کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
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2914241 | 1575507 | 2010 | 8 صفحه PDF | دانلود رایگان |

Objectives/designIn 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/methodsForty-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 (10–80 mg) to target low-density lipoprotein (LDL) < 100 mg dl−1. Blood samples and plaques' GSM score contralateral to brain infarct were assayed at baseline and after 6 months.ResultsAt 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).ConclusionIpsilateral 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.
Journal: European Journal of Vascular and Endovascular Surgery - Volume 39, Issue 3, March 2010, Pages 258–265