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Query: UMLS:C0004153 (atherosclerosis)
 77,401 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

An association between skin tags and insulin resistance, obesity, impaired carbohydrate and lipid metabolism has been suggested. However, there still is a need for comprehensive and controlled clinical studies. We aimed to evaluate the atherogenic risk factors in patients with skin tags. Thirty-six patients with skin tags who were admitted to the dermatology department and 22 healthy controls were included in this study. Possible subjects who were taking systemic drugs or who had a systemic disease that may be associated with lipid or carbohydrate metabolism abnormalities were excluded from the study. All the measurements were completed in 26 patients. Standard oral glucose tolerance tests were performed on the patient and control groups. Serum insulin, total cholesterol, triglyceride and HDL-cholesterol levels were measured. LDL-cholesterol and VLDL-cholesterol ratios and HOMA-IR and body mass indices were calculated. The mean levels of body mass index, HOMA-IR, and total cholesterol were significantly higher in patients than in controls. In conclusion, skin tags may not be innocent tumoral proliferations; instead, follow-up of such patients with regard to the development of diseases associated with atherosclerosis may be beneficial.
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PMID:Skin tags and atherosclerotic risk factors. 1604

Ischemic nephropathy is recognized as a distinct cause of renal insufficiency and it is defined as a significant reduction in glomerular filtration rate in patients with hemodynamically significant renovascular occlusive disease. We argue the epidemiologic and clinical manifestations of atherosclerotic renovascular disease, and we evaluate the pronostic agents. Published studies of the outcome of revascularization for renal-artery stenosis have been excellent, offering a durable patency and functional improvement but they have had numerous limitations. The atherosclerosis is a systemic disease and it provides the general prognosis of patients. We conclude that ischemic renal disease is a nephropathy of smoker men, with proteinuria excretion similar to nephropathy with unilateral stenosis. The age of patients is the clinical feature that decide the treatment: surgery, angioplasty/stent or medical management. Comparative analysis of percutaneous transluminal angioplasty and operation for renal revascularization and medically treated patients have proved that the advanced chronic renal insufficiency is associated with an unfavourable response of treatment of the ischemic nephropathy. But, in this nephropathy the revascularization can be the better therapy for selected patients. The revascularization with angioplasty/stent for patients with unilateral renal stenosis and chronic renal insufficiency has a doubtful effectiveness, as the chronic renal failure is result of nephroangiosclerosis.
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PMID:[Ischemic renal disease: revascularization or conservative treatment?]. 1605 7

Atherosclerosis is a diffuse, systemic disease that affects the coronary, cerebral, and peripheral arterial trees. Disruption of atherosclerotic plaques leads to thrombus formation and arterial occlusion. This unpredictable and potentially life-threatening atherothrombotic sequence underlies clinical events such as angina, myocardial infarction, transient ischemic attacks, and stroke. One of the key components of a clot is the platelet. Although it was previously thought that platelets were relatively inactive cells that merely provided a framework for the attachment of other cells and proteins to mechanically stop bleeding due to injury, it is now known that this is not the case. Platelets secrete and express a large number of substances that are crucial mediators of both coagulation and inflammation. This article reviews the centrality of the platelet in atherothrombosis and briefly looks at the efficacy of antiplatelet agents in preventing and treating cardiovascular disease.
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PMID:Platelets in atherothrombosis. 1643 80

We review the pathogenesis of atherosclerosis and the issues that must be taken into consideration when performing microsurgery in atherosclerotic patients. Atherosclerosis is a systemic disease, and may affect the success of microsurgery. Atherosclerotic patients have a tendency toward thrombosis, because the nature of the arteries is changed. Such patients are usually old and have additional medical problems. To increase the success rate of microsurgery in atherosclerotic patients, special precautions should be considered. Patients must be evaluated properly for the suitability of microsurgery. The microsurgical technique requires a meticulous approach, and various technical tricks can be used to avoid thrombosis. Recipient-vessel selection, anastomotic technique, and the use of vein grafts are all important issues. Prophylactic anticoagulation is recommended in severely atherosclerotic patients. Close monitoring of the patient and flap is necessary after the operation, as with routine microvascular free-tissue transfers. We conclude that atherosclerosis is not a contraindication for microsurgery. If the microsurgeon knows how to deal with the difficulties in atherosclerotic patients, microsurgery can be performed safely.
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PMID:Guidelines for the optimization of microsurgery in atherosclerotic patients. 1676 Dec 66

Atherothrombosis (i.e., atherosclerosis and its thrombotic complications) is a systemic disease with local manifestations. Basic understanding of the pathological processes involved in the development and progression of the disease makes it possible to adopt a general approach to early diagnosis with a view to timely treatment. Knowledge of an individual's overall atherosclerotic burden is extremely important, as it enables risk factors to be treated more aggressively. Non-invasive imaging provides a means of quantifying atherosclerotic burden in accessible areas such as the carotid arteries and the aorta. There is some evidence that there is a correlation between atherosclerotic burden in these areas and that in other less accessible areas, such as the coronary arteries. It may be possible, therefore, to obtain an estimate of overall atherosclerotic burden using non-invasive techniques. Novel imaging modalities, such as multidetector computed axial tomography, enable the coronary artery tree to be explored non-invasively, with highly promising results for both diagnosis and screening in high-risk patients. Molecular imaging techniques enable not only the anatomy but also the function of specific tissues and anatomical territories to be studied non-invasively. These new techniques provide highly promising tools for an early diagnosis in high-risk locations.
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PMID:[Novel imaging techniques for quantifying overall atherosclerotic burden]. 1739 76

Inflammation is a recognized risk factor for the vulnerable atherosclerotic plaque. USPIO-enhanced MRI imaging is a promising non-invasive method to identify high-risk atheromatous plaque inflammation in vivo in humans, in which areas of focal signal loss on MR images have been shown to correspond to the location of activated macrophages, typically at the shoulder regions of the plaque. This is the first report in humans describing simultaneous USPIO uptake within atheroma in two different arterial territories and again emphasises that atherosclerosis is a truly systemic disease. With further work, USPIO-enhanced MR imaging may be useful in identifying inflamed vulnerable atheromatous plaques in vivo, so refining patient selection for intervention and allowing appropriate early aggressive pharmacotherapy to prevent plaque rupture.
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PMID:Non-invasive MR imaging of inflammation in a patient with both asymptomatic carotid atheroma and an abdominal aortic aneurysm: a case report. 1741 49

Paraoxonase (PON1) is a high-density lipoprotein (HDL)-associated enzyme that protects low-density lipoprotein (LDL) and HDL from peroxidation. In this study, PON1 activities were determined in patients with erectile dysfunction (ED) to investigate the relationship between ED and atherosclerosis. Forty patients, who had been diagnosed with ED by the medical and sexual anamnesis and routine laboratory tests, were included in the study. Thirty healthy, sexually active, married and age-matched men were selected as the control group. The patients and controls who underwent surgical or medical treatment in 1-week time and had a systemic disease such as malignancy, liver and renal insufficiency, and active infection and who smoked cigarettes were excluded. PON1 activities were measured spectrophotometrically. Unpaired samples t-test, correlation analyses and multiple linear regression analyses were used for statistical analyses. The results are given as mean+/-standard deviation of mean. The mean ages of the patient and the control groups were 31.05+/-6.90 (range 22-51) and 29.40+/-6.26 (range 19-46), respectively (P=0.307). Serum PON1 levels of the patient and the control groups were found to be 119.05+/-62.11 and 185.04+/-55.64, respectively. The difference between the groups was quite significant (P=0.001). Epidemiological and experimental studies indicate that PON1 activation was lower in individuals who had a tendency to develop atherosclerosis due to comorbidities such as diabetes, familial hypercholesterolemia and kidney disease. In this study, PON1 activity level was found to be significantly lower in ED patients than in control group. The decrease of PON1 activity may have a role in the ethiopathogenesis of ED, and the atherosclerosis development may be faster in the patients due to decreased activity of PON1, which is an antiatherogenic enzyme.
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PMID:Paraoxonase activity in patients with erectile dysfunction. 1778 55

Atherosclerosis is a systemic disease responsible for strokes, myocardial infarction, renal hypertension, and intermittent claudication. Acute coronary syndromes (unstable angina, acute myocardial infarction, and sudden cardiac death) are the major causes of morbidity and mortality in developed countries. These acute manifestations of heart disease share a common pathophysiologic phenomenon: coronary thrombosis. Two principal mechanisms are responsible for coronary thrombosis: plaque disruption (75%) and plaque erosion (25%). Disrupted plaques exhibit a large lipid content, increased macrophages, and a thin fibrous cap. Hypercholesterolemia and diabetes are associated with plaque disruption. Eroded plaques are smooth muscle-cell rich with an intact fibrous cap. Cigarette smoking is associated with plaque erosion, most frequently in women with sudden death when they are younger than 50 years of age. Systemic inflammation is a novel, robust marker for future cardiovascular events, not only in patients with established atherosclerotic disease but also in apparently healthy individuals. Local inflammation at the plaque disruption site is documented by increased macrophage infiltration. Macrophages are responsible for plaque disruption, neovascularization, smooth muscle cell apoptosis, and plaque thrombogenicity. Experimental studies have identified the lipid core as the most thrombogenic substrate of the atherosclerotic plaque. Tissue factor, a cell membrane-bound protein, is crucial in thrombus formation. Tissue factor is expressed in apoptotic macrophages, suggesting that macrophages are not only responsible for plaque disruption but also pivotal in thrombus generation, the most important mechanism of acute coronary syndromes.
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PMID:Pathophysiology of plaque disruption and thrombosis in acute ischemic syndromes. 1790 43

Atherosclerosis is a systemic disease that starts early in life, asymptomatically progressing though adulthood, until clinically manifested. In the last few years, experimental, clinical and pathological investigation has led us to a better knowledge of the pathophysiology of atherothrombotic disease. Atherothrombosis is the result of atherosclerosis progression, and its potentially life-threatening clinical consequences include coronary artery disease, cerebrovascular disease and peripheral artery disease. These events are mostly secondary to atherosclerotic plaque disruption and subsequent in situ thrombus formation which may be embolized and dragged by the arterial flow until occluding distal vessels. The demonstrated beneficial role of antiplatelet drugs in reducing the incidence of nonfatal events in many large clinical trials has demonstrated the major role of platelets in the atherothrombotic process in the arterial tree.
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PMID:Platelets, arterial thrombosis and cerebral ischemia. 1797 37

Atherosclerotic cardiovascular disease is the leading cause of morbidity and mortality in the United States, and the obesity epidemic combined with aging of the population seems destined to increase the burden of this disease. Traditional cardiovascular risk assessment accounts for <50% of the variability in risk in the United States. Therefore, better and more effective identification of persons at high cardiovascular risk is needed. Our understanding of atherosclerosis has shifted from a focal disease whose hallmark is symptoms caused by a severe stenosis to a systemic disease characterized by endothelial dysfunction (ED) and plaque inflammation, with the potential for rupture and thrombosis mainly in those with subcritical stenosis. Under the new paradigm, clinicians require updated strategies to better assess the quality of arterial plaque. Effective tools for primary and secondary prevention of heart attack and stroke include intensive lifestyle modification, blood pressure reduction, and lipid-modifying therapies. These interventions are now understood to decrease plaque inflammation and thereby promote plaque stability. Lipoprotein-associated phospholipase A(2) (Lp-PLA(2)) appears to be a specific marker of plaque inflammation that may play a direct role in the formation of rupture-prone plaque. In contrast, traditional risk factors, lipid measurement, and most vascular imaging modalities do not directly assess the acute ischemic potential in the arterial wall. Measuring Lp-PLA(2) levels in human serum or plasma is noninvasive and relatively inexpensive. Lp-PLA(2) may provide additional clinically relevant information that shows which patients have a high level of atherosclerotic disease activity as manifested by vascular inflammation, ED, and increased risk for progression toward rupture-prone plaque.
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PMID:Identifying the vulnerable patient with rupture-prone plaque. 1854 69


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