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.
Title | 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. |
Publication Type | Journal Article |
Year of Publication | 2010 |
Authors | Kadoglou, N. P. E., Gerasimidis T., Kapelouzou A., Moumtzouoglou A., Avgerinos E. D., Kakisis J. D., Karayannacos P. E., & Liapis C. D. |
Journal | Eur J Vasc Endovasc Surg |
Volume | 39 |
Issue | 3 |
Pagination | 258-65 |
Date Published | 2010 Mar |
ISSN | 1532-2165 |
Keywords | Aged, Angioplasty, Biological Markers, C-Reactive Protein, Calcinosis, Carotid Stenosis, Combined Modality Therapy, Down-Regulation, Female, Greece, Heptanoic Acids, Humans, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Male, Middle Aged, Osteopontin, Osteoprotegerin, Prospective Studies, Pyrroles, Severity of Illness Index, Stents, Time Factors, Treatment Outcome, Ultrasonography, Doppler |
Abstract | 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. |
DOI | 10.1016/j.ejvs.2009.11.013 |
Alternate Journal | Eur J Vasc Endovasc Surg |
PubMed ID | 20004120 |