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Relationships of Coronary Atherosclerosis Carotid Intima-Media Thickness and Level of Blood Lipids

Author: YangJiong
Tutor: ZhangZhiMian
School: Shandong University
Course: Geriatrics
Keywords: Carotid intima-media thickness blood lipids coronary artery diease
CLC: R541.4
Type: Master's thesis
Year: 2013
Downloads: 30
Quote: 0
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Abstract


Background:In selected patients, we can use noninvasive imaging to directly visulize atherosclerotic plaque and help refine the risk assessment. Early Appropriate medical management can be taken as long as we reclassify those intermediate risk patients into either low risk group or high risk group. If the patient is at low risk, he does not need any treatment, whereas secondary prevention should be taken in high risk patients. Computed tomographic coronary angiography (CTA) and electron beam computed tomography are widely used for assessment in the presence of atherosclerosis, which are useful but expose the patient to radiation. Carotid intima-media thickness (CIMT) measured by ultrasound, comparatively, is simpler and safer, being chanper and using no radiation, indirectly assess for the presence of coronary artery atherosclerosis. Increased CIMT correlate well with cardiovascular risk factors, for patients with higher CIMT have higher mean values of those risk factors than patients with normal CIMT. More inportantly, as an independent predictor for future cadiovascular events, CIMT has already been used as a surrogate end point, which can be found in many research trils. Many consensus statements have recommended that the usage of noninvasive imaging of patients at intermediate risk level for the further risk assessment for the clarification of coromary artery disease (CAD), such as CIMT measurement or the coronary artery calcification (CAC) score.Objective:To analyse the relevance of coromary atherosclerosis, carotid intima-media thickness and level of blood lipids.Methods:Collect the information of patients who did their health examination in Qilu Hospital of Shandong University with items including Computed tomographic coronary angiography the reasults of which were ncgtive. and blood lipids tests. That is the control group as well as no coronary artery disease group. Collect the information of patients who were hospitaled in the department of cardiology of Qilu Hospital of Shandong University for coronary arteriography and blood lipids tests. Those patients were devided into3groups according to the results of coronary arteriography:single vessel disease group, double vessel disease group and triple vessel disease group. The deviding standard here is the stenosis of main arteries including the anterior interventricular branch, circumflex branch and the right coronary artery is greater or equal to50%. If the stenosis of the left coronary artery is greater or equal to50%, the patient would be devided into the double vessel disease group. All of the patients and members of control group were free from lipid lowering drugs for at least1month. The statistics were analysed by SPSS16.0software.Results:There are no significant statistical differences between all those groups in terms of age and sex (p>0.05), while the difference between the histoy of hypertention (p=0.013)、history of diabetes mellitus (p=0.018)、history of cigarette smoking (p=0.026) have statistical differences (p<0.05). There are no significant statistical differences between all those groups in terms of Triglycerides (TG),high density lipoprotein(HDL) and low density lopoprotein(LDL)(the p values are0.147,0.353,0.076) while the difference between human lipoprotein-a(Lp-a)has statistical difference (p<0.05), and the difference between Carotid intima thickness (CIMT) has significant statistical difference (p<0.001)。Conclusion:Our results supports that Carotid intima-media thickness (CIMT) and human lipoprotein-a (Lp-a) are in association with coronary artery disease and can be used as surrogates to predicte the severity of coronary atery disease.

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CLC: > Medicine, health > Internal Medicine > Heart, blood vessels ( circulatory ) disease > Heart disease > Coronary arteries ( atherosclerosis ),heart disease (CHD)
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