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Giornale Italiano di Chirurgia Vascolare 1998 September;5(3):141-9

Copyright © 2000 EDIZIONI MINERVA MEDICA

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


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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.

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