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Evidence of an anti-inflammatory effect of PCSK9 inhibitors within the human atherosclerotic plaque
CONCLUSIONS: The use of PCSK9 inhibitors is accompanied by a beneficial remodelling of the inflammatory burden within the human atheroma, an effect possibly or partly independent of their LDL-C lowering ability. This phenomenon might provide an additional cardiovascular benefit.PMID:37422356 | DOI:10.1016/j.atherosclerosis.2023.06.971
Source: Atherosclerosis - July 8, 2023 Category: Cardiology Authors: Raffaele Marfella Francesco Prattichizzo Celestino Sardu Pasquale Paolisso Nunzia D'Onofrio Lucia Scisciola Rosalba La Grotta Chiara Frig é Franca Ferraraccio Iacopo Panarese Mara Fanelli Piero Modugno Antonio Maria Calafiore Mario Melchionna Ferdinando Source Type: research

Investigation of Combined Carotid Endarterectomy and Coronary Artery Bypass Graft Surgery Outcomes and Adverse Event Risk Factors in the Vascular Quality Initiative
CONCLUSIONS: Combined CEA and CABG provides excellent long-term mortality prevention in patients with co-existing severe coronary and carotid atherosclerosis. Simultaneous CEA and CABG provides equivalent stroke prevention and long-term survival to both a cohort of patients undergoing coronary revascularization within 5 years of CEA and patients undergoing isolated CEA or CABG in the literature. The two most impactful modifiable risk factors towards long-term stroke and mortality prevention for patients undergoing simultaneous CEA-CABG are patch placement at CEA site and adherence to statin medication therapy.PMID:37303074...
Source: Atherosclerosis - June 11, 2023 Category: Cardiology Authors: Ashley Penton Jonathan Lin Grant Kolde Matthew DeJong Matthew Blecha Source Type: research

Young Patients Undergoing Carotid Endarterectomy Have Increased Rates of Recurrent Disease and Late Neurologic Events
CONCLUSIONS: Young patients undergoing CEA are more likely to be African American, female, and active smokers. They are more likely to present symptomatically and undergo non-elective CEA. Although perioperative outcomes are similar, younger patients are more likely to experience carotid occlusion or restenosis as well as subsequent neurological events, during relatively short follow-up. These data suggest that younger CEA patients may require more diligent follow-up, and a continued aggressive approach to medical management of atherosclerosis to prevent future events related to the operated artery, given the particularly ...
Source: Atherosclerosis - March 4, 2023 Category: Cardiology Authors: Molly Ratner Karan Garg Heepeel Chang William Johnson Mikel Sadek Thomas Maldonado Neal Cayne Jeffrey Siracuse Glenn Jacobowitz Caron Rockman Source Type: research

Perioperative Medical Management for Symptomatic Carotid Artery Interventions
AbstractPurpose of ReviewThe goal of this review is to provide the reader with an overview of symptomatic carotid stenosis and the approach to medical management of patients undergoing surgical intervention with both carotid endarterectomy (CEA) and carotid artery stenting (CAS).Recent FindingsCEA is recommended for patients with moderate to severe symptomatic carotid stenosis and transient ischemic attack (TIA) or non-disabling stroke. More recently CAS has also been shown to be a beneficial, less invasive option for patients with symptomatic carotid stenosis. All patients need urgent medical therapy to reduce the risk of...
Source: Current Treatment Options in Cardiovascular Medicine - October 1, 2022 Category: Cardiology Source Type: research

Arterial Atherosclerosis: Vascular Surgery Interventions
Am Fam Physician. 2022 Jan 1;105(1):65-72.ABSTRACTAtherosclerotic vascular disease is a leading cause of death worldwide. Atherosclerotic stenosis of the internal carotid or intracranial arteries causes up to 15% of strokes. Peripheral artery disease affects up to one in five people in the United States who are 60 years and older and nearly one-half of those who are 85 years and older. Renal artery stenosis may affect up to 5% of people with isolated hypertension and up to 40% of people with other atherosclerotic diseases. All patients with atherosclerotic vascular disease should receive a comprehensive program of guidelin...
Source: Atherosclerosis - January 14, 2022 Category: Cardiology Authors: Jonathon M Firnhaber C S Powell Source Type: research

Imaging High-Risk Atherothrombosis Using a Novel Fibrin-Binding Positron Emission Tomography Probe
CONCLUSIONS: We demonstrated that molecular fibrin PET imaging using 68Ga-CM246 could be a useful tool to diagnose experimental and clinical atherothrombosis. Based on our initial results using human carotid plaque specimens, in vivo molecular imaging studies are warranted to test 68Ga-CM246 PET as a tool to stratify risk in atherosclerotic patients.PMID:34965737 | DOI:10.1161/STROKEAHA.121.035638
Source: Atherosclerosis - December 30, 2021 Category: Cardiology Authors: David Izquierdo-Garcia Himashinie Diyabalanage Ian A Ramsay Nicholas J Rotile Adam Mauskapf Ji-Kyung Choi Thomas Witzel Valerie Humblet Farouc A Jaffer Anna-Liisa Brownell Ahmed Tawakol Ciprian Catana Mark F Conrad Peter Caravan Ilknur Ay Source Type: research

Association and Implications of Blood and Plaque n-3 Polyunsaturated Fatty Acid Composition in Patients Treated with Oral Eicosapentaenoic Acid before Carotid Endarterectomy
In this study, we evaluate whether the serum EPA/AA ratio would be a useful biomarker for determining the efficacy of orally administered EPA in preventing stroke by investigating tissue and serum EPA/AA ratios, serum inflammatory markers, and carotid artery intimamedia thickness (IMT). Patients with dyslipidemia, as the primary illness scheduled for carotid endarterectomy (CEA), were included and randomly assigned to the EPA group (EPA: 1,800 mg/day plus statin; 10 patients) or non-EPA group (statin only; 15 patients). PUFA fraction was evaluated in the tissue (post-CEA) and serum (pre-CEA and 6 months thereafter). As f...
Source: International Journal of Angiology - August 25, 2021 Category: Cardiology Authors: Ishikawa, Tatsuya Yamaguchi, Koji Funatsu, Takayuki Okada, Yoshikazu Kawamata, Takakazu Tags: Original Article Source Type: research

Prognostic factors of long-term survival to guide selection of asymptomatic patients for carotid endarterectomy.
CONCLUSIONS: The presence of one or more prognostic factors as well as the various risk prediction models can guide selection of ACS patient subgroups for which a prophylactic CEA should or should not be offered. Decisions to offer prophylactic CEA should weigh in factors like surgeon's experience and hospital expertise/volume. Asymptomatic patients not expected to live long enough to benefit from the procedure should not be considered for CEA, but should be offered best medical treatment. PMID: 31814375 [PubMed - as supplied by publisher]
Source: International Angiology - December 11, 2019 Category: Cardiology Tags: Int Angiol Source Type: research

Poor Long-term Outcomes after Carotid Endarterectomy: A Retrospective Analysis of Two Portuguese Centers.
CONCLUSIONS: Patients continue to have high rates of AMI, MACE and death after CEA. Prior CAD is a risk factor for future AMI, whereas CKD is a significant predictor of MACE and death. Aggressive best medical treatment (BMT) and risk factors modification should be advised in patients with systemic atherosclerosis. PMID: 31251084 [PubMed - as supplied by publisher]
Source: Scandinavian Cardiovascular Journal - June 30, 2019 Category: Cardiology Tags: Scand Cardiovasc J Source Type: research

Symptomatic Carotid Artery Stenosis: Surgery, Stenting, or Medical Therapy?
Opinion statementSymptomatic carotid artery disease is a significant cause of ischemic stroke, and these patients are at high risk for recurrent vascular events. Patients with symptoms of stroke or transient ischemic attack attributable to a significantly stenotic vessel (70 –99% luminal narrowing) should be treated with intensive medical therapy. Intensive medical therapy is a combination of pharmacologic and lifestyle interventions consistent with best-known practices as follows: initiation of antiplatelet agent or anticoagulation if medically indicated, high potenc y statin medication, blood pressure control with goal...
Source: Current Treatment Options in Cardiovascular Medicine - July 5, 2017 Category: Cardiology Source Type: research

Withdrawal of statins therapy in patients after carotid endarterectomy associated with increasing risk of significant restenosis
Background: The benefit of carotid revascularization is decreased by the occurrence of restenosis at the site of surgery, which is associated with a modestly increased risk of stroke. Preventing restenosis plays pivotal role in the overall treatment and prevention of stroke in patients with carotid artery disease.
Source: Artery Research - November 25, 2016 Category: Cardiology Authors: Olga Tereshina, Alexcey Vachev Source Type: research

High-grade carotid artery stenosis: A forgotten area in cardiovascular risk management
Conclusions The clinical event rate was high in patients with high-grade CAS and the management of cardiovascular risk was deficient in all aspects.
Source: European Journal of Preventive Cardiology - August 10, 2016 Category: Cardiology Authors: Good, E., Länne, T., Wilhelm, E., Perk, J., Jaarsma, T., de Muinck, E. Tags: Original scientific papers Source Type: research

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