Polymorphisms of fractalkine receptor CX3CR1 gene in patients with symptomatic and asymptomatic carotid artery stenosis

Aim: The chemokine fractalikine is expresses in vascular endothelium, exerting a pro-atherogenic effect. Two single-nucleotide polymorphisms of the CX3CR1 gene (T280M and V2491) affect fractalkine receptor expression and function. We aimed to assess the prevalence of CX3CR1 polymorphisms and the asociation with ischemic cerebrovascular attacts in a cohort of carotid atheromatous disease patients and age-matched controls. Methods: Using PCR-RFLP, we analyzed allelotypes for T280M and V249I in 150 patients with and 151 controls without carotid atherosclerosis assessed using carotid duplex ultrasound; the sugjects were patients admitted for any reason to a tertiary hospital. Genotype data were compared with modifiable risk factors for cerebrovascular disease and the reason for admission, using ischemic stroke as an endpoint. Stroke types associated with carotid atherosclerosis were analysed separately. Results: The M280 allelic frequency was lower among carotid atherosclerosis patients than controls (0.15 versus 0.23, adjusted OR 0.47, 95% CI 0.30-0.74). Absence of M280 allele was an independent factor associated with carotid atherosclerosis (OR 3.70, 95% CI 1.92-7.14), strongers than hypertension, dyslipidemia, diabetes and cigarette smoking. The I249 allele was also under-represented in carotid atherosclerosis; this was not statistically significant. T280M and V249I genotypes were not associated with admission due to ischemic stroke of the large vessel subtype (TOAST classification, 73 episodes), whereas carotid atherosclerosis, previous ischemic event, age, hypertension, diabetes, hyperlipidemia and cigarette smoking were all independently associated. Conclusions: The M280 fractalkine receptor gene allele is associated with a lower risk of carotid atheromatous disease, independent from the modifiable cerebrovascular risk factors

Prognostic significance of plasma resistin levels in patients with atherothrombotic ischemic stroke

Background: Resistin (RSN) is an adipocytokine involved in insulin resistance, obesity and atherosclerosis. This study aimed to investigate the association between plasma RSN and outcome after ischemic stroke. Methods: RSN measured within 24 h after the event was related to functional outcome and 5-year survival in 211 subjects with first-ever atherothrombotic ischemic stroke. Prognosis was assessed by the Kaplan Meier and the Cox techniques. Results: The probabilities of death were 80.4%, 46.2% and 15.7% (p < 0.001) for patients stratified according to tertiles of RSN (> 30 ng/mL, 2030 ng/mL and < 20 ng/mL, respectively). The proportion of dependency (modified Rankin Scale score ! 3) was greater in 5-year survivors with RSN in the upper tertile (6/11 [54.5%]) compared to the middle (20/56 [35.7%]) and the lowest tertile (8/43 [18.6%]; p < 0.01). C-reactive protein levels (hazard ratio [HR] 3.96 [95% CI 2.06, 8.91]; p < 0.001), coronary heart disease (2.69 [1.62, 6.23]; p < 0.001), RSN levels (2.12 [1.31, 5.08] p < 0.001), National Institute of Health Stroke Scale score (2.02 [1.23, 4.49]; p < 0.01) and age (1.84 [1.19, 3.93]; p < 0.01) were independent predictors of death. Conclusions: High plasma RSN appears to be associated with increased risk of 5-year mortality or disability after atherothrombotic ischemic stroke, independently of other adverse predictors. (c) 2006 Elsevier B.V. All rights reserved

Stress management and dietary counseling in hypertensive patients: a pilot study of additional effect

Background: In Western societies, cardiovascular (CV) disease is the primary cause of mortality, and high blood pressure (BP) is the main reversible factor leading to CV disease. Dietary habits and psychosocial stress contribute to the establishment of hypertension, while its role in the control of high BP is currently examined. In this study, we examined the effect and feasibility of a combined intervention of dietary education and stress management on the control of hypertension. Methodology: A randomized, controlled pilot study was designed to evaluate the effect of combined education on stress management techniques and dietary habits (Mediterranean diet principle) on office BP after eight weeks. Results: Of the 45 randomized subjects, 36 were included in the final analysis (control group = 20 (age: 67 +/- 12 years, 31.8%, males) and intervention group516 (age: 62 +/- 12 years, 47%, males)). CV disease risk factors (except smoking), BP, dietary habits, perceived stress and physical activity (all assessed with validated questionnaires) were similar between the two groups at baseline. After eight weeks, office BP (systolic and diastolic) and perceived stress were significantly reduced, whereas the adherence in Mediterranean diet principle was significantly increased, but only in the intervention group. Conclusions: A combined intervention of stress management techniques and Mediterranean diet education seems to be beneficial for BP reduction. Such interventions could possibly serve as a complementary treatment along with drug therapy or in the early treatment of high normal BP. A call to action for designing epidemiological studies and evaluating the efficacy of such non-pharmacological treatment strategies is therefore warranted