Atorvastatin treatment and carotid plaque morphology in first-ever atherosclerotic transient ischemic attack/stroke: a case-control study.

Background: A relationship between echolucency of carotid plaques and the consequent risk of ipsilateral ischemic stroke has been observed. An aggressive lipid-lowering therapy may increase the echogenicity of carotid plaque in patients with elevated low-density lipoprotein cholesterol levels. The a...

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Publicado en:Journal of Stroke & Cerebrovascular Diseases Vol. 24; no. 1; pp. 138 - 144
Autores principales: Marchione, Pasquale, Vento, Claudio, Morreale, Manuela, Izzo, Chiara, Maugeri, Andrea, Manuppella, Federica, Romeo, Tommaso, Giacomini, Patrizia
Formato: research randomized controlled trial Journal Article
Publicado: W B Saunders Jan2015
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Jan2015
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      pub: W B Saunders
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        10.1016/j.jstrokecerebrovasdis.2014.08.006
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        atl: Atorvastatin treatment and carotid plaque morphology in first-ever atherosclerotic transient ischemic attack/stroke: a case-control study.
      aug:
        au:
          Marchione, Pasquale
          Vento, Claudio
          Morreale, Manuela
          Izzo, Chiara
          Maugeri, Andrea
          Manuppella, Federica
          Romeo, Tommaso
          Giacomini, Patrizia
      sug:
        subj:
          Carotid Artery Diseases Drug Therapy
          Carotid Artery Diseases Pathology
          Fatty Acids Therapeutic Use
          Antilipemic Agents Therapeutic Use
          Cerebral Ischemia, Transient Drug Therapy
          Cerebral Ischemia, Transient Pathology
          Atherosclerosis Drug Therapy
          Atherosclerosis Pathology
          Heterocyclic Compounds Therapeutic Use
          Stroke Drug Therapy
          Stroke Pathology
          Aged
          Carotid Artery Diseases Ultrasonography
          Case Control Studies
          Dose-Response Relationship, Drug
          Female
          Fatty Acids Adverse Effects
          Human
          Antilipemic Agents Adverse Effects
          Image Processing, Computer Assisted
          Cerebral Ischemia, Transient Ultrasonography
          Male
          Middle Age
          Atherosclerosis Ultrasonography
          Prospective Studies
          Heterocyclic Compounds Adverse Effects
          Aged: 65+ years
          Middle Aged: 45-64 years
          Female
          Male
      ab: Background: A relationship between echolucency of carotid plaques and the consequent risk of ipsilateral ischemic stroke has been observed. An aggressive lipid-lowering therapy may increase the echogenicity of carotid plaque in patients with elevated low-density lipoprotein cholesterol levels. The aim of this study is to prospectively evaluate the long-term effect of high-dose atorvastatin on carotid plaque morphology in patients with first-ever transient ischemic attack or stroke. Methods: All patients with symptomatic first ischemic atherosclerotic cerebrovascular event occurred within the previous 10 days were enrolled. Carotid Doppler ultrasound of the neck vessels with 7-11 MHz probe for the definition of the atherosclerotic carotid framework was performed. The analysis of the gray-scale median (GSM) of each plate was carried out with image processing software. Results: A total of 240 symptomatic plaques were included and divided into 3 groups: 80 in group A (atorvastatin 80 mg), 80 in group B (atorvastatin 40 mg), and 80 to group C (no atorvastatin). GSM score increases significantly more extensive in group A than in group B (+48.65 vs. +39.46, P < .02) and group C (+48.65 vs. 19.3, P = .0002). An inverse association between reduction of low-density lipoprotein and the increase in the GSM score (r = -.456, P = .007) has been observed. Moreover, the reduction of high-sensitive C-reactive protein correlates inversely with the increase of the GSM (r = -.398, P = .021). Conclusions: Dose-dependent effect of atorvastatin on symptomatic carotid plaque morphology may suggest a specific role of this drug in the atherosclerotic stroke prevention.
      pubtype: Academic Journal
      doctype:
        research
        randomized controlled trial
        Journal Article
      ougenre: Article
    language: English
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