Imaging of functional and structural alterations of large arteries after acute ischaemic atherothrombotic stroke or acute coronary syndromes
Gilles Barone-Rochette, Gerald Vanzetto, Olivier Detante, Jean-Louis Quesada, Marc Hommel, Jean-Michel Mallion, Jean-Philippe Baguet, Gilles Barone-Rochette, Gerald Vanzetto, Olivier Detante, Jean-Louis Quesada, Marc Hommel, Jean-Michel Mallion, Jean-Philippe Baguet
Abstract
Background: Non-invasive methods allow the evaluation of structural and functional arterial abnormalities. So far, no study has focused on the comparison of vascular parameters by type of cardiovascular event.
Methods: In this pilot study, cardiovascular risk factors, carotid parameters, carotid-to-femoral pulse wave velocity (PWV), brachial flow-mediated dilation and ambulatory blood pressure were assessed in patients who presented with acute coronary syndromes (ACS) or ischaemic atherothrombotic stroke (IAS). Groups were matched for age and gender.
Results: Prevalences of hypertension, diabetes and dyslipidaemia and heredity, smoking and body mass index were similar in the ACS (n=50) and IAS (n=50) groups. Carotid intima-media thickness (IMT) and PWV were significantly higher in the IAS vs. ACS group (769±180 vs. 701±136 μm; P=0.039 and 12.5±3.5 vs. 10.7±2.4 m/s; P=0.006). Carotid distensibility was significantly lower in the IAS vs. ACS group (16.2±3.2 vs. 18.9±7.6 10(-3)/kPa; P=0.02). These differences persisted after adjustment for blood pressure for carotid distensibility but not for PWV. The prevalences of endothelial dysfunction and carotid plaques were not significantly different in the ACS and IAS groups (86% and 74%; 80% and 78%). In a multivariable model, carotid distensibility remained associated with ACS (odds ratio 1.19; 95% confidence interval 1.03-1.38; P=0.016).
Conclusions: Stiffness and carotid wall thickness were higher in IAS than in ACS patients. These differences may support the interest in new therapeutic targets for cardiovascular secondary prevention.
Nct no: NCT00926874.
Keywords: Accident vasculaire cérébral; Acute coronary syndromes; Brachial flow-mediated dilatation; Carotid-to-femoral pulse wave velocity; Dilatation de l’artère humérale médiée par le flux; Intima-media thickness; L’épaisseur intima-média; Stroke; Syndrome coronarien aigu; Vitesse de l’onde pouls.
Copyright © 2014 Elsevier Masson SAS. All rights reserved.
Source: PubMed