Fruits and vegetables (typically associated with the Mediterranean diet) are very rich in carotenoids, i.e. fat-soluble pigments really important in human life. Structurally, carotenoids consists of eleven (beta-carotene, zeaxanthin, lycopene) or ten (alpha-carotene, lutein) conjugated double bonds, responsible for their antioxidant capability in agreement with their substituents. Low-Density Lipoprotein (LDL) particles oxidation process is the one of the most important first steps of atherosclerotic disease and, consequentially, the first pathogenetical step of cerebro- and cardiovascular events like myocardial infarction and stroke, which are the first cause of death in industrialized countries. Reactive oxygen species (ROS) also seem to be the target of Carotenoids main action, by scavenging singlet oxygen (1O2) and free radicals. Literature data showed that ROS increase atherosclerotic individual burden. The carotenoids scavenging action could reduce atherosclerosis progression partly due to such a decrease in ROS concentrations. Many studied demonstrated such a reduction by analyzing the relationship between carotenoids and Intima-Media Thickness of common carotid artery wall (CCA-IMT), [a well established marker of atherosclerosis evolution] reduction. Aim of this review is to evaluate actual knowledge about the importance of carotenoids molecules in slowing down the starting and the progression of atherosclerotic plaque, and to consider their implementation in everyone's diet as a tool to obtain a sharp decrease of LDL oxidation and their possible effect on endothelial function.

Aims: Dolichocarotids (DCs) represent a rare (2-6%) carotid imaging finding in the general population that may be free of clinical significance or be associated with cerebrovascular events. Their detection is traditionally assigned to carotid echo-color Doppler (ECD) and selective angiography (the standard method). The primary aim of this study was to estimate the sensitivity, specificity and accuracy of ECD in detecting DCs. Moreover, we monitored the DC curvature angle and the incidence of TIA, ischemic stroke, myocardial infarction and cardiovascular death over a five-year followup period. Methods: A total of 112 consecutive patients with DCs (80 men, mean age: 61±7 years) were recruited for carotid ECD and carotid angiography due to the persistence of neurological symptoms not well explained on ultrasound evaluations, according to the current guidelines. Results: ECD proved to have 100% sensitivity in detecting tortuosity and coiling and 96% sensitivity in detecting kinking, with an overall accuracy ranging from 92% to 100%. The specificity was 75% for tortuosity, 91% for kinking and 100% for coiling. During the five-year follow-up period, there was a statistically significant increase in tortuosity (61±11° at baseline versus 81±11° after five years, p＜0.001) and the kinking curvature angle (97±3° at baseline versus 100±3° at five years, p＜0.001), whilst no differences were observed with respect to coiling (136±10° at baseline versus 138±11° at five years, p = ns). Moreover, kinking was found to be more frequently statistically associated with cardiovascular death than tortuosity (p = 0.005). Conclusions: DCs predispose patients to potentially disabling and fatal events. ECD plays a primary role in the detection of DCs and therefore should be considered to be a secure and reproducible technique.

Purpose: To evaluate waiting lists during the coronary artery bypass graft (CABG) diagnostictherapeutic pathway of patients, in order to detect the actual waiting time between diagnostic evaluation and surgery, and to explore if coronary angiography provides an option as a starting point of waiting lists for CABG patients. Methods: We analyzed 496 hospital discharge cards (year 2009) from main cardiac surgery units in Apulia, Italy. Exclusion criteria were emergency patients coming from regions other than Apulia, and CABG associated with cardiac valve surgery. Results: A total of 97.6% patients underwent CABG within 0-30 days of their reservation date, and 81.7% passed from the first diagnostic step to coronary angiography within 0-30 days. The mean time delay in the diagnostic (ie, the time elapsing from the date of first test performed to detect coronary heart disease and that of coronary angiography) and therapeutic (ie, the time elapsing from the date of waiting-list admission and that of cardiac surgery unit admission) phases was 17.3 ± 31.306 and 5.09 ± 9.375 days respectively; 27% and 19.8% underwent CABG within the same day or at least the day after reservation day, whilst 47.2% completed the diagnostic phase on the same day. Conclusion: The waiting lists for CABG surgery diagnostic-therapeutic phase in Apulia are short.

Objective: To determine whether age at menarche is an independent predictor of common carotid artery intima-media thickness in overweight and obese adult women. Methods: 403 overweight and obese women, aged 18-72 years, were evaluated. We examined the associations among common carotid artery intima-media thickness (CCA-IMT), age at menarche, body mass index, central fat accumulation (indirectly measured by waist circumference), and other well-known cardiovascular risk factors (blood pressure; fasting serum insulin, glucose and lipids concentrations; insulin resistance [estimated by homeostasis model assessment for insulin resistance]). Results: CCA-IMT was significantly and positively correlated with age (r=0.632, p<0.001), age of menarche (r=0.156, p<0.01), waist circumference (r=0.110, p<0.05), systolic (r=0.292, p<0.001) and diastolic (r=0.183, p<0.001) blood pressure, fasting blood glucose (r=0.265, p<0.001), triglycerides (r=0.204, p<0.001) and total cholesterol (r=0.396, p<0.001) levels. Conversely, CCA-IMT was negatively associated with high-density lipoprotein cholesterol (r=-0.111, p<0.05). Age at menarche was associated with CCA-IMT (r=0.156, p<0.01), age (r=0.110, p<0.05) and waist circumference (r=0.121, p<0.05). Multiple linear analysis showed that only age and age at menarche maintained an independent positive relationship with the CCA-IMT. Conclusions: Age at menarche is positively associated with CCA-IMT, independently of common cardiovascular risk factors (adverse glucose and lipid levels, higher blood pressure, insulin resistance, body fatness and central body fat). Late age at menarche can be considered as an independent cardiovascular risk factor in obese subjects.

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