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A Journal on Vascular and Endovascular Surgery
Giornale Italiano di Chirurgia Vascolare 1998 September;5(3):141-9
language: English, Italian
Importance of lipid and non lipid factors in extracranial carotid atherogenesis
Ercolini L., Chiti E., Terreni A., Anichini M., Cesaretti S., Lepori M., Pratesi C.
From the Department of Vascular Surgery University of Florence INRCA Istituto di Analisi, Florence, Italy
Background and aim. The study aimed to evaluate the importance of lipid and non-lipid factors in the pathogenesis of carotid stenosis.
Methods. A total of 342 carotid endarterectomies were performed in 1997 from which 48 consecutive cases were enrolled to form the study group; a control group of 40 cases was also studied. Cholesterol, triglycerides, HDL, LDL, VLDL, lipoprotein (a), homocysteine and antibodies against oxidised LDL were evaluated in each patient. The mean and standard deviation were calculated for each parameter; statistical analysis and variance analysis were performed and p was considered significant if <0.005. The study took the form of a prospective, comparative and randomised case/ control study.
Results. Only cholesterol was found to be higher in controls: 232.7 mg/dl vs 196.9 mg/dl (p=0.001). HDL levels were 47.1 mg/dl in controls vs 38.1 mg/dl (p=0.002). Lipoprotein (a) in the first group was 46.6 mg/dl vs 36.2 mg/dl in controls (p=0.0004). Homocysteine was 8.1 μM/L in the study group and 6.6 μM/L in controls (p=0.003). Antibodies against oxidised LDL were 188.4 mU/ml in patients undergoing surgery and 150.1 mU/ml in controls (p=0.002).
Conclusions. The authors found statistically significant differences between non-lipid factors in both groups and non-significant differences between the classic lipid factors. Further research is required in order to confirm these results, also taking account of the repercussions of the non-surgical treatment of carotid stenosis.