Article

Carotid Atherosclerosis Does Not Predict Coronary, Vertebral, or Aortic Atherosclerosis in Patients With Acute Stroke Symptoms

Department of Radiology, University of California, San Francisco, San Francisco, Calif, USA.
Stroke (Impact Factor: 6.02). 08/2010; 41(8):1604-9. DOI: 10.1161/STROKEAHA.109.577437
Source: PubMed

ABSTRACT The purpose of this study was to determine whether significant atherosclerotic disease in the carotid arteries predicts significant atherosclerotic disease in the coronary arteries, vertebral arteries, or aorta in patients with symptoms of acute ischemic stroke.
Atherosclerotic disease was imaged using CT angiography in a prospective study of 120 consecutive patients undergoing emergent CT evaluation for symptoms of stroke. Using a comprehensive CT angiography protocol that captured the carotid arteries, coronary arteries, vertebral arteries, and aorta, we evaluated these arteries for the presence and severity of atherosclerotic disease. Significant atherosclerotic disease was defined as >50% stenosis in the carotid, coronary, and vertebral arteries, or >or=4 mm thickness and encroaching in the aorta. Presence of any and significant atherosclerotic disease was compared in the different types of arteries assessed.
Of these 120 patients, 79 had CT angiography examinations of adequate image quality and were evaluated in this study. Of these 79 patients, 33 had significant atherosclerotic disease. In 26 of these 33 patients (79%), significant disease was isolated to 1 type of artery, most often to the coronary arteries (N=14; 54%). Nonsignificant atherosclerotic disease was more systemic and involved multiple arteries.
Significant atherosclerotic disease in the carotid arteries does not predict significant atherosclerotic disease in the coronary arteries, vertebral arteries, or aorta in patients with symptoms of acute ischemic stroke. Significant atherosclerotic disease is most often isolated to 1 type of artery in these patients, whereas nonsignificant atherosclerotic disease tends to be more systemic.

Download full-text

Full-text

Available from: Andre Furtado, Jul 04, 2015
0 Followers
 · 
66 Views
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: OBJECTIVE: Effects of systemic hyperglycemia and normoglycemia on gastric emptying in people with type 2 diabetes are not clear. The aim of the study was to investigate the gastric emptying time in people with newly detected diabetes before and after control of diabetes compared with healthy controls. METHODS: Gastric emptying to solid meal was studied in 30 asymptomatic women with newly detected diabetes before and after achieving euglycemia and compared with 20 healthy age, sex and weight matched controls using egg white labelled with Technetium 99m Sulfur Colloid. RESULTS: Delayed gastric emptying was seen in 90% of women with diabetes and none in healthy controls. Lag phase was 83.1±11.8min in cases compared to 37.2±4.0 in controls (p=0.05). Gastric emptying at 4h was 46.73%±4.84% in cases and 97.65%±0.59% in controls (p=0.05).T50 was 250±8.8min in cases against 94.70±5.10min in controls (p<0.05). After control of diabetes, lag phase normalized to 37.2±4.0min against 35.2±4.6min in controls. Similarly all other parameters also normalized after control of diabetes. CONCLUSIONS: Delayed gastric emptying to solids was seen in 90% of women with type 2 diabetes at the time of hyperglycemia and normalized after control of diabetes.
    Journal of diabetes and its complications 09/2012; 27(1). DOI:10.1016/j.jdiacomp.2012.08.001 · 1.93 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: To evaluate the prevalence of atherosclerosis detected by both carotid and lower extremity ultrasonography in hospitalized Chinese type 2 diabetic patients and to examine whether plaque formation in the carotid arteries could be an indicator of generalized atherosclerosis in type 2 diabetes mellitus. Totally, 709 hospitalized Chinese type 2 diabetic patients (men 357, women 352) aged from 18 to 88 years were included. Both carotid and lower extremity atherosclerosis were assessed by Doppler ultrasound. Atherosclerosis was defined as the presence of either the carotid or lower extremity plaque in any of the above-mentioned arteries segments. The prevalence of atherosclerosis was calculated, and the risk factors associated with atherosclerosis were evaluated using binary logistic regression. The prevalence of atherosclerosis was 81.23% in male and 77.56% in female type 2 diabetic patients, respectively. There was no significant difference in the prevalence of atherosclerosis in patients between the sexes. The prevalence of atherosclerosis was significantly higher in the lower extremity arteries than in the carotid arteries (73.91% and 44.43%, respectively, P<.001). Atherosclerosis was significantly associated with smoking, age, duration of diabetes, systolic blood pressure, total number of white blood cells, and mean carotid and femoral intima-media thickness (IMT). The prevalence of atherosclerosis was very high in Chinese inpatients with type 2 diabetes. Carotid atherosclerosis could not be an indicator of generalized atherosclerosis in type 2 diabetes. The combination of carotid and lower extremity ultrasound examination can significantly improve the detection of atherosclerosis in type 2 diabetes.
    Journal of diabetes and its complications 01/2012; 26(1):23-8. DOI:10.1016/j.jdiacomp.2011.11.006 · 1.93 Impact Factor
  • Stroke 09/2010; 41(11):e597; author reply e598. DOI:10.1161/STROKEAHA.110.596049 · 6.02 Impact Factor