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Lowering Targeted Atherogenic Lipoprotein Cholesterol Goals for Patients at “Extreme” ASCVD Risk
AbstractPurpose of ReviewTo review randomized interventional clinical and imaging trials that support lower targeted atherogenic lipoprotein cholesterol goals in “extreme” and “very high” atherosclerotic cardiovascular disease (ASCVD) risk settings. Major atherosclerotic cardiovascular event (MACE) prevention among the highest risk patients with ASCVD requires aggressive management of global risks, including lowering of the fundamental atherogenic ap olipoprotein B-associated lipoprotein cholesterol particles [i.e., triglyceride-rich lipoprotein remnant cholesterol, low-density lipoprotein cholesterol (LDL-C), and ...
Source: Current Diabetes Reports - November 20, 2019 Category: Endocrinology Source Type: research

Evaluating the Efficacy of Atorvastatin on Patients with Carotid Plaque by an Innovative Ultrasonography
Background: The present study aimed to explore the efficacy of atorvastatin on patients with carotid plaque, applying superb microvascular imaging (SMI), and contrast-enhanced ultrasound (CEUS) for evaluating carotid intraplaque neovascularization. Methods: A total of 82 patients (82 carotid plaques) who were randomized into treatment group and control group underwent conventional ultrasound, CEUS, and SMI examinations. Patients in treatment group received a dose of 20 mg atorvastatin per day for 6 months while those in control group received placebo instead.
Source: Journal of Stroke and Cerebrovascular Diseases - December 15, 2018 Category: Neurology Authors: Yi-Cheng Zhu, Xiao-Zhen Jiang, Qing-Ke Bai, Shu-Hao Deng, Yuan Zhang, Zhi-Peng Zhang, Quan Jiang Source Type: research

Fractal dimension based carotid plaque characterization from three-dimensional ultrasound images
AbstractIrregularity of the plaque surface associated with previous plaque rupture plays an important role in the risk estimation of stroke caused by carotid atherosclerotic lesions. Thus, the aim of this study is to develop and validate novel vulnerability biomarkers from three-dimensional ultrasound (3DUS) images by analyzing the surface morphological characteristics of carotid plaque using fractal geometry features. In the experiments, a total of 38 3DUS plaque images were obtained from two groups of patients treated with 80  mg of atorvastatin or placebo daily for 3 months respectively. Two types of 3D fractal dimens...
Source: Medical and Biological Engineering and Computing - July 26, 2018 Category: Biomedical Engineering Source Type: research

Ischemic stroke in a patient with Parry-Romberg syndrome (P4.064)
Conclusions:The only other reported patient with PRS and stroke was also found to have a PFO. It is possible that the elevated ANA seen in this patient correlates with propensity towards small venous clots not seen on ultrasound. This may lead to paradoxical emboli and ischemic strokes. It is important to note this potential association between PRS and ischemic stroke in young patients without other known risk factors. It would be worthwhile to treat this subset of patients with medications for secondary stroke prevention.Disclosure: Dr. Ebiana has nothing to disclose. Dr. Singh has nothing to disclose. Dr. Khosa has nothi...
Source: Neurology - April 17, 2017 Category: Neurology Authors: Ebiana, V., Singh, S., Khosa, S., Moheb, N., Trikamji, B., Rao, N., Mishra, S. Tags: General Neurology: Vascular Neurology Source Type: research

Clinical Reasoning: A 66-year-old man with recurrent multi-territory infarcts
A 66-year-old man was referred to our center for evaluation of recurrent infarcts in multiple vascular territories over the preceding 6 months (figure 1). The patient first presented with a 3-month, stuttering course of transient neurologic deficits, including right arm and leg hemiparesis, expressive aphasia, and right homonymous hemianopia. He was initially evaluated at a community Stroke Prevention Clinic. His medical history was significant for several classic vascular risk factors: coronary artery disease requiring a coronary artery bypass graft, dyslipidemia for which he was taking atorvastatin 20 mg daily, and obstr...
Source: Neurology - June 8, 2015 Category: Neurology Authors: Kouzmitcheva, E., Steriade, C., Prica, A., Hazrati, L.-N., Mandell, D. M. Tags: All Cerebrovascular disease/Stroke, All Education RESIDENT AND FELLOW SECTION Source Type: research

Coronary atheroma volume and cardiovascular events during maximally intensive statin therapy
Conclusion Following 2 years of high-intensity statin therapy, a baseline coronary atheroma volume predicted MACE, despite the achievement of very low on-treatment LDL-C levels.
Source: European Heart Journal - November 1, 2013 Category: Cardiology Authors: Puri, R., Nissen, S. E., Shao, M., Ballantyne, C. M., Barter, P. J., Chapman, M. J., Erbel, R., Libby, P., Raichlen, J. S., Uno, K., Kataoka, Y., Nicholls, S. J. Tags: Coronary artery disease Source Type: research

C-Reactive Protein, but not Low-Density Lipoprotein Cholesterol Levels, Associate with Coronary Atheroma Regression and Cardiovascular Events Following Maximally Intensive Statin Therapy.
CONCLUSIONS: Following 24 months of potent statin therapy, on-treatment CRP levels associated with MACE. Inflammation may be an important driver of residual cardiovascular risk in patients with coronary artery disease despite aggressive statin therapy. CLINICAL TRIAL REGISTRATION INFORMATION: ClinicalTrials.gov. Identifier: NCT000620542. PMID: 24043299 [PubMed - as supplied by publisher]
Source: Circulation - September 16, 2013 Category: Cardiology Authors: Puri R, Nissen SE, Libby P, Shao M, Ballantyne CM, Barter PJ, Chapman MJ, Erbel R, Raichlen JS, Uno K, Kataoka Y, Nicholls SJ Tags: Circulation Source Type: research