Carotid Plaques Correlates in Patients With Familial Hypercholesterolemia

Abstract

Patients with familial hypercholesterolemia (FH) are at increased risk of premature cardiovascular disease. We compared factors associated with the presence of carotid plaques and carotid intima-media thickness (cIMT), markers of subclinical atherosclerosis, in 241 patients with FH (98, 40.7% men; mean age 41 ± 18.4 years). Patients with FH having carotid plaques (36.5%) had mean age, apolipoprotein (apo) B, glucose, apoA1, systolic blood pressure (SBP) and diastolic BP, waist/hip ratio (WHR), and body mass index higher than patients without plaques. Logistic regression revealed that apoB (odds ratio [OR] per 1 unit change 1.03,P= .005), high-density lipoprotein cholesterol (HDL-C; OR per 1 standard deviation [SD] change 0.59,P= .015), and non-HDL-C (OR per 1SD change 1.53,P= .04) were significantly associated with the presence of plaques. The cIMT correlated with obesity parameters, BP, apoB, glucose, high-sensitivity C-reactive protein, creatinine, γ-glutamyl transpeptidase, and alanine transaminase (P< .001). Regression analysis revealed that cIMT was significantly associated with apoB, SBP, and WHR. These results confirm the role of apoB-containing lipoproteins and low HDL-C with the presence of carotid plaques and apoB, BP, and WHR with cIMT.

Does metabolic syndrome influence short and long term durability of carotid endarterectomy and stenting?

“…4 Various studies have shown an increased incidence and more rapid progression of carotid atherosclerosis in patients with MetS, 6 in both men 7 and women. 8,9 The presence of MetS is associated with an amplified vascular wall thickness and stiffness 10,11 and an overall prothrombotic state. 12 Carotid endarterectomy (CEA) is the current gold standard therapy for carotid artery stenosis caused by atheromatous narrowing at the carotid bifurcation.…”

“…Various studies have shown an increased incidence and more rapid progression of carotid atherosclerosis in patients with MetS, in both men and women . The presence of MetS is associated with an amplified vascular wall thickness and stiffness and an overall prothrombotic state …”

The Influence of the Metabolic Syndrome on the Short- and Long-Term Outcome After Carotid Endarterectomy

“…4 Various studies have shown a positive association between MetS and the development of atherosclerosis, resulting in an increased incidence and more rapid progression of carotid atherosclerosis in patients with MetS. [5][6][7] Carotid endarterectomy (CEA) is the preferred treatment for ischemic stroke in selected patients with symptomatic or severe asymptomatic carotid disease. In 2011, a Cochrane analysis showed an absolute risk reduction in ipsilateral ischemic stroke of 16% in patients with a 70% to 99% symptomatic stenosis who underwent CEA compared with best medical treatment alone.…”

Lipoprotein(a) level associates with coronary artery disease rather than carotid lesions in patients with familial hypercholesterolemia

“…However, their study did not provide information regarding CAD. In addition, similar to prior study, we have found that apoB was associated with the presence of carotid plaques . Unquestionably, more studies about the irrelevant results between Lp(a) and carotid lesions in our observation may be needed considering our small sample size.…”