Pre-Procedural Statin Use Is Associated with Improved Long-Term Survival and Reduced Major Cardiovascular Events in Patients Undergoing Carotid Artery Stenting: A Retrospective Study

Carotid artery stenting (CAS) is a minimal invasive procedure used to resolve carotid occlusion that can be affected by peri-procedural complications. Statin use before CAS has shown to reduce peri-procedural risk and improve survival, though time-dependent cofactors that influence mortality has not been considered. The aim of this study was to evaluate long-term survival of patients who undergo CAS considering new occurred major adverse cardiovascular event (MACE) as time-dependent cofactor. In this study, 171 high cardiovascular risk patients (age 72 \ub1 8 years, 125 males) were enrolled after CAS procedure and were followed for a median of 8.4 years. Death occurred in 44% of patients with a mean time to death of 69 \ub1 39 months and MACE in 34% with a mean time of 35 \ub1 42 months. In patients who used or not statins at baseline, death occurred in 33% and 65%, respectively (p < 0.001). Survival analysis showed that statin use reduced risk of death (hazard ratio HR 0.36, 95% confidence interval CI 0.23\u207b0.58, p < 0.0001). Including MACE as time-dependent variable did not change beneficial effects of statins. Additionally, statin use was associated with a protective effect on MACE (HR 0.48, 95% CI 0.27\u207b0.85, p = 0.012); particularly, the prevalence of stroke was reduced by 59% (p = 0.018). In multivariate analysis, effects of statins were independent of demographic and anthropometric variables, prevalence of cardiovascular risk factors, renal function, antiplatelet use, and MACE occurrence. In conclusion, use of statins before CAS procedure is associated with increased long-term survival and reduced MACE occurrence. This evidence supports the hypothesis that statin use before CAS might be beneficial in high risk patients

Lipoprotein (a) levels in diabetic patients with peripheral artery disease

High concentrations of Lp(a)are considered to be an independent risk factor for the development of ischemic heart disease and peripheral vascular disease. Some studies have shown as elevated levels of Lp(a)correlate with cardiovascular mortality and morbidity in diabetic subject. Some studies also suggest a role of Lp(a) as an independent risk factor for restenosis after percutaneous revascularization. The aim of our study is to analyze the association between Lp(a)levels in patency of percutaneous transluminal angioplasty (PTA), cardiovascular morbility and mortality during a five year follow-up period in a cohort of diabetic people with symptomatic artery disease. Patients included in our study (M=65, F=33; mean age 69.5 years)were divided into 2 groups according to Lp(a) circulating levels at baseline, considering as cut-off a serum concentration of Lp(a)>30 mg/dl. In our population higher levels of Lp(a) were associated with worse prognosis after PTA. During 5 years follow-up survival time free from symptoms were significantly lower in diabetics with levels of Lp(a)>30 mg/dl (long rank 4,281 P 0.039). Relative risk for developing symptoms after PTA were significantly higher in the group with major levels of Lp(a) (Cox 0,759; p-value 0,044; OR 2,1 IC 95% 1,2-4,4). There were no significant differences in prevalence of cardiovascular morbidity and mortality in the two groups. With the limitations linked to the small number of patients our data suggest a possible role of Lp(a) as independent risk factor for restenosis after PTA in diabetic people with symptomatic peripheral artery

Rôle du glycocluster dans la formation de nanostructures biologiques lectines/glycoclusters sur surface

International audienceno abstrac

Rôle du glycocluster dans la formation de nanostructures biologiques lectines/glycoclusters sur surface

International audienceno abstrac

Effects of the Surface Densities of Glycoclusters on the Determination of Their IC50 and Kd Value Determination by Using a Microarray

International audienceno abstrac

Measure de l'interaction PA-IL/glicomime à la nano-échelle

15-16/06/2015International audienceno abstrac

The cystic fibrosis pathogen Pseudomonas aeruginosa: an atomic force microscopy study for the bacterium inhibition via multivalent glycocluster

International audienc

Measure de l'interaction PA-IL/glicomime à la nano-échelle

15-16/06/2015International audienceno abstrac