Statin Pretreatment and Microembolic Signals in Large Artery Atherosclerosis

Apostolos Safouris, Christos Krogias, Vijay K. Sharma, Aristeidis H. Katsanos, Simon Faissner, Andromachi Roussopoulou, Christina Zompola, Janina Kneiphof, Odysseas Kargiotis, Spyridon Deftereos, Georgios Giannopoulos, Nikos Triantafyllou, Konstantinos Voumvourakis, Konstantinos Vadikolias, Georgios Tsivgoulis

Research output: Contribution to journalArticle

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Abstract

Objective - Although statin pretreatment (SP) is associated with better outcomes in patients with acute cerebral ischemia after an ischemic stroke/transient ischemic attack, data on the underlying mechanism of this beneficial effect are limited. Approach and Results - We sought to evaluate the potential association between SP and microembolic signal (MES) burden in acute cerebral ischemia because of large artery atherosclerosis (LAA). We prospectively evaluated consecutive patients with first-ever acute cerebral ischemia because of LAA in 3 tertiary stroke centers over a 2-year period. All patients underwent continuous 1-hour transcranial Doppler monitoring of the relevant vessel at baseline (≤24 hours). SP was recorded and dichotomized as high dose or low-to-moderate dose. SP was documented in 43 (41%) of 106 LAA patients (mean age, 65.4±10.3 years; 72% men; low-to-moderate dose, 32%; high dose, 8%). There was a significant (P=0.022) dose-dependent effect between SP and MES prevalence: no SP (37%), SP with low-to-moderate dose (18%), and SP with high dose (0%). Similarly, a significant (P=0.045) dose-dependent effect was documented between SP and MES burden: no SP (1.1±1.8), SP with low-to-moderate dose (0.7±1.6), and SP with high dose (0±0). In multivariable logistic regression analysis adjusting for demographics, vascular risk factors, location of LAA, stroke severity, and other prevention therapies, SP was associated with lower likelihood of MES presence (odds ratio, 0.29; 95% confidence interval, 0.09-0.92; P=0.036). In addition, SP was found also to be independently related to higher odds of functional improvement (common odds ratio, 3.33; 95% confidence interval, 1.07-10.0; P=0.037). Conclusions - We found that SP in patients with acute LAA is related with reduced MES presence and lower MES burden with an apparently dose-dependent association.

Original languageEnglish (US)
Pages (from-to)1415-1422
Number of pages8
JournalArteriosclerosis, thrombosis, and vascular biology
Volume37
Issue number7
DOIs
StatePublished - Jul 1 2017

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Hydroxymethylglutaryl-CoA Reductase Inhibitors
Atherosclerosis
Arteries
Brain Ischemia
Stroke
Odds Ratio
Confidence Intervals
Transient Ischemic Attack

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Statin Pretreatment and Microembolic Signals in Large Artery Atherosclerosis. / Safouris, Apostolos; Krogias, Christos; Sharma, Vijay K.; Katsanos, Aristeidis H.; Faissner, Simon; Roussopoulou, Andromachi; Zompola, Christina; Kneiphof, Janina; Kargiotis, Odysseas; Deftereos, Spyridon; Giannopoulos, Georgios; Triantafyllou, Nikos; Voumvourakis, Konstantinos; Vadikolias, Konstantinos; Tsivgoulis, Georgios.

In: Arteriosclerosis, thrombosis, and vascular biology, Vol. 37, No. 7, 01.07.2017, p. 1415-1422.

Research output: Contribution to journalArticle

Safouris, A, Krogias, C, Sharma, VK, Katsanos, AH, Faissner, S, Roussopoulou, A, Zompola, C, Kneiphof, J, Kargiotis, O, Deftereos, S, Giannopoulos, G, Triantafyllou, N, Voumvourakis, K, Vadikolias, K & Tsivgoulis, G 2017, 'Statin Pretreatment and Microembolic Signals in Large Artery Atherosclerosis', Arteriosclerosis, thrombosis, and vascular biology, vol. 37, no. 7, pp. 1415-1422. https://doi.org/10.1161/ATVBAHA.117.309292
Safouris A, Krogias C, Sharma VK, Katsanos AH, Faissner S, Roussopoulou A et al. Statin Pretreatment and Microembolic Signals in Large Artery Atherosclerosis. Arteriosclerosis, thrombosis, and vascular biology. 2017 Jul 1;37(7):1415-1422. https://doi.org/10.1161/ATVBAHA.117.309292
Safouris, Apostolos ; Krogias, Christos ; Sharma, Vijay K. ; Katsanos, Aristeidis H. ; Faissner, Simon ; Roussopoulou, Andromachi ; Zompola, Christina ; Kneiphof, Janina ; Kargiotis, Odysseas ; Deftereos, Spyridon ; Giannopoulos, Georgios ; Triantafyllou, Nikos ; Voumvourakis, Konstantinos ; Vadikolias, Konstantinos ; Tsivgoulis, Georgios. / Statin Pretreatment and Microembolic Signals in Large Artery Atherosclerosis. In: Arteriosclerosis, thrombosis, and vascular biology. 2017 ; Vol. 37, No. 7. pp. 1415-1422.
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abstract = "Objective - Although statin pretreatment (SP) is associated with better outcomes in patients with acute cerebral ischemia after an ischemic stroke/transient ischemic attack, data on the underlying mechanism of this beneficial effect are limited. Approach and Results - We sought to evaluate the potential association between SP and microembolic signal (MES) burden in acute cerebral ischemia because of large artery atherosclerosis (LAA). We prospectively evaluated consecutive patients with first-ever acute cerebral ischemia because of LAA in 3 tertiary stroke centers over a 2-year period. All patients underwent continuous 1-hour transcranial Doppler monitoring of the relevant vessel at baseline (≤24 hours). SP was recorded and dichotomized as high dose or low-to-moderate dose. SP was documented in 43 (41{\%}) of 106 LAA patients (mean age, 65.4±10.3 years; 72{\%} men; low-to-moderate dose, 32{\%}; high dose, 8{\%}). There was a significant (P=0.022) dose-dependent effect between SP and MES prevalence: no SP (37{\%}), SP with low-to-moderate dose (18{\%}), and SP with high dose (0{\%}). Similarly, a significant (P=0.045) dose-dependent effect was documented between SP and MES burden: no SP (1.1±1.8), SP with low-to-moderate dose (0.7±1.6), and SP with high dose (0±0). In multivariable logistic regression analysis adjusting for demographics, vascular risk factors, location of LAA, stroke severity, and other prevention therapies, SP was associated with lower likelihood of MES presence (odds ratio, 0.29; 95{\%} confidence interval, 0.09-0.92; P=0.036). In addition, SP was found also to be independently related to higher odds of functional improvement (common odds ratio, 3.33; 95{\%} confidence interval, 1.07-10.0; P=0.037). Conclusions - We found that SP in patients with acute LAA is related with reduced MES presence and lower MES burden with an apparently dose-dependent association.",
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AU - Safouris, Apostolos

AU - Krogias, Christos

AU - Sharma, Vijay K.

AU - Katsanos, Aristeidis H.

AU - Faissner, Simon

AU - Roussopoulou, Andromachi

AU - Zompola, Christina

AU - Kneiphof, Janina

AU - Kargiotis, Odysseas

AU - Deftereos, Spyridon

AU - Giannopoulos, Georgios

AU - Triantafyllou, Nikos

AU - Voumvourakis, Konstantinos

AU - Vadikolias, Konstantinos

AU - Tsivgoulis, Georgios

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N2 - Objective - Although statin pretreatment (SP) is associated with better outcomes in patients with acute cerebral ischemia after an ischemic stroke/transient ischemic attack, data on the underlying mechanism of this beneficial effect are limited. Approach and Results - We sought to evaluate the potential association between SP and microembolic signal (MES) burden in acute cerebral ischemia because of large artery atherosclerosis (LAA). We prospectively evaluated consecutive patients with first-ever acute cerebral ischemia because of LAA in 3 tertiary stroke centers over a 2-year period. All patients underwent continuous 1-hour transcranial Doppler monitoring of the relevant vessel at baseline (≤24 hours). SP was recorded and dichotomized as high dose or low-to-moderate dose. SP was documented in 43 (41%) of 106 LAA patients (mean age, 65.4±10.3 years; 72% men; low-to-moderate dose, 32%; high dose, 8%). There was a significant (P=0.022) dose-dependent effect between SP and MES prevalence: no SP (37%), SP with low-to-moderate dose (18%), and SP with high dose (0%). Similarly, a significant (P=0.045) dose-dependent effect was documented between SP and MES burden: no SP (1.1±1.8), SP with low-to-moderate dose (0.7±1.6), and SP with high dose (0±0). In multivariable logistic regression analysis adjusting for demographics, vascular risk factors, location of LAA, stroke severity, and other prevention therapies, SP was associated with lower likelihood of MES presence (odds ratio, 0.29; 95% confidence interval, 0.09-0.92; P=0.036). In addition, SP was found also to be independently related to higher odds of functional improvement (common odds ratio, 3.33; 95% confidence interval, 1.07-10.0; P=0.037). Conclusions - We found that SP in patients with acute LAA is related with reduced MES presence and lower MES burden with an apparently dose-dependent association.

AB - Objective - Although statin pretreatment (SP) is associated with better outcomes in patients with acute cerebral ischemia after an ischemic stroke/transient ischemic attack, data on the underlying mechanism of this beneficial effect are limited. Approach and Results - We sought to evaluate the potential association between SP and microembolic signal (MES) burden in acute cerebral ischemia because of large artery atherosclerosis (LAA). We prospectively evaluated consecutive patients with first-ever acute cerebral ischemia because of LAA in 3 tertiary stroke centers over a 2-year period. All patients underwent continuous 1-hour transcranial Doppler monitoring of the relevant vessel at baseline (≤24 hours). SP was recorded and dichotomized as high dose or low-to-moderate dose. SP was documented in 43 (41%) of 106 LAA patients (mean age, 65.4±10.3 years; 72% men; low-to-moderate dose, 32%; high dose, 8%). There was a significant (P=0.022) dose-dependent effect between SP and MES prevalence: no SP (37%), SP with low-to-moderate dose (18%), and SP with high dose (0%). Similarly, a significant (P=0.045) dose-dependent effect was documented between SP and MES burden: no SP (1.1±1.8), SP with low-to-moderate dose (0.7±1.6), and SP with high dose (0±0). In multivariable logistic regression analysis adjusting for demographics, vascular risk factors, location of LAA, stroke severity, and other prevention therapies, SP was associated with lower likelihood of MES presence (odds ratio, 0.29; 95% confidence interval, 0.09-0.92; P=0.036). In addition, SP was found also to be independently related to higher odds of functional improvement (common odds ratio, 3.33; 95% confidence interval, 1.07-10.0; P=0.037). Conclusions - We found that SP in patients with acute LAA is related with reduced MES presence and lower MES burden with an apparently dose-dependent association.

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