Active clinical trials for "Atherosclerosis"

Coronary artery disease (CAD), the most common type of heart disease, is caused by hardening of the arteries, or atherosclerosis that is an inflammatory process in which immune mechanisms interact with metabolic risk factors to initiate, propagate, and activate lesions in the arterial trees. Epidemiological studies have found that increased cardiovascular risks are associated with increased levels of inflammatory cytokines (eg, interleukin-6 [IL-6] and tumor necrosis factor-alpha[TNF-alpha]) or their hepatic product, C-reactive protein (CRP). Higher expression of interleukin-Ibeta(IL-1beta),IL-6, monocyte chemotactic protein-1 (MCP-1), and TNF-alpha were observed in epicardial adipose tissues in patients with CAD. These findings suggested that the pericoronary tissues could be a source of inflammatory mediators or act as paracrine that lead to vascular inflammation on CAD pathogenesis. However, adiponectin, a kind of adipocytokine, produced and secreted exclusively by adipose tissue, has been reported to have a variety of anti-inflammatory functions against atherosclerosis, resulting in risk reduction for incidence of CAD events. It remains unclear whether adiponectin and inflammatory mediators in mediastinal adipose tissue contribute to CAD. We therefore aim to analyze the expression of adiponectin and inflammatory mediators in mediastinal adipose tissue between patients with CAD and with valve diseases, and to correlate these parameters with clinical atherosclerotic risks, medications (statins or antiplatelet), and blood sugar.

During fluoroscopic imaging, diagnostic information is carried in the primary beam. These high intensity X-rays are the chief hazard to the patient. Lower energy scattered radiation deviates in all directions from the patient. Despite typical precautions (i.e., hanging a lead shield between the patient and the operator), many operators will be exposed to high radiation dose (higher than the permitted 50 miliS per year), this long term radiation exposure may result in stochastic and deterministic effects. The purpose of this study was to test the hypothesis that a non disposable radiation protection drape (that will cover the lower part of the patient) could help minimize the radiation scattered from the patient to the operator. In a procedure done through the Radial approach, there is a large portion of the patients (from the umbilicus and down) that is a source of scatter radiation to the operator. This portion can be covered with a lead rectangle. A non disposable, lead drape of uniform thickness will be inserted into a sterile nylon bag and will be used during fluoroscopic and cineangiography coronary angioplasty procedures. The lead drapes will cover the femoral puncture site. The widths and length of the drape is 50-60cm and 100 cm respectively and was shown not to hinder the field of radiation needed for fluoroscopy and cineangiography. (The upper border of the lead is under the patient's umbilicus and was shown not to interfere with the radiation field needed for angiography or angioplasty). The Investigators anticipate that the study will show a significant reduction in radiation exposure and hence reduce the radiation hazard to the operator.

The aim of this study is to determine whether high high density lipoprotein-cholesterol(HDL-C) level and low Cholesteryl Ester Transfer Protein(CETP) activity is atherogenic or not in subjects who received health checkups. We investigate the association between CETP activities and the severity of atherosclerosis assessed by intima-media thickness (IMT) and compare the atherogenic change between in subjects with high HDL-C level, low HDL-C level, high CETP activities and low CETP activities by examining the morbidity rate of atherogenic diseases, the rate of ischemic electrocardiography(ECG) change, Calc Score of artery from chest X-ray, Ankle Brachial Index/Pulse Wave Velocity and various serum atherogenic markers. And we also examine the correlation between normal lipid profile and concentration, activity and function of surface lipoprotein in subjects with variety of lipoprotein levels, including patients with hyper-LDL-cholesterolemia, hyper-HDL-cholesterolemia with low or no CETP activity, patients with high level of remnant cholesterol or hyperlipoproteinemia of apolipoprotein(Apo)B-48.

Patients with SLE have increased rates of atherosclerosis, while the risk factors for atherosclerosis in those patients were not fully revealed. This study is an observational study to investigate the natural process and risk factors for atherosclerosis based on a Chinese SLE cohort. Carotid intima media thickness (CIMT) and brachial-ankle pulse wave velocity (baPWV) will be measured for each patient at baseline and 5-year follow-up. Blood tests including cholesterol levels, fasting plasma glucose levels and etc. will also be performed.

The main aim of the study is to investigate the prevalence and characteristics of ischemic stroke patients with atrial fibrillation and concurrent carotid atherosclerosis. Additionally, this study will investigate the effect of concurrent carotid atherosclerosis on the outcomes of recurrent stroke, myocardial infarction and death during follow-up

In a cohort of symptomatic patients referred to coronary computed tomography angiography (CCTA), the investigators aim is: To investigate and compare the diagnostic precision of Rubidium Positron Emission Tomography (Rb PET) and 15O-water PET (15O-water PET) in patients where CCTA does not exclude obstructive coronary artery disease (CAD) using invasive coronary angiography with fractional flow reserve (ICA-FFR) as reference standard. To study the diagnostic accuracy and prognostic value of computed tomography fractional flow reserve (CT-FFR) in patients where CCTA does not exclude obstructive CAD with ICA-FFR as reference standard. To validated a pre-test probability model including genetic and circulating biomarkers. To identify and characterize genetic risk variants and circulating biomarkers importance in developing CAD. To evaluate the bone mineral density in the hip and spine and correlate this to the degree of vascular calcification.

BACKGROUND Treatment of coronary atherosclerotic disease has been significantly advanced by interventional cardiology, and the advent of coronary arterial stents. In comparison to angioplasty alone, stents have reduced the incidence of angiographic as well as clinical restenosis, the recurrence of angina, the need for coronary arterial bypass graft (CABG) surgery, repeat revascularization and the occurrence of major adverse cardiac events (MACE).However the long-term success of this therapy has been limited by the occurrence of in-stent restenosis. Despite the effectiveness of intracoronary stents in maintaining a larger luminal diameter, as compared to angioplasty alone, in-stent restenosis occurs within 6 to 9 months after stent placement in 15% to 35% of patients. While stents can reduce restenosis by blocking vascular recoil and remodeling, mechanical intervention alone has been incapable of treating this biological problem of neointimal hyperplasia, particularly in the subset of patients with diabetes, long lesions or small vessel disease.Drug-eluting stents (DES) were developed as a viable method for focused delivery of anti-restenosis compounds to target lesions for the reduction of restenosis. Of the DES available and with the results of up to six (6) years clinical follow-up, the sirolimus-eluting stent (SES) has become the current gold standard for stent implantation. With the advent of using DES to treat complex lesions such as longer lesions requiring the use of multiple stents and the use in bifurcation lesions, the risk of stent thrombosis has increase.Late stent thrombosis has also been reported following DES implantation.Long term treatment with dual anti-platelet therapy following stent implantation has become the solution used to counteract the risk of stent thrombosis, this solution does not come without it's own risks and is an expensive therapy. Another specific problem of DES is delayed endothelization, and this may be and attributing factor in prolonging the period of thrombotic risk as shown by pathological findings at autopsy following SES implantation. These examinations have shown that even after 16 months, neointimal healing is still incomplete with approximately 20% of stent struts being found uncovered. Questions have arose that the problems of late thrombosis and delayed endothelization of stent struts with DES could be the result of the permanent polymer that is used as the bonding agent for the anti-restenosis compounds to the stents.Intravascular Ultrasound (IVUS) along with angiography has been the techniques used to gain data on DES to this point. Angiography is a 2 dimensional tool that gives a view of the vessel and IVUS gives a more 3 dimensional view of the vessel. IVUS does have its limitations, as stent struts are reflectors of sonic waves, shadowing around and behind the struts occurs. IVUS is also limited in detecting malapposition of the struts to the vessel wall especially if the area between the vessel wall and the strut in very small. RATIONALE Optical Coherence Tomography (OCT) is an optical analogue of IVUS that uses an infrared light source and measures the backscatter of the light. With this technique a higher level of resolution compared with IVUS has been reported.OCT has been reported as being able to visualize and detect atherosclerotic plaques and assess more accurately strut malapposition and the presence or thickness of neointimal hyperplasia as compared to IVUS. With the question of delayed endothelization due to the permanent polymer being a probable risk for late stent thrombosis, it is felt that OCT post stent implantation may give a more accurate assessment of stent strut endothelial coverage. This study is designed to compare the intimal hyperplasia following implantation of the Excel DES with a biodegradable polymer vs. the Cypher DES with a permanent polymer using OCT.

About 13 million people in the United States have coronary artery disease (CAD). It is the leading cause of death in both men and women. Coronary artery disease (CAD) occurs when the blood vessels that supply blood to the heart muscle (the coronary arteries) become hardened and narrowed. The arteries harden and narrow due to buildup of fatty and calcified material called plaque on their inner walls. The buildup of plaque is also called atherosclerosis. This is a process which starts early in life, but can be influenced by multiple factors. Several factors increase the risk of developing atherosclerosis. They include high blood pressure, smoking, diabetes, high cholesterol and being related to someone who had a heart attack or a stroke. The more risk factors you have, the greater the chance that you have severe atherosclerosis. Some of the risk factors cannot be modified, like age and family history of early heart disease. The influenceable factors include high blood pressure, high blood cholesterol, high blood sugar, cigarette smoking, overweight or obesity, and lack of physical activity. Nevertheless, there are patients without any above mentioned risk factors who develop atherosclerosis. In addition to that, there are also patients with several risk factors who do not develop severe coronary artery disease. According to research studies high blood levels of some substances in the blood (biochemical markers) as well as some genes in the DNA of our cells may be associated with an increased risk of developing CAD and faster progression of the disease. The purpose of this study is to find a correlation between certain blood markers and growth of the plaques, regardless of the presence of the classic risk factors for atherosclerosis. If we prove our hypothesis we will be one step closer to predicting the extent of atherosclerosis by performing certain blood tests.

Mechanisms that link metabolic syndrome to atherosclerosis are incompletely understood. As a part of Hämeenlinna Metabolic Syndrome Research Program (HMS) surrogate indicators for atherosclerosis are studied in 120 men with metabolic syndrome, 120 men with coronary heart disease and 80 physically active controls and in different settings.

The retinal vein occlusion (RVO) is the second most common retinal disease after diabetic retinopathy, and is a common cause of unilateral visual loss. The risk factors that predispose to RVO are many and are generally the same as those found in vascular alterations involving other parts of the body, as in the case of stroke or coronary heart disease. Several authors have attempted to determine whether the pathogenesis of RVO can be of arterial type, considering the disease as consequent to atherosclerosis, rather than resulting from venous disease. Although less frequent than the other diseases RVO affects considerably on health care costs. Direct medical costs showed that in one year a patient with this disease has a higher than average cost for a patient with hypertension or glaucoma. Knowing the prevalence of the disease in Italy and identify modifiable risk factors, recognizing additional risk factors related to gender, genetic predisposition and especially the social-economic and cultural background in the pathogenesis of RVO, are the objectives that led to the planning of this study. In order to assess the prevalence of the disease and the current "clinical practice" we aim to create an online register between Italian specialist centers (ophthalmic emergency care and thrombosis centers) with immediate portability and usability of the data.