Abstract
Carotid artery disease is a well-established cause of cerebrovascular events. This risk is predicted by the severity of stenosis and other plaque characteristics that can be documented using imaging techniques. Among these techniques, ultrasound is the most widely available. Increased carotid intima-media thickness (IMT) measured ultrasonically is associated with a higher risk for cerebrovascular as well as coronary heart disease. Furthermore, it is increasingly recognized that echolucent and heterogeneous carotid plaques in patients with high-grade carotid stenosis are associated with a greater risk for cerebrovascular events. Several local and systemic factors can influence plaque stability. Identifying the high-risk carotid plaque could improve selection for vascular intervention (surgery/angioplasty) and increase cost-effectiveness. Aggressive medical treatment should always be provided for these high-risk patients. For example, lipid-lowering, anthihypertensive and antiplatelet drugs decrease the carotid IMT, stabilize carotid plaques or reduce the risk of cerebrovascular and systemic events. Continuously evolving technology will lead to more accurate identification of high-risk carotid plaques. A combination of comprehensive non- or minimally-invasive imaging techniques together with measuring clinical and systemic biochemical markers of risk may facilitate the identification of the vulnerable plaque in the vulnerable patient, and help select the best treatment options.
Keywords: Carotid atherosclerosis, intima-media thickness, high-risk plaque, imaging, lipid-lowering drugs, stroke, antihypertensive drugs
Current Pharmaceutical Design
Title: Carotid Artery Atherosclerosis: What is the Evidence for Drug Action?
Volume: 13 Issue: 11
Author(s): Stella S. Daskalopoulou, Marios E. Daskalopoulos, Despina Perrea, Andrew N. Nicolaides and Christos D. Liapis
Affiliation:
Keywords: Carotid atherosclerosis, intima-media thickness, high-risk plaque, imaging, lipid-lowering drugs, stroke, antihypertensive drugs
Abstract: Carotid artery disease is a well-established cause of cerebrovascular events. This risk is predicted by the severity of stenosis and other plaque characteristics that can be documented using imaging techniques. Among these techniques, ultrasound is the most widely available. Increased carotid intima-media thickness (IMT) measured ultrasonically is associated with a higher risk for cerebrovascular as well as coronary heart disease. Furthermore, it is increasingly recognized that echolucent and heterogeneous carotid plaques in patients with high-grade carotid stenosis are associated with a greater risk for cerebrovascular events. Several local and systemic factors can influence plaque stability. Identifying the high-risk carotid plaque could improve selection for vascular intervention (surgery/angioplasty) and increase cost-effectiveness. Aggressive medical treatment should always be provided for these high-risk patients. For example, lipid-lowering, anthihypertensive and antiplatelet drugs decrease the carotid IMT, stabilize carotid plaques or reduce the risk of cerebrovascular and systemic events. Continuously evolving technology will lead to more accurate identification of high-risk carotid plaques. A combination of comprehensive non- or minimally-invasive imaging techniques together with measuring clinical and systemic biochemical markers of risk may facilitate the identification of the vulnerable plaque in the vulnerable patient, and help select the best treatment options.
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Cite this article as:
Daskalopoulou S. Stella, Daskalopoulos E. Marios, Perrea Despina, Nicolaides N. Andrew and Liapis D. Christos, Carotid Artery Atherosclerosis: What is the Evidence for Drug Action?, Current Pharmaceutical Design 2007; 13 (11) . https://dx.doi.org/10.2174/138161207780619019
DOI https://dx.doi.org/10.2174/138161207780619019 |
Print ISSN 1381-6128 |
Publisher Name Bentham Science Publisher |
Online ISSN 1873-4286 |
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