Ambient Air Pollution and Atherosclerosis in Los Angeles

Associations have been found between long-term exposure to ambient air pollution and cardiovascular morbidity and mortality. The contribution of air pollution to atherosclerosis that underlies many cardiovascular diseases has not been investigated. Animal data suggest that ambient particulate matter (PM) may contribute to atherogenesis. We used data on 798 participants from two clinical trials to investigate the association between atherosclerosis and long-term exposure to ambient PM up to 2.5 μm in aerodynamic diameter (PM(2.5)). Baseline data included assessment of the carotid intima-media thickness (CIMT), a measure of subclinical atherosclerosis. We geocoded subjects’ residential areas to assign annual mean concentrations of ambient PM(2.5). Exposure values were assigned from a PM(2.5) surface derived from a geostatistical model. Individually assigned annual mean PM(2.5) concentrations ranged from 5.2 to 26.9 μg/m3 (mean, 20.3). For a cross-sectional exposure contrast of 10 μg/m3 PM(2.5), CIMT increased by 5.9% (95% confidence interval, 1–11%). Adjustment for age reduced the coefficients, but further adjustment for covariates indicated robust estimates in the range of 3.9–4.3% (p-values, 0.05–0.1). Among older subjects (≥60 years of age), women, never smokers, and those reporting lipid-lowering treatment at baseline, the associations of PM(2.5) and CIMT were larger with the strongest associations in women ≥60 years of age (15.7%, 5.7–26.6%). These results represent the first epidemiologic evidence of an association between atherosclerosis and ambient air pollution. Given the leading role of cardiovascular disease as a cause of death and the large populations exposed to ambient PM(2.5), these findings may be important and need further confirmation

Correlations between measures of atherosclerosis change using carotid ultrasonography and coronary angiography

Abstract Few studies have examined the correlation between change in carotid artery intima-media thickness (IMT) and change in coronary artery disease. In the Cholesterol Lowering Atherosclerosis Study, current nonsmoking men with coronary artery disease were randomized to colestipol-niacin or placebo. Among 133 subjects with baseline and on-trial coronary angiography and carotid ultrasonography, colestipol-niacin treatment significantly reduced progression of atherosclerosis by both end point measures (2-year average change in percent diameter stenosis by coronary angiography and rate of change in carotid IMT). Significant correlations between change in common carotid artery IMT and quantitative coronary angiographic measures of change were evident over all coronary artery lesions, and in mild/moderate ( B 50% diameter stenosis), but not severe ( ] 50% diameter stenosis) coronary artery lesions. In mild/moderate lesions, correlations with change in common carotid IMT were: percent diameter stenosis (r= 0.28, P=0.002), minimum lumen diameter (r= −0.28, P =0.002), and vessel edge roughness (r= 0.25, P= 0.003). While measures obtained by carotid ultrasonography and coronary angiography are correlated, they each assess different aspects of atherosclerosis change

Trabeculectomy in pseudophakic patients: postoperative 5-fluorouracil versus intraoperative mitomycin C antiproliferative therapy

Trabeculectomy outcome in pseudophakic glaucoma patients treated with mitomycin C (MMC) or 5-fluorouracil (5-FU) was analyzed retrospectively in 46 cases (46 eyes). Thirty patients received intraoperative MMC; 16, 5-FU. There were no significant differences between the two groups in terms of preoperative data (demographics, number of previous filtering procedures, visual acuity, and intraocular pressure [IOP]). After a mean follow up of 13.4 +/- 8.1 and 11.5 +/- 5.8 months for the 5-FU and MMC groups, respectively, 12 5-FU eyes (75%) and 21 MMC eyes (70%) were deemed at least qualified successes (IOP less-than-or-equal-to 21 mm Hg with or without antiglaucoma medications). Six (37.5%) of the 5-FU eyes and 13 (43.3%) of the MMC eyes were complete successes (IOP less-than-or-equal-to 21 mm Hg without antiglaucoma medications). There were no significant differences between the two groups in terms of duration of follow up, number of qualified successes, and number of complete successes (P = .35, .9, and .7, respectively). Nor were there any significant differences in the mean final IOPs and visual acuities. Excluding transient corneal effects associated with 5-FU therapy, there were no significant differences in the frequency of postoperative complications.These results suggest that 5-FU and MMC antiproliferative therapy are associated with similar short-term success rates and postoperative complications.UNIV SO CALIF,SCH MED,DOHENY EYE INST,DEPT OPHTHALMOL,LOS ANGELES,CA 90033ESCOLA PAULISTA MED,DEPT OPHTHALMOL,SAO PAULO,BRAZILESCOLA PAULISTA MED,DEPT OPHTHALMOL,SAO PAULO,BRAZILWeb of Scienc

Effect of age on aortic atherosclerosis.

To examine the association of atherosclerosis burden in the survivors of an asymptomatic elderly cohort study and its relationship to other coronary risk factors (specifically, age) by evaluating aortic atherosclerotic wall burden by magnetic resonance imaging (MRI).A total of 312 participants in an ongoing observational cohort study underwent cardiac and descending thoracic aorta imaging by MRI. Maximum wall thickness was measured and the mean wall thickness calculated. Wall/outer wall ratio was used as a normalized wall index (NWI) adjusted for artery size difference among participants. Percent wall volume (PWV) was calculated as NWI × 100.IN THIS ASYMPTOMATIC COHORT (MEAN AGE: 76 years), the mean (SD) aortic wall area and wall thickness were 222 ± 45 mm(2) and 2.7 ± 0.4 mm, respectively. Maximum wall thickness was 3.4 ± 0.6 mm, and PWV was 32% ± 4%. Women appeared to have smaller wall area, but after correcting for their smaller artery size, had significantly higher PWV than men (P = 0.03). Older age was associated with larger wall area (P = 0.04 for trend) with similar PWVs. However, there were no statistically significant associations between standard risk factors, Framingham global risk, or metabolic syndrome status, therapy for cholesterol or hypertension, coronary or aortic calcium score, and the aortic wall burden. Aortic calcification was associated with coronary calcification.Asymptomatic elderly in this cohort had a greater descending thoracic aortic wall volume that correlated with age, and women had a significantly increased PWV compared to men. In these survivors, the atherosclerotic aortic wall burden was not significantly associated with traditional risk factors or with coronary or aortic calcium scores or coronary calcium progression. Results suggest that age, or as yet unidentified risk factor(s), may be responsible for the increase in atherosclerosis