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    Self-reported Sleep Duration and Subclinical Atherosclerosis in a General Population of Japanese Men. Suzuki Sentaro,Arima Hisatomi,Miyazaki Soichiro,Fujiyoshi Akira,Kadota Aya,Takashima Naoyuki,Hisamatsu Takashi,Kadowaki Sayaka,Zaid Maryam,Torii Sayuki,Horie Minoru,Murata Kiyoshi,Miura Katsuyuki,Ueshima Hirotsugu, Journal of atherosclerosis and thrombosis AIM:There are few data regarding associations between sleep duration and subclinical atherosclerosis in Japan. The aim of this study was to evaluate associations of self-reported sleep duration with calcification in the coronary arteries (CAC) and carotid intima media thickness (IMT) in Japanese men. METHODS:This was a cross-sectional survey of 1093 randomly selected men from Kusatsu City, Japan. Average sleep duration on weekdays was estimated through questionnaire; CAC by computed tomography; and carotid IMT by ultrasonography. RESULTS:The prevalence of CAC was 50.0% for participants with sleep duration <5.5 h, 43.9% with 5.5-6.4 h, 50.0% with 6.5-7.4 h, 49.3% with 7.5-8.4 h, and 62.5% with ≥8.5 h. In univariate analysis, participants with sleep duration ≥8.5 h had significantly higher prevalence of CAC than those with 6.5-7.4 h (p=0.043). After adjustment for age and other risk factors, however, the association was not significant (p=0.776). The average IMT was 0.85 mm for participants with sleep duration <5.5 h, 0.83 mm with 5.5-6.4 h, 0.85 mm with 6.5-7.4 h, 0.88 mm with 7.5-8.4 h, and 0.90 mm with ≥8.5 h. None of the differences in IMT observed in crude or multivariable-adjusted analyses was significant (all p>0.1). CONCLUSION:Self-reported sleep duration was not associated with increased CAC or carotid IMT in a general population of Japanese men. 10.5551/jat.40527
    Apolipoprotein E Gene Polymorphism and Subclinical Carotid Atherosclerosis: The Northern Manhattan Study. Doliner Brett,Dong Chuanhui,Blanton Susan H,Gardener Hannah,Elkind Mitchell S V,Sacco Ralph L,Demmer Ryan T,Desvarieux Moise,Rundek Tatjana Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association BACKGROUND:Apolipoprotein E (APOE) polymorphism has previously been associated with carotid intima-media thickness (cIMT) in predominantly Caucasian populations. We sought to test the strength of the relationship between APOE-ε4 carrier status and subclinical atherosclerosis in a tri-ethnic population with a large Hispanic representation. METHODS:We assessed the association between APOE polymorphism and cIMT and plaque burden among 1243 stroke-free individuals (mean age 69 years, 65% Hispanic, 18% black, 17% white) using a sequence of multivariable regression models. RESULTS:After adjusting for demographics, vascular risk factors and plasma low-density lipoprotein (LDL) levels, APOE-ε4 carrier status was positively associated with cIMT (mean difference, .013 mm; 95% confidence interval, .003-.023 mm). The APOE-ε4 association with cIMT appeared to be segment-specific with greater differences in IMT between APOE-ε4 carriers and noncarriers in the common carotid artery (CCA, .014 mm) and bifurcation (.017 mm) than in the internal carotid artery (ICA) IMT (.007 mm). This relationship was not modified by race-ethnicity. Presence of diabetes modified the ε4-cIMT relationship in CCA (P = .045) and ICA (P = .046). APOE-ε4 carrier status was not associated with plaque presence or plaque area. CONCLUSIONS:APOE-ε4 carriers had elevated cIMT independent of demographics and vascular risk factors including LDL levels. Diabetes was an effect modifier of the relationship between APOE-ε4 and IMT, such that ε4 carriers with diabetes had greater IMT in the CCA and ICA than those without diabetes. The APOE-IMT relationship was not modified by race-ethnicity. 10.1016/j.jstrokecerebrovasdis.2017.09.053
    Assessment of subclinical atherosclerosis in systemic lupus erythematosus: A systematic review and meta-analysis. Henrot Pauline,Foret Jennifer,Barnetche Thomas,Lazaro Estibaliz,Duffau Pierre,Seneschal Julien,Schaeverbeke Thierry,Truchetet Marie-Elise,Richez Christophe Joint bone spine OBJECTIVES:To determine whether subclinical atherosclerosis is increased in patients with systemic lupus erythematosus (SLE) compared to healthy individuals, using carotid intima-media thickness (CIMT), carotid plaque (CP) presence or flow-mediated dilatation (FMD). METHODS:A systematic literature search was performed using MedLine, Embase and Cochrane databases. Two reviewers independently screened the articles to identify studies that compared the rates of atherosclerosis in SLE patients versus healthy controls. The results were pooled in a meta-analysis. Factors influencing the CIMT, CP or FMD results were collected. RESULTS:Of the 203 articles initially identified, 68 were selected for the meta-analysis. Compared to healthy controls, SLE patients had a significantly increased CIMT (mean difference [MD] of 0.08mm, 95% CI [0.06-0.09], P<0.05), more CP (odds ratio 2.01, 95% CI [1.63-2.47], P<0.05) and decreased FMD (MD -3.96%, 95% CI [-5.37 to -2.54)], P<0.05). There was marked heterogeneity among the studies. However, the results of the meta-analysis that included only the CIMT per new international recommendations also showed an increased CIMT in SLE patients, but the heterogeneity was low (MD 0.04mm, 95% CI [0.02-0.06], P<0.05; I=23%). CONCLUSION:SLE patients exhibit increased subclinical atherosclerosis compared to healthy controls. CIMT is a promising measure for cardiovascular risk evaluations because non-invasive, non-radiation-based, reproducible. Thus, CIMT can be proposed as an alternative to the reliable CP evaluation and to FMD, which is influenced by independent factors such as smoking. Future studies should focus on reducing the heterogeneity of these measures using standardized procedures. 10.1016/j.jbspin.2017.12.009
    Comparison of carotid intima-media thickness and coronary artery calcium score for estimating subclinical atherosclerosis in patients with fatty liver disease. Kim Hyun-Jin,Park Hyung-Bok,Suh Yongsung,Cho Yoon-Hyeong,Hwang Eui-Seok,Cho Deok-Kyu,Choi Tae-Young Cardiovascular journal of Africa INTRODUCTION:Fatty liver disease (FLD) is correlated with cardiovascular disease. Carotid intima-media thickness (CIMT) and coronary artery calcium score (CACS) can noninvasively identify subclinical atherosclerosis and predict risk for cardiovascular events. This study evaluated CIMT and CACS measurements to detect subclinical atherosclerosis in patients with and without FLD. METHODS:Patients who underwent carotid and abdominal ultrasounds as well as cardiac computed tomography (CT) scans were evaluated retrospectively. The differences between the mean CIMT value and CACS measurements in patients with FLD and those with normal livers were estimated. RESULTS:Among 819 patients (average age of 53.3 ± 11.2 years), 330 had FLD. The CIMT was greater in patients with FLD compared to the controls (0.79 ± 0.17 vs 0.76 ± 0.17 mm, p = 0.012), and carotid plaques were more commonly seen in patients with FLD. The incidence of a composite of larger CIMT ( ≥ 75th percentile) plus plaque presence was higher in FLD patients (43.3 vs 36.0%, p = 0.041). Particularly among young patients (≤ 50), the CIMT was larger in patients with FLD than in the controls. FLD increased the risk of a composite of large CIMT plus plaque presence in young patients (odds ratio 1.92, 95% confidence interval 1.05-3.49, p = 0.034). However, patients with FLD had no greater incidence of CACS of over 100 than the controls. CONCLUSION:CIMT was a better marker of underlying subclinical atherosclerotic risk among patients with FLD than CACS. FLD particularly, increases the risk of subclinical atherosclerosis in patients younger than 50 years of age. These patients should undergo screening CIMT to detect atherosclerosis and modify risk factors. 10.5830/CVJA-2017-052
    Association between non-alcoholic fatty liver disease and subclinical coronary atherosclerosis: An observational cohort study. Lee Seung Bum,Park Gyung-Min,Lee Jong-Young,Lee Byung Uk,Park Jae Ho,Kim Byung Gyu,Jung Seok Won,Jeong In Du,Bang Sung-Jo,Shin Jung Woo,Park Neung Hwa,Yang Dong Hyun,Kang Joon-Won,Lim Tae-Hwan,Kim Hong-Kyu,Choe Jaewon,Lee Han Chu Journal of hepatology BACKGROUND & AIMS:There are limited data on the association between non-alcoholic fatty liver disease (NAFLD) and subclinical coronary atherosclerosis. This study investigated the influence of NAFLD on subclinical coronary atherosclerosis as detected by coronary computed tomography angiography (CCTA) in an asymptomatic population. METHODS:A total of 5,121 consecutive asymptomatic individuals with no prior history of coronary artery disease or significant alcohol intake voluntarily underwent abdominal ultrasonography and CCTA as part of a general health examination. Fatty liver was assessed by ultrasonography examination. The fatty liver index and NAFLD fibrosis score were also calculated. Coronary atherosclerotic plaques on CCTA were evaluated. The association between NAFLD and subclinical coronary atherosclerosis was determined by logistic regression analysis. RESULTS:Of the study participants, 1,979 (38.6%) had ultrasonography-diagnosed NAFLD. After adjustment for cardiovascular risk factors, there were no statistically significant differences in the adjusted odds ratios of NAFLD for calcified plaque (1.03; 95% CI 0.89-1.20; p = 0.673) and mixed plaque (1.15; 95% CI 0.93-1.42; p = 0.214). However, adjusted odds ratios for any atherosclerotic plaque (1.18; 95% CI 1.03-1.35; p = 0.016) and non-calcified plaque (1.27; 95% CI 1.08-1.48; p = 0.003) were significantly higher in NAFLD. In addition, there was a significant association of fatty liver index ≥30 with non-calcified plaque (1.37; 95% CI 1.14-1.65; p = 0.001) and NAFLD fibrosis score ≥-1.455 with non-calcified plaque (1.20; 95% CI 1.08-1.42; p = 0.030). CONCLUSIONS:In this large cross-sectional study of asymptomatic individuals undergoing CCTA, NAFLD was consistently associated with non-calcified plaque, suggesting an increased cardiovascular risk. LAY SUMMARY:In asymptomatic individuals, non-alcoholic fatty liver disease (NAFLD) was an independent risk factor for non-calcified plaque, which has been known as a vulnerable plaque associated with sudden and unexpected cardiac events. Therefore, appropriate medical therapy for NAFLD was required to reduce future cardiac events. 10.1016/j.jhep.2017.12.012
    Evaluation of Subclinical Atherosclerosis by Ultrasound Radiofrequency Data Technology in Patients With Familial Mediterranean Fever. Kaplanoglu Hatice,Özisler Cem Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine OBJECTIVES:The aim of this study was to noninvasively demonstrate the presence of early risk associated with subclinical inflammatory activity in patients with familial Mediterranean fever (FMF) who had stable disease, using ultrasound (US) radiofrequency data technology. METHODS:A total of 110 participants, including 55 patients with FMF and 55 healthy control participants, were evaluated with Doppler US. The intima-media thickness and arterial stiffness were measured from bilateral common carotid arteries (CCAs) by the radiofrequency method. RESULTS:No statistically significant difference was found between the patients with FMF and controls in terms of the right and left CCA intima-media thickness, distensibility coefficient, compliance coefficient, α and β stiffness indices, and pulsed wave velocity (P > .05). Symptom duration and diagnosis and treatment time of the patients with FMF had a negative correlation with the distensibility and compliance measurements obtained by Doppler US (r = -0.324 and -0.303), and a positive (r = 0.380 and 0.339) and statistically significant relationship was detected between the α stiffness index, β stiffness index, and pulsed wave velocity (P < .05). CONCLUSIONS:Common carotid artery intima-media thickness and arterial stiffness measurements can aid in early prediction of cardiovascular disease development in patients with FMF. Radiofrequency data technology provides a noninvasive method for accurately and quantitatively showing the CCA intima-media thickness elevation and the decrease in vascular elasticity in patients with FMF. 10.1002/jum.14512
    Association between sarcoidosis, pulse wave velocity, and other measures of subclinical atherosclerosis: a systematic review and meta-analysis. Yong Wai Chung,Sanguankeo Anawin,Upala Sikarin Clinical rheumatology Chronic inflammation from autoimmune diseases has shown to be a risk factor for atherosclerosis, subsequently leading to cardiovascular disease. Endothelial dysfunction is the early pathogenesis of atherosclerosis in chronic inflammation, but the risk of atherosclerosis in sarcoidosis is less well defined. This meta-analysis aimed to explore the association of subclinical atherosclerosis and arterial stiffness in sarcoidosis. A comprehensive search of the MEDLINE and EMBASE databases was performed from date of inception through August 2017. The inclusion criterion was observational studies evaluating the association between sarcoidosis, subclinical atherosclerosis, and arterial stiffness by measuring pulse wave velocity (PWV). Definitions of sarcoidosis and methods to assess PWV were recorded for each study. The pooled standardized mean difference (SMD) of PWV and 95% confidence interval (CI) was calculated using a random-effects meta-analysis. The between-study heterogeneity of effect size was quantified using the Q statistic and I . Data were extracted from five observational studies involving 499 subjects. Pooled result demonstrated a significant increase in PWV in patients who have sarcoidosis compared with controls (SMD = 0.57 m/s; 95% CI 0.21-0.92, p value = 0.002, I  = 75%, P  < 0.01). After excluding studies with low or moderate quality, there was an increase in PWV in sarcoidosis compared with controls (SMD = 0.29 m/s; 95% CI 0.00-0.57, p value = 0.05, I  = 55%, P  = 0.08). Our study suggests that sarcoidosis is associated with increased arterial stiffness and therefore at risk of subclinical atherosclerosis. Prospective study is required to investigate the association of subclinical atherosclerosis causing overt cardiovascular disease in patients with sarcoidosis. 10.1007/s10067-017-3926-9