title: Imaging of functional and structural alterations of large arteries after acute ischaemic atherothrombotic stroke or acute coronary syndromes.
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.
  NCT00926874.
authors.affiliation: Department of Cardiology, University Hospital, Grenoble, France; INSERM U1039, Bioclinic Radiopharmaceutics Laboratory, Grenoble, France. Electronic address: GBarone@chu-grenoble.fr.
authors.forename: Gilles
authors.initials: G
authors.lastname: Barone-Rochette
authors.affiliation: Department of Cardiology, University Hospital, Grenoble, France; INSERM U1039, Bioclinic Radiopharmaceutics Laboratory, Grenoble, France.
authors.forename: Gerald
authors.initials: G
authors.lastname: Vanzetto
authors.affiliation: Department of Neurology (Stroke Unit), University Hospital, Grenoble, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Detante
authors.affiliation: Clinical Research Center INSERM CIC03, University Hospital, Grenoble, France.
authors.forename: Jean-Louis
authors.initials: JL
authors.lastname: Quesada
authors.affiliation: Department of Neurology (Stroke Unit), University Hospital, Grenoble, France.
authors.forename: Marc
authors.initials: M
authors.lastname: Hommel
authors.affiliation: Department of Cardiology, University Hospital, Grenoble, France.
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Mallion
authors.affiliation: Department of Cardiology, University Hospital, Grenoble, France; INSERM U1039, Bioclinic Radiopharmaceutics Laboratory, Grenoble, France.
authors.forename: Jean-Philippe
authors.initials: JP
authors.lastname: Baguet
mesh_terms: D054058:Acute Coronary Syndrome / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D000328:Adult; D000368:Aged; D001011:Aorta / Q000503:physiopathology*; D001795:Blood Pressure Determination; D001916:Brachial Artery / Q000503:physiopathology*; D002545:Brain Ischemia / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D002339:Carotid Arteries / Q000000981:diagnostic imaging / Q000503:physiopathology*; D002340:Carotid Artery Diseases / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D059168:Carotid Intima-Media Thickness; D015897:Comorbidity; D005260:Female; D005602:France; D020022:Genetic Predisposition to Disease; D006439:Hemodynamics; D040941:Heredity; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D010865:Pilot Projects; D058226:Plaque, Atherosclerotic; D011237:Predictive Value of Tests; D015995:Prevalence; D063177:Pulse Wave Analysis; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology; D020521:Stroke / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D059289:Vascular Stiffness; D014664:Vasodilation
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