1728.
  • 5. Bland JM, Altman DJ (1986) Statistical method for assessing agreement between two methods of clinical measurements. Lancet, 1: 307–310.
  • 6. Bots ML, Hoes AW, Koudstaal PJ, Hofman A, Grobbee DE (1997) Common carotid intima-media thickness and risk of stroke and myocardial infarction. Circulation, 96: 1432–1437.
  • 7. Cao JJ, Thach C, Manolio TA, Psaty BM, Kuller LH, Chaves PH, Polak JF, Sutton-Tyrrell K, Herrington DM, Price TR, Cushman M (2003) C-reactive protein, carotid intima-media thickness, and incidence of ischemic stroke in the elderly: the Cardiovascular Health Study. Circulation, 108: 166–170.
  • 8. Cermak J, Key NS, Bach RR, Balla J, Jacob HS, Vercellotti GM (1993) C-reactive protein induces human peripherial blood monocytes to synthesize tissue factor. Blood, 82: 513–520.
  • 9. Czarnecka D, Zabojszcz M (2002) Vascular remodeling and the risk of cardiovascular events. Przegl Lek, 59: supl. 3: 15–24.
  • 10. Demuth K, Drunat S, Girerd X, Moatti N, Paul J-L, Safar M, Boutouyrie P (2002) Homocysteine is the only plasma thiol associated with carotid artery remodeling. Athersoclerosis, 165: 167–174.
  • 11. Ferrara A, Barnet-Connor E, Shan J (1997) Total, LDL and HDL cholesterol decrease with age in older men and women: the Rancho Bernardo Study 1984–1994. Circulation, 96: 37–43.
  • 12. Fichtlscherer S, Rosenberg G, Walter DH, Breuer S, Dimmelers S, Zeiher AM (2000) Elevated C-reactive protein levels and impaired endothelial vasoreactivity in patients with coronary artery disease. Circulation, 102: 1000–1006.
  • 13. Friedewald W, Levy RI, Fredrickson DS (1972) Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem, 18: 499–502.
  • 14. Grobbee DE, Bots ML (1994) Carotid intima-media thickness as an indicator of generalized atherosclerosis. J Intern Med, 236: 363–370.
  • 15. Iso H, Jacobs DR, Wentworth D, Neaton JD, Cohen JD, for the MRFIT Research Group (1989) Serum cholesterol levels and six-year mortality from stroke in 350,977 men screened for the multiple risk factor international trial. N Engl J Med, 320: 904–910.
  • 16. Kannel WB (1988) Nutrition and the occurrence and prevention of cardiovascular disease in the elderly. Nutr Rev, 46: 66–78.
  • 17. Kaźmierski R, Niezgoda A, Guzik P, Łukasik M, Ambrosius W, Kozubski W (2003) An evaluation of the reproducibility of the measurement of the intima-media thickness of carotid arteries. Folia Morphol, 62: 25–31.
  • 18. Kittner SJ, Giles WH, Macko RF (1999) Homocyst(e)ine and risk of cerebral infarction in a biracial population: the stroke prevention in young women study. Stroke, 30: 1554–1560.
  • 19. Ledue TB, Weiner DL, Sipe JD, Poulin SE, Collins MF, Rifai N (1998) Analytical evaluation of particle-enhanced immunonephelometric assays for C-reactive protein, serum amyloid A and mannose-binding protein in human serum. Ann Clin Biochem, 35: 745–753.
  • 20. Naghavi M, Libby P, Falk E, Casscells SW, Litovsky S, Rumberger J, Badimon JJ, Stefanadis C, Moreno P, Pasterkamp G, Fayad Z, Stone PH, Waxman S, Raggi P, Madjid M, Zarrabi A, Burke A, Yuan C, Fitzgerald PJ, Siscovick DS, de Korte CL, Aikawa M, Airaksinen KE, Assmann G, Becker CR, Chesebro JH, Farb A, Galis ZS, Jackson C, Jang IK, Koenig W, Lodder RA, March K, Demirovic J, Navab M, Priori SG, Rekhter MD, Bahr R, Grundy SM, Mehran R, Colombo A, Boerwinkle E, Ballantyne C, Insull W Jr, Schwartz RS, Vogel R, Serruys PW, Hansson GK, Faxon DP, Kaul S, Drexler H, Greenland P, Muller JE, Virmani R, Ridker PM, Zipes DP, Shah PK, Willerson JT (2003) From vulnerable plaque to vulnerable patient. A call for new definition and risk assessment strategies: Part II. Circulation, 108: 1772–1778.
  • 21. O’Leary DH, Polak JF, Kronmal RA, Manolio TA, Burke GL, Wolfson SK (1999) Carotid-artery intima and media thickness as a risk factor for myocardial infarction and stroke in older adults. N Engl J Med, 340: 14–22.
  • 22. Prospective Studies Collaboration (1995) Cholesterol, diastolic blood pressure and stroke: 13,000 strokes in 450,000 people in 45 prospective cohorts. Lancet, 346: 1647–1653.
  • 23. Rifai N, Tracy RP, Ridker PM (1999) Clinical efficacy of an automated high-sensitivity C-reactive protein assay. Clin Chem, 45: 2136–2141.
  • 24. Rothblat GH, de la Llera Moya M, Atger V, Kellner-Weibel G, Williams DL, Phillips MC (1999) Cell cholesterol efflux: integration of old and new observations provides new insights. J Lipid Res, 40: 781–796.
  • 25. Ridker PM (2001) High-sensitivity C-reactive protein: potential adjunct for global risk assessment in the primary prevention of cardiovascular disease. Circulation, 103: 1813–1818.
  • 26. Ridker PM, Stampfer MJ, Rifai N ( 2001) Novel risk factors for systemic atherosclerosis: a comparison of C-reactive protein, fibrinogen, homocysteine, lipoprotein (a), and standard cholesterol screening as predictors of peripheral arterial disease. JAMA, 285: 2481–2485.
  • 27. Sander D, Winbeck K, Klingelhöfer J, Etgen T, Conrad B (2002) Reduced progression of early carotid atherosclerosis after antibiotic treatment and Chlamydia pneumoniae seropositivity. Circulation, 106: 2428–2433.
  • 28. Silvestrini M, Pietroiusti A, Troisi E, Franceschelli L, Piccolo P, Magrini A, Bernardi G, Galante A (1998) Leukocyte count and aggregation during the evolution of cerebral ischemic injury. Cerebrovasc Dis, 8: 305–309.
  • 29. Spence JD, Barnett PA, Bulman DE, Hegele RA (1999) An approach to ascertain probants with non-traditional risk factor for carotid atherosclecrosis. Atherosclerosis, 144: 429–434.
  • 30. Spence JD, Eliasziw M, DiCicco M, Hackam DG, Galil R, Lohmann T (2002) Carotid plaque area: a tool for targeting and evaluating vascular preventive therapy. Stroke, 33: 2916–2922.
  • 31. Taylor AJ, Kent SM, Flaherty PJ, Coyle LC, Markwood TT, Vernalis MN (2002) ARBITER: Arterial biology for the investigation of the treatment effects of reducing cholesterol: a randomized trial comparing the effects of atorvastatin and provastatin on carotid intima-media thickness. Circulation, 106: 2055–2060.
  • 32. Tell GS, Crouse JR, Furberg CD (1988) Relation between blood lipids, lipoproteins, and cerebrovascular atherosclerosis: a review. Stroke, 19: 423–430.
  • 33. Toubul JP, Elbaz A, Koller C, Lucas C, Adrai V, Chedru F, Amarenco P (2000) Common carotid artery intima-media thickness and brain infarction. Circulation, 102: 313–318.
  • 34. van Lenten BJ, Navab M, Shih D, Fogelman AM, Lusis AJ (2001) The role of high-density lipoproteins in oxidation and inflammation. Trends Cardiovasc Med, 11: 155–161.
  • 35. Warlow CP, van Gijn DJ, Hankey GJ, Sandercock PAG, Bamford JM, Wardlaw JM (2001) Stroke: a practical guide to management. Blackwell Science, Oxford, pp. 223–300.
  • 36. Winbeck K, Poppert H, Etgen T, Conrad B, Sander D (2002) Prognostic relevance of early serial C-reactive protein measurements after first ischemic stroke. Stroke, 33: 2459–2464.

Typ dokumentu

Bibliografia

Identyfikatory

Identyfikator YADDA

bwmeta1.element.agro-article-7e6b13ae-e473-4e9c-a51f-b23ba9bde419
JavaScript jest wyłączony w Twojej przeglądarce internetowej. Włącz go, a następnie odśwież stronę, aby móc w pełni z niej korzystać.