Document Detail


Beneficial changes of serum calcification markers and contralateral carotid plaques echogenicity after combined carotid artery stenting plus intensive lipid-lowering therapy in patients with bilateral carotid stenosis.
MedLine Citation:
PMID:  20004120     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES/DESIGN: In symptomatic patients treated with ipsilateral carotid artery stenting (CAS) plus intensive lipid lowering, we assessed the changes of osteopontin (OPN), osteoprotegerin (OPG) and the Gray-Scale Median (GSM) score contralateral to symptomatic carotid stenosis. MATERIALS/METHODS: Forty-six symptomatic patients (group A) with significant carotid stenosis (North American Symptomatic Carotid Endarterectomy Trial (NASCET): >70%) underwent ipsilateral CAS. Those patients had simultaneously contralateral low-grade carotid stenosis (NASCET: 30-69%). Group B included 67 symptomatic patients with low-grade bilateral carotid stenosis (NASCET: 30-69%), but without indications for revascularisation. All patients were treated with atorvastatin (10-80mg) to target low-density lipoprotein (LDL)<100mgdl(-1). Blood samples and plaques' GSM score contralateral to brain infarct were assayed at baseline and after 6 months. RESULTS: At baseline, there were no significant differences between groups (p>0.05). Six-month atorvastatin treatment equivalently improved lipid profile in both groups (p<0.05). The parameters hsCRP, OPN and OPG were significantly down-regulated within both groups, but to a greater extent in group A (p<0.05). Besides this, contralateral GSM score was significantly improved from baseline in both groups (p<0.01), but that increment was more pronounced in group A (vs. group B; p=0.041). These changes were inversely correlated with changes in OPN (p=0.014), OPG (p=0.011) and LDL (p=0.041). CONCLUSION: Ipsilateral CAS plus intensive lipid-lowering therapy was associated with enhanced contralateral carotid plaque stability and attenuated inflammatory burden and calcification inhibitors to a greater extent than atorvastatin therapy alone in patients with bilateral carotid stenosis.
Authors:
N P E Kadoglou; T Gerasimidis; A Kapelouzou; A Moumtzouoglou; E D Avgerinos; J D Kakisis; P E Karayannacos; C D Liapis
Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't     Date:  2009-12-08
Journal Detail:
Title:  European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery     Volume:  39     ISSN:  1532-2165     ISO Abbreviation:  Eur J Vasc Endovasc Surg     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-03-15     Completed Date:  2010-04-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9512728     Medline TA:  Eur J Vasc Endovasc Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  258-65     Citation Subset:  IM    
Copyright Information:
Copyright 2009 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.
Affiliation:
First Department of Internal Medicine, Hippokratio General Hospital of Thessaloniki, Thessaloniki, Greece. nikoskad@yahoo.com
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MeSH Terms
Descriptor/Qualifier:
Aged
Angioplasty / instrumentation*
Biological Markers / blood
C-Reactive Protein / metabolism
Calcinosis / blood,  drug therapy,  therapy*,  ultrasonography
Carotid Stenosis / blood,  drug therapy,  therapy*,  ultrasonography
Combined Modality Therapy
Down-Regulation
Female
Greece
Heptanoic Acids / therapeutic use*
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use*
Male
Middle Aged
Osteopontin / blood*
Osteoprotegerin / blood*
Prospective Studies
Pyrroles / therapeutic use*
Severity of Illness Index
Stents*
Time Factors
Treatment Outcome
Ultrasonography, Doppler*
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Heptanoic Acids; 0/Hydroxymethylglutaryl-CoA Reductase Inhibitors; 0/Osteoprotegerin; 0/Pyrroles; 0/SPP1 protein, human; 0/TNFRSF11B protein, human; 106441-73-0/Osteopontin; 110862-48-1/atorvastatin; 9007-41-4/C-Reactive Protein

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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