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1. Low Ankle-brachial index predicts an adverse 1-year outcome after acute coronary and cerebrovascular events

Author

Agnelli, G., Cimminiello, C., Meneghetti, G., Urbinati, S., Cappielo, E., Bazzi, P., Arpaia, G., Santamaria, M. G., Tassara, R. I., Rebuttato, A. I., Perna, G. P., Gabrielli, D., Ruga, O., Moretti, L., Gregori, G., Marconi, M. K., Burali, A., DE LUCA, I. M., Ciriello, N. M., Ciampa, G. N., Pitscheider, W., Tomaino, M., Poma, E., Poggio, G., Spissu, A., Melis, A., Pinna, L., Lastilla, M., Bonaventura, A. R., Visonà, A. S., Tonello, D. S., Pennisi, G., Bella, R, Santonocito, D., Borrello, G. U., Mazza, M. L., Mattoscio, N., Garzaro, L., Pinneri, F., Zarcone, D., Lanfranchi, S., Moretti, V., Busettini, G., Bordin, P., Delfino, R. Z., Zingarelli, A., Caroppo, E. A., Puccetti, I. A., Orlandi, M., Losi, L., DE CAROLIS, P., Zanini, R., Cionini, F., Viecca, M., Lazzaroni, A., Satta, T., Manenti, V., Basile, G., Tuccillo, B., Accadia, M., Piatto, A., Annunziata, L., Mandarini, A., Androne, V. A., Traccis, S. A., Ottina, M., D'Angelo, A., Fazio, M., Damiani, L. A., Lupo, I., Savettieri, G., DEL PINTO, M., Notaristefano, S., Imberti, D., Tartarin, G., Lucarini, A., Topi, A., D'Anna, S., Saccardi, M., Paciello, M. A., Tordini, G., D'Arienzo, E., Piovaccari, G., Pesaresi, A., Amabile, G., Fiermonte, G., Gallù, M. C., Fontana, L., Ferri, F., Curatola, L., Gobbato, R., Paci, C., Simone, P., DI VIESTI, P., Tonizzo, M., LI VOLSI, P., Gionco, M., Onofri, M., Scorzoni, D., Grimoldi, P., Dentali, F., Ageno, W., Venco, A., and Grillo, G.

Subjects
Male, Brachial Artery, Myocardial Infarction, Blood Pressure, Coronary Disease, Cohort Studies, Angina, Odds Ratio, Prospective Studies, Myocardial infarction, Transient ischemic attack, Prospective cohort study, Stroke, Acute myocardial infarction, Ankle-brachial index, Atherosclerosis, Unstable angina, Acute Disease, Aged, Angina, Unstable, Ankle, Cerebrovascular Disorders, Female, Follow-Up Studies, Hospitalization, Humans, Ischemic Attack, Transient, Italy, Predictive Value of Tests, Prognosis, Regression Analysis, Survival Analysis, Syndrome, Hematology, Ischemic Attack, Transient, Predictive value of tests, cardiovascular system, Cardiology, medicine.symptom, medicine.medical_specialty, Unstable, Asymptomatic, Internal medicine, medicine, cardiovascular diseases, business.industry, Odds ratio, medicine.disease, body regions, business, human activities
Abstract

Summary. Background: Low ankle–brachial Index (ABI) identifies patients with symptomatic and asymptomatic peripheral arterial disease. The aim of this study was to correlate ABI value (normal or low) with 1-year clinical outcome in patients hospitalized for acute coronary syndromes or cerebrovascular diseases (CVD). Methods: ABI was measured in consecutive patients hospitalized because of acute myocardial infarction, unstable angina, stroke or transient ischemic attack (TIA). An ABI lower than or equal to 0.90 was considered abnormal. The primary outcome of the study was the composite of non-fatal acute myocardial infarction, non-fatal ischemic stroke, and death from any cause during the year following the index event. Results: An abnormal ABI was found in 27.2% of 1003 patients with acute coronary syndromes, and in 33.5% of 755 patients with acute CVD. After a median follow-up of 372 days, the frequency of the primary outcome was 10.8% (57/526) in patients with abnormal ABI and 5.9% (73/1232) in patients with normal ABI [odds ratio (OR) 1.96; 95% CI 1.36–2.81]. Death was more common in patients with abnormal ABI (OR 2.05; 95% CI 1.31–3.22). Cardiovascular mortality accounted for 81.7% of overall mortality. ABI was predictive of adverse outcome after adjustment for vascular risk factors in the logistic regression analysis (OR 1.93; 95% CI 1.24–3.01). The predictive value of ABI was mainly accounted for by patients hospitalized for acute coronary syndromes (adverse outcome: 12.8% in patients with abnormal ABI and 5.9% in patients with normal ABI, OR 2.35; 95% CI 1.47–3.76). Conclusions: An abnormal ABI can be found in one-third of patients hospitalized for acute coronary or cerebrovascular events and is a predictor of an adverse 1-year outcome.

Published
2006

2. RANDOMIZED CONTROLLED TRIAL OF STREPTOKINASE, ASPIRIN, AND COMBINATION OF BOTH IN TREATMENT OF ACUTE ISCHEMIC STROKE

Author

CANDELISE L, ARITZU E, CICCONE A, RICCI S, WARDLAW J, TOGNONI G, RONCAGLIONI MC, NEGRI E, COLOMBO F, BOCCARDI E, DEGRANDI C, SCIALFA G, ARGENTINO C, BERTELE V, MAGGIONI AP, PERRONE P, BARNETT HJM, BOGOUSSLAVSKY J, DELFAVERO A, LOI U, PETO R, WARLOW C, CANZI S, COMPARETTI S, CLERICI F, PALUMBO A, SGARONI G, POLONARA S, REGINELLI R, CERAVOLO MG, PROVINCIALI L, DELGOBBO M, SCARPINO O, BOTTACCHI E, DALESSANDRO G, DIGIOVANNI M, BLANC S, ROVEYAZ L, RALLI L, VANNI D, REFI C, FEDERICO F, CONTE C, INCHINGOLO V, INSABATO R, SALSA F, LORIZIO A, ROTTOLI MR, BRUNI L, DEFANTI CA, FERA L, CAMERLINGO M, CASTO L, CENSORI B, MAMOLI A, PORAZZI D, GRAMPA G, LASPINA I, GIGLIA L, AVENIA V, GUELI S, LOLLI V, MIELE V, SANTANGELO M, COPPOLA G, TRIANNI G, MARRA M, GRECO E, TONTI D, PRETOLANI E, STELLIO M, ARNABOLDI M, CIOLA R, DANIELI G, REZZONICO M, GUIDOTTI M, PELLEGRINI G, RAUDINO F, DELFAVERO C, FRATTINI T, RICCARDI T, LEVIMINZI C, LOCATELLI F, PASSERI F, LOMBARDO G, COCCO F, PRATESI M, SANTINI S, CARDOPATRI F, TAFANI O, LANDINI GC, PIERAGNOLI E, BELLESI R, BAGNOLI L, GHETTI A, MARRAZZA OB, MENEGAZZO P, SPOLVERI S, CAPPELLETTI C, CANDELIERE G, COSTANTINO G, DACUNO F, LOMUZIO T, RIZZITELLI FP, BOVIO G, GRILLI GP, ZOCCHI M, MAZZANTI I, PISAPIA G, NUZZI R, RUSSO G, LAMA G, BALDASSARRI G, BETTINI R, CANI E, CERIOLI E, DEGIORGI M, GARAGNANI A, PASQUALI S, CHIOMA V, FINI C, MARZARA G, BALOTTA A, BERTUZZI D, MASINA M, MATACENA C, MICHELINI M, PIRAZZOLI G, SACCHET C, MAROTTA P, CALVI L, SCACCABAROZZI C, MENOZZI C, SASANELLI F, BASCELLI C, PONTRELLI V, SCHIERONI F, BELVEDERE D, DECAPITANI E, DICOSTANZO M, RASCAROLI M, CITTERIO O, MILANI R, CAPIALBI R, ARENA G, MUSOLINO R, DIPERRI R, BONAVENTI C, FINZI F, MESSINA A, ROMANAZZI V, STERZI R, BOTTINI G, SANTILLI I, BRUCATO A, DEJULI E, PALMIERI G, RAGAINI S, THIELLA G, ALLI C, CAROSELLA L, RIZZATO G, BIANCHI M, MOTTO C, PINARDI G, SCARLATO G, BETTINELLI A, PORRO F, RANDAZZO A, MARINI U, LATTUADA P, PIETRA A, FRANCESCHI M, VOLOUTE MA, MALFERRARI G, BONDI M, GARUTI W, MELINI L, COLOMBO A, ALBORINI G, PANZETTI P, SCARPA M, SORGATO P, CRISI G, BONASERA N, BASSO F, NATALI E, MONACO P, GASPARRO AM, TRIOLO F, LECHI A, COLONNA F, DASCOLA I, GIORGI C, SCODITTI U, BASSI P, MENOZZI R, PIAZZA P, DEGLIANTONI G, DESIMONI M, GIANNINI A, MICILI G, BOSONE D, CAVALLINI A, MARTELLI A, BARZIZZA F, POLI M, BIAGINI S, CAPOCCHI G, CELANI MG, PICCHIARELLI A, RIGHETTI E, ZAMPOLINI M, CAPUTO N, BARTOLINI S, SANTONI M, SITA D, TAGLIOLI M, VOLPI G, ROSSI F, ALOY F, CASTELLANO AE, MINOTTA F, GATTA A, VINATTIERI A, CANTINI A, REBUCCI GG, BISSI G, DEBLASI F, PASCARELLI E, TURIAMO F, GUIDETTI D, BARATTI M, FERRARINI G, GHIDONI E, GRECO G, MARCELLO N, MOTTI L, SOLIME F, TERENZIANI S, ZUCCO R, TROISO A, VENEZIANI M, IORI I, CURATOLA L, BOLLETTINI G, CARBONI T, GOBBATO R, INFRICCIOLO P, SABATINI D, SFRAPPINI M, FANCELLU A, CASU G, DELEDDA MG, SPANU MA, PIRISI A, MARRAS FA, ROSATI G, BRAMBILLA A, ERLI GC, FELICE B, GRANDI R, MIRABILE D, ZADRA M, CAVESTRI R, GORI D, LONGHINI E, MIELE N, DIVIZIA G, GRASSELLI S, PEZZELLA F, ZUCCARI F, SALLUSTO L, LINCESSO F, SCARPATI C, IANNONE G, BARTOCCI A, COSTANTINI F, DESANTIS L, LANCIA G, MOSCHINI E, PACI A, SENSIDONI A, TRENTA A, BARTOLINI N, OTTAVIANO P, BISCOTTINI B, ALUNNI G, BARTOLINI I, BELLADONNA D, BOCCALI A, CRUCIANI M, IBBA R, LUCCIOLI R, MARCECA A, PACINI M, PALLONE M, GIRARDI P, ORRICO D, LANZA E, BALLINI A, GRANDI FC, MUSCO G, STEIDL L, SANTORO G, VEMCO A, DUDINE P, MILONE FF, MUNARI L, PERRETI A, PORTA M, LONGONI C, FERANI R, WATT M, SANDERCOCK P, FENNETRY A, BANNISTER P, CLARKE CE, BAMFORD J, VENABLES G, CORREIA M, CANDELISE L, ARITZU E, CICCONE A, RICCI S, WARDLAW J, TOGNONI G, RONCAGLIONI MC, NEGRI E, COLOMBO F, BOCCARDI E, DEGRANDI C, SCIALFA G, ARGENTINO C, BERTELE V, MAGGIONI AP, PERRONE P, BARNETT HJM, BOGOUSSLAVSKY J, DELFAVERO A, LOI U, PETO R, WARLOW C, CANZI S, COMPARETTI S, CLERICI F, PALUMBO A, SGARONI G, POLONARA S, REGINELLI R, CERAVOLO MG, PROVINCIALI L, DELGOBBO M, SCARPINO O, BOTTACCHI E, DALESSANDRO G, DIGIOVANNI M, BLANC S, ROVEYAZ L, RALLI L, VANNI D, REFI C, FEDERICO F, CONTE C, INCHINGOLO V, INSABATO R, SALSA F, LORIZIO A, ROTTOLI MR, BRUNI L, DEFANTI CA, FERA L, CAMERLINGO M, CASTO L, CENSORI B, MAMOLI A, PORAZZI D, GRAMPA G, LASPINA I, GIGLIA L, AVENIA V, GUELI S, LOLLI V, MIELE V, SANTANGELO M, COPPOLA G, TRIANNI G, MARRA M, GRECO E, TONTI D, PRETOLANI E, STELLIO M, ARNABOLDI M, CIOLA R, DANIELI G, REZZONICO M, GUIDOTTI M, PELLEGRINI G, RAUDINO F, DELFAVERO C, FRATTINI T, RICCARDI T, LEVIMINZI C, LOCATELLI F, PASSERI F, LOMBARDO G, COCCO F, PRATESI M, SANTINI S, CARDOPATRI F, TAFANI O, LANDINI GC, PIERAGNOLI E, BELLESI R, BAGNOLI L, GHETTI A, MARRAZZA OB, MENEGAZZO P, SPOLVERI S, CAPPELLETTI C, CANDELIERE G, COSTANTINO G, DACUNO F, LOMUZIO T, RIZZITELLI FP, BOVIO G, GRILLI GP, ZOCCHI M, MAZZANTI I, PISAPIA G, NUZZI R, RUSSO G, LAMA G, BALDASSARRI G, BETTINI R, CANI E, CERIOLI E, DEGIORGI M, GARAGNANI A, PASQUALI S, CHIOMA V, FINI C, MARZARA G, BALOTTA A, BERTUZZI D, MASINA M, MATACENA C, MICHELINI M, PIRAZZOLI G, SACCHET C, MAROTTA P, CALVI L, SCACCABAROZZI C, MENOZZI C, SASANELLI F, BASCELLI C, PONTRELLI V, SCHIERONI F, BELVEDERE D, DECAPITANI E, DICOSTANZO M, RASCAROLI M, CITTERIO O, MILANI R, CAPIALBI R, ARENA G, MUSOLINO R, DIPERRI R, BONAVENTI C, FINZI F, MESSINA A, ROMANAZZI V, STERZI R, BOTTINI G, SANTILLI I, BRUCATO A, DEJULI E, PALMIERI G, RAGAINI S, THIELLA G, ALLI C, CAROSELLA L, RIZZATO G, BIANCHI M, MOTTO C, PINARDI G, SCARLATO G, BETTINELLI A, PORRO F, RANDAZZO A, MARINI U, LATTUADA P, PIETRA A, FRANCESCHI M, VOLOUTE MA, MALFERRARI G, BONDI M, GARUTI W, MELINI L, COLOMBO A, ALBORINI G, PANZETTI P, SCARPA M, SORGATO P, CRISI G, BONASERA N, BASSO F, NATALI E, MONACO P, GASPARRO AM, TRIOLO F, LECHI A, COLONNA F, DASCOLA I, GIORGI C, SCODITTI U, BASSI P, MENOZZI R, PIAZZA P, DEGLIANTONI G, DESIMONI M, GIANNINI A, MICILI G, BOSONE D, CAVALLINI A, MARTELLI A, BARZIZZA F, POLI M, BIAGINI S, CAPOCCHI G, CELANI MG, PICCHIARELLI A, RIGHETTI E, ZAMPOLINI M, CAPUTO N, BARTOLINI S, SANTONI M, SITA D, TAGLIOLI M, VOLPI G, ROSSI F, ALOY F, CASTELLANO AE, MINOTTA F, GATTA A, VINATTIERI A, CANTINI A, REBUCCI GG, BISSI G, DEBLASI F, PASCARELLI E, TURIAMO F, GUIDETTI D, BARATTI M, FERRARINI G, GHIDONI E, GRECO G, MARCELLO N, MOTTI L, SOLIME F, TERENZIANI S, ZUCCO R, TROISO A, VENEZIANI M, IORI I, CURATOLA L, BOLLETTINI G, CARBONI T, GOBBATO R, INFRICCIOLO P, SABATINI D, SFRAPPINI M, FANCELLU A, CASU G, DELEDDA MG, SPANU MA, PIRISI A, MARRAS FA, ROSATI G, BRAMBILLA A, ERLI GC, FELICE B, GRANDI R, MIRABILE D, ZADRA M, CAVESTRI R, GORI D, LONGHINI E, MIELE N, DIVIZIA G, GRASSELLI S, PEZZELLA F, ZUCCARI F, SALLUSTO L, LINCESSO F, SCARPATI C, IANNONE G, BARTOCCI A, COSTANTINI F, DESANTIS L, LANCIA G, MOSCHINI E, PACI A, SENSIDONI A, TRENTA A, BARTOLINI N, OTTAVIANO P, BISCOTTINI B, ALUNNI G, BARTOLINI I, BELLADONNA D, BOCCALI A, CRUCIANI M, IBBA R, LUCCIOLI R, MARCECA A, PACINI M, PALLONE M, GIRARDI P, ORRICO D, LANZA E, BALLINI A, GRANDI FC, MUSCO G, STEIDL L, SANTORO G, VEMCO A, DUDINE P, MILONE FF, MUNARI L, PERRETI A, PORTA M, LONGONI C, FERANI R, WATT M, SANDERCOCK P, FENNETRY A, BANNISTER P, CLARKE CE, BAMFORD J, VENABLES G, and CORREIA M

Abstract

In ischaemic stroke, thrombolytic drugs speed the recanalisation of intracerebral arteries. The effects of aspirin are not known. A trial was conducted to determine whether, separately or together, streptokinase and aspirin have clinical benefits in acute ischaemic stroke similar to those in acute myocardial infarction. 622 patients with acute ischaemic stroke within 6 hours of symptom onset were randomised with a 2x2 factorial design to (i) a 1-hour intravenous infusion of 1 . 5 MU streptokinase, (ii) 300 mg/day buffered aspirin for 10 days, (iii) both active treatments, or (iv) neither. Early results raised a question whether the trial should be continued. Streptokinase (alone or with aspirin) was associated with an excess of 10-day case fatality (odds ratio 2 . 7; 95% confidence interval 1 . 7-4 . 3; 2p

Published
1995

3. RANDOMIZED CONTROLLED TRIAL OF STREPTOKINASE, ASPIRIN, AND COMBINATION OF BOTH IN TREATMENT OF ACUTE ISCHEMIC STROKE

Author

CANDELISE, L, ARITZU, E, CICCONE, A, RICCI, S, WARDLAW, J, TOGNONI, G, RONCAGLIONI, M, NEGRI, E, COLOMBO, F, BOCCARDI, E, DEGRANDI, C, SCIALFA, G, ARGENTINO, C, BERTELE, V, MAGGIONI, A, PERRONE, P, BARNETT, H, BOGOUSSLAVSKY, J, DELFAVERO, A, LOI, U, PETO, R, WARLOW, C, CANZI, S, COMPARETTI, S, CLERICI, F, PALUMBO, A, SGARONI, G, POLONARA, S, REGINELLI, R, CERAVOLO, M, PROVINCIALI, L, DELGOBBO, M, SCARPINO, O, BOTTACCHI, E, DALESSANDRO, G, DIGIOVANNI, M, BLANC, S, ROVEYAZ, L, RALLI, L, VANNI, D, REFI, C, FEDERICO, F, CONTE, C, INCHINGOLO, V, INSABATO, R, SALSA, F, LORIZIO, A, ROTTOLI, M, BRUNI, L, DEFANTI, C, FERA, L, CAMERLINGO, M, CASTO, L, CENSORI, B, MAMOLI, A, PORAZZI, D, GRAMPA, G, LASPINA, I, GIGLIA, L, AVENIA, V, GUELI, S, LOLLI, V, MIELE, V, SANTANGELO, M, COPPOLA, G, TRIANNI, G, MARRA, M, GRECO, E, TONTI, D, PRETOLANI, E, STELLIO, M, ARNABOLDI, M, CIOLA, R, DANIELI, G, REZZONICO, M, GUIDOTTI, M, PELLEGRINI, G, RAUDINO, F, DELFAVERO, C, FRATTINI, T, RICCARDI, T, LEVIMINZI, C, LOCATELLI, F, PASSERI, F, LOMBARDO, G, COCCO, F, PRATESI, M, SANTINI, S, CARDOPATRI, F, TAFANI, O, LANDINI, G, PIERAGNOLI, E, BELLESI, R, BAGNOLI, L, GHETTI, A, MARRAZZA, O, MENEGAZZO, P, SPOLVERI, S, CAPPELLETTI, C, CANDELIERE, G, COSTANTINO, G, DACUNO, F, LOMUZIO, T, RIZZITELLI, F, BOVIO, G, GRILLI, G, ZOCCHI, M, MAZZANTI, I, PISAPIA, G, NUZZI, R, RUSSO, G, LAMA, G, BALDASSARRI, G, BETTINI, R, CANI, E, CERIOLI, E, DEGIORGI, M, GARAGNANI, A, PASQUALI, S, CHIOMA, V, FINI, C, MARZARA, G, BALOTTA, A, BERTUZZI, D, MASINA, M, MATACENA, C, MICHELINI, M, PIRAZZOLI, G, SACCHET, C, MAROTTA, P, CALVI, L, SCACCABAROZZI, C, MENOZZI, C, SASANELLI, F, BASCELLI, C, PONTRELLI, V, SCHIERONI, F, BELVEDERE, D, DECAPITANI, E, DICOSTANZO, M, RASCAROLI, M, CITTERIO, O, MILANI, R, CAPIALBI, R, ARENA, G, MUSOLINO, R, DIPERRI, R, BONAVENTI, C, FINZI, F, MESSINA, A, ROMANAZZI, V, STERZI, R, BOTTINI, G, SANTILLI, I, BRUCATO, A, DEJULI, E, PALMIERI, G, RAGAINI, S, THIELLA, G, ALLI, C, CAROSELLA, L, RIZZATO, G, BIANCHI, M, MOTTO, C, PINARDI, G, SCARLATO, G, BETTINELLI, A, PORRO, F, RANDAZZO, A, MARINI, U, LATTUADA, P, PIETRA, A, FRANCESCHI, M, VOLOUTE, M, MALFERRARI, G, BONDI, M, GARUTI, W, MELINI, L, COLOMBO, A, ALBORINI, G, PANZETTI, P, SCARPA, M, SORGATO, P, CRISI, G, BONASERA, N, BASSO, F, NATALI, E, MONACO, P, GASPARRO, A, TRIOLO, F, LECHI, A, COLONNA, F, DASCOLA, I, GIORGI, C, SCODITTI, U, BASSI, P, MENOZZI, R, PIAZZA, P, DEGLIANTONI, G, DESIMONI, M, GIANNINI, A, MICILI, G, BOSONE, D, CAVALLINI, A, MARTELLI, A, BARZIZZA, F, POLI, M, BIAGINI, S, CAPOCCHI, G, CELANI, M, PICCHIARELLI, A, RIGHETTI, E, ZAMPOLINI, M, CAPUTO, N, BARTOLINI, S, SANTONI, M, SITA, D, TAGLIOLI, M, VOLPI, G, ROSSI, F, ALOY, F, CASTELLANO, A, MINOTTA, F, GATTA, A, VINATTIERI, A, CANTINI, A, REBUCCI, G, BISSI, G, DEBLASI, F, PASCARELLI, E, TURIAMO, F, GUIDETTI, D, BARATTI, M, FERRARINI, G, GHIDONI, E, GRECO, G, MARCELLO, N, MOTTI, L, SOLIME, F, TERENZIANI, S, ZUCCO, R, TROISO, A, VENEZIANI, M, IORI, I, CURATOLA, L, BOLLETTINI, G, CARBONI, T, GOBBATO, R, INFRICCIOLO, P, SABATINI, D, SFRAPPINI, M, FANCELLU, A, CASU, G, DELEDDA, M, SPANU, M, PIRISI, A, MARRAS, F, ROSATI, G, BRAMBILLA, A, ERLI, G, FELICE, B, GRANDI, R, MIRABILE, D, ZADRA, M, CAVESTRI, R, GORI, D, LONGHINI, E, MIELE, N, DIVIZIA, G, GRASSELLI, S, PEZZELLA, F, ZUCCARI, F, SALLUSTO, L, LINCESSO, F, SCARPATI, C, IANNONE, G, BARTOCCI, A, COSTANTINI, F, DESANTIS, L, LANCIA, G, MOSCHINI, E, PACI, A, SENSIDONI, A, TRENTA, A, BARTOLINI, N, OTTAVIANO, P, BISCOTTINI, B, ALUNNI, G, BARTOLINI, I, BELLADONNA, D, BOCCALI, A, CRUCIANI, M, IBBA, R, LUCCIOLI, R, MARCECA, A, PACINI, M, PALLONE, M, GIRARDI, P, ORRICO, D, LANZA, E, BALLINI, A, GRANDI, F, MUSCO, G, STEIDL, L, SANTORO, G, VEMCO, A, DUDINE, P, MILONE, F, MUNARI, L, PERRETI, A, PORTA, M, LONGONI, C, FERANI, R, WATT, M, SANDERCOCK, P, FENNETRY, A, BANNISTER, P, CLARKE, C, BAMFORD, J, VENABLES, G, and CORREIA, M

Published
1995

4. MMP-9 microsatellite polymorphism and susceptibility to carotid arteries atherosclerosis

Author

Nicola Carraro, Raffaella Gobbato, Gabriele Grassi, Nicola Altamura, Lucio Torelli, B. Timothy Baxter, Laura Uxa, Nicola Fiotti, Carlo Giansante, Maurizio Fisicaro, Gianfranco Guarnieri, Fiotti, Nicola, Altamura, N, Fisicaro, M, Carraro, N, Uxa, L, Grassi, Gabriele, Torelli, Lucio, Gobbato, R, Guarnieri, G, Baxter, Bt, and Giansante, Carlo

Subjects
Adult, Carotid Artery Diseases, Male, medicine.medical_specialty, Pathology, Gastroenterology, genetic polymorphisms, Gene Frequency, Internal medicine, medicine, genetic polymorphism, Humans, Genetic Predisposition to Disease, Stroke, Coronary atherosclerosis, Ultrasonography, Sex Characteristics, Polymorphism, Genetic, Vascular disease, business.industry, Fibrous cap, Smoking, Case-control study, Odds ratio, Adult, Carotid Arterie, Atherosclerosis, medicine.disease, Intracranial Arteriosclerosis, Genotype frequency, Carotid Arteries, medicine.anatomical_structure, Logistic Models, Adult, Carotid Arteries, Matrix Metalloproteinase 9, Atherosclerosi, Case-Control Studies, Hypertension, Female, Cardiology and Cardiovascular Medicine, business, Artery, Microsatellite Repeats
Abstract

Objective— The aims of this study were to compare a microsatellite polymorphism (PM) of matrix metalloproteinase (MMP)-9 in patients with carotid atherosclerosis and control population, and to assess the relationship between this PM and plaque structure. Methods and Results— One hundred fifty patients referring to vascular diagnostic centers for suspected carotid atherosclerosis (at ultrasound examination: 110 positive, 40 negative) and controls (n=110) have been genotyped for MMP-9 PM. After controlling for risk factors, allelic and genotype frequencies were significantly different among the groups, with significant prevalence of long microsatellites in patients with carotid atherosclerosis. Long microsatellites (settled as 22 to 27 repeats) were associated with carotid atherosclerosis (odds ratio [OR], 5.2; 95% confidence interval [CI], 2.9 to 9.2), compared with controls; an independent case control study on patients with coronary atherosclerosis confirmed such result. Binary logistic regression showed that hypertension, long microsatellites in MMP-9 PM and smoking habits were variables accounting for the difference between ultrasound-positive patients and controls. Long microsatellites were also associated to plaques with thin fibrous cap and echolucent core (OR, 13.1; 95% CI, 1.6 to 100). These alleles were slightly more represented in female patients (χ 2 test=0.019; OR, 2.7; 95% CI, 1.2 to 6) but not associated with other risk factors. Plasma MMP-9 levels were related neither to MMP-9 PM nor to plaque type, and were related to gender and extension of atherosclerosis in carotid arteries. Conclusions— The number of repeats (≥22 CA) in the microsatellite of MMP-9 promoter, but not MMP-9 plasma levels, is associated to carotid atherosclerosis and particularly to plaques with a thin fibrous cap.

Published
2006

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