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Author Spotlight: Assessing the Cardiovascular Profile of Patients with Metabolic Syndrome
Published on: September 27, 2024
Non-Fasting Hypertriglyceridemia Burden as a Residual Risk of the Progression of Carotid Artery Stenosis
Yoichi Miura1, Ryuta Yasuda1, Naoki Toma1
1Department of Neurosurgery, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu 514-8507, Mie, Japan.
Insights
Repeatedly elevated non-fasting triglyceride (TG) levels, especially when integrated over time (area [TG ≥ 175]), are linked to carotid stenosis progression. Controlling TG levels below 175 mg/dL may prevent this arterial narrowing.
Area of Science:
- Cardiovascular Medicine
- Metabolic Syndrome
- Vascular Biology
Background:
- Carotid stenosis progression is a significant risk factor for stroke.
- The impact of repeated non-fasting triglyceride (TG) measurements on carotid stenosis progression remains under-investigated.
- Existing research often focuses on fasting lipid profiles, neglecting the clinical relevance of non-fasting TG levels.
Purpose of the Study:
- To investigate the association between repeated non-fasting triglyceride (TG) measurements and the progression of carotid stenosis.
- To introduce and evaluate a novel parameter, area [TG ≥ 175], representing the cumulative burden of elevated non-fasting TG levels.
- To identify independent risk factors for carotid stenosis progression in patients with existing atherosclerotic stenosis.
Main Methods:
- A cohort of 111 carotid arteries from 88 patients with ≥50% stenosis and ≥3 non-fasting TG measurements over ≥1 year was analyzed.
- A new parameter, area [TG ≥ 175], was calculated by integrating TG values ≥ 175 mg/dL with measurement intervals.
- Clinical variables were compared between arteries with and without subsequent stenosis progression using univariate and multivariate analyses.
Main Results:
- Carotid stenosis progression was observed in 19.8% of arteries during a mean follow-up of 1185 days.
- Univariate analysis identified younger age, symptomatic stenosis, higher mean TG, maximum TG, and area [TG ≥ 175] as significant factors.
- Multivariate analysis revealed symptomatic stenosis and area [TG ≥ 175] ≥ 6.35 year-mg/dL as independent predictors of stenosis progression.
Conclusions:
- The cumulative burden of non-fasting triglyceride levels, quantified by area [TG ≥ 175], is an independent risk factor for carotid stenosis progression.
- Maintaining non-fasting TG levels below 175 mg/dL throughout follow-up is crucial for preventing the progression of carotid atherosclerosis.
- This study highlights the importance of continuous monitoring and management of non-fasting TG levels in patients at risk for cerebrovascular events.
Abstract:
The relationships between repeated non-fasting triglyceride (TG) measurements and carotid stenosis progression during follow-ups have never been investigated. In 111 consecutive carotid arteries of 88 patients with ≥50% atherosclerotic stenosis on at least one side, who had ≥3 blood samples taken during ≥one-year follow-ups, clinical variables were compared between carotid arteries with and without subsequent stenosis progression. To evaluate non-fasting TG burden, a new parameter area [TG ≥ 175] was calculated by integrating non-fasting TG values ≥ 175 mg/dL (i.e., TG values minus 175) with the measurement intervals (year). Carotid stenosis progression occurred in 22 arteries (19.8%) during the mean follow-up period of 1185 days. Younger age, symptomatic stenosis, higher mean values of TG during follow-ups, the area [TG ≥ 175], mean TG values ≥ 175 mg/dL and maximum TG values ≥175 mg/dL were significant factors related to the progression on univariate analyses. The cut-off value of the area [TG ≥ 175] to discriminate carotid stenosis progression was 6.35 year-mg/dL. Multivariate analyses demonstrated that symptomatic stenosis and the area [TG ≥ 175] ≥ 6.35 year-mg/dL were independently related to carotid stenosis progression. In conclusion, the area [TG ≥ 175] was an independent risk factor for carotid stenosis progression, and this study suggests the importance to continuously control non-fasting TG levels < 175 mg/dL during follow-ups to prevent carotid stenosis progression.
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