Endothelial Dysfunction and Carotid Atherosclerosis in Malawian Adults: A Cross-sectional Study

Overview

Journal eNeurologicalSci

Specialty Neurology

Date 2020 Jul 10

PMID 32642566

Citations 2

Authors

Joseph Kamtchum-Tatuene

Gloria Mwangalika Kachingwe

Henry C Mwandumba

Tom Solomon

Laura A Benjamin

Affiliations

Soon will be listed here.

Abstract

Background And Objective: In sub-Saharan Africa, data on prevalence, risk factors and pathobiology of carotid atherosclerosis are scarce. We aimed to investigate the relationship between biomarkers of endothelial dysfunction and carotid atherosclerosis.

Methods: Carotid ultrasound was performed in 66 patients. Plasma concentration of ICAM-1, PAI-1, VEGF, and soluble thrombomodulin were measured by ELISA. A univariable logistic regression analysis was performed to study the relationship between carotid atherosclerosis, biomarkers of endothelial dysfunction, and various demographic and clinical parameters of the participants.

Results: The mean age of the participants was 58.7 years (95% CI: 54.4-63.1). Carotid atherosclerosis was diagnosed in 39.4% (95% CI: 27.6-52.2). In the univariable logistic regression, the following factors were associated with carotid atherosclerosis: age > 45 years (OR = 12.0, 95% CI: 1.4-98.8, = .02), hypertension (OR = 3.8, 95% CI: 1.2-12.1, p = .02), and high-level of soluble thrombomodulin (OR = 3.4, 95% CI: 1.2-10.0, p = .02).

Conclusions: There is an association between high levels of soluble thrombomodulin and carotid atherosclerosis in Malawian adults. Further studies with a larger sample size are needed to confirm our findings in other African populations.

Citing Articles

[Predictive value of four items of new thrombus markers combined with conventional coagulation tests for thrombosis in antiphospholipid syndrome].

Hong L, Chen Y, Jiang Q, Jia R, Li C, Feng L Beijing Da Xue Xue Bao Yi Xue Ban. 2023; 55(6):1033-1038.

PMID: 38101785 PMC: 10723993.

Clinical study on the feasibility of new thrombus markers in predicting massive cerebral infarction.

Zhao X, Yang S, Lei R, Duan Q, Li J, Meng J Front Neurol. 2023; 13:942887.

PMID: 36761916 PMC: 9905744. DOI: 10.3389/fneur.2022.942887.

References

Graham S, Mwilu R, Liles W . Clinical utility of biomarkers of endothelial activation and coagulation for prognosis in HIV infection: a systematic review. Virulence. 2013; 4(6):564-71. PMC: 5359730. DOI: 10.4161/viru.25221. View

Vos A, Idris N, Barth R, Klipstein-Grobusch K, Grobbee D . Pro-Inflammatory Markers in Relation to Cardiovascular Disease in HIV Infection. A Systematic Review. PLoS One. 2016; 11(1):e0147484. PMC: 4726827. DOI: 10.1371/journal.pone.0147484. View

Kamtchum-Tatuene J, Mwandumba H, Mwangalika Kachingwe G, Bonnett L, Kayange N, Solomon T . A cross-sectional feasibility study of neurovascular ultrasound in Malawian adults with acute stroke-like syndrome. PLoS One. 2020; 15(2):e0229033. PMC: 7006928. DOI: 10.1371/journal.pone.0229033. View

Salomaa V, Matei C, Aleksic N, Sansores-Garcia L, Folsom A, Juneja H . Cross-sectional association of soluble thrombomodulin with mild peripheral artery disease; the ARIC study. Atherosclerosis Risk in Communities. Atherosclerosis. 2001; 157(2):309-14. DOI: 10.1016/s0021-9150(00)00729-2. View

Touboul P, Labreuche J, Vicaut E, Belliard J, Cohen S, Kownator S . Country-based reference values and impact of cardiovascular risk factors on carotid intima-media thickness in a French population: the 'Paroi Artérielle et Risque Cardio-Vasculaire' (PARC) Study. Cerebrovasc Dis. 2009; 27(4):361-7. DOI: 10.1159/000202013. View

Ruparelia N, Chai J, Fisher E, Choudhury R . Inflammatory processes in cardiovascular disease: a route to targeted therapies. Nat Rev Cardiol. 2016; 14(3):133-144. PMC: 5525550. DOI: 10.1038/nrcardio.2016.185. View

Munzel T, Sinning C, Post F, Warnholtz A, Schulz E . Pathophysiology, diagnosis and prognostic implications of endothelial dysfunction. Ann Med. 2008; 40(3):180-96. DOI: 10.1080/07853890701854702. View

Kamtchum-Tatuene J, Al-Bayati Z, Mwandumba H, Solomon T, Christmas S, Benjamin L . Serum concentration of anti-Cytomegalovirus IgG and ischaemic stroke in patients with advanced HIV infection in Malawi. PLoS One. 2018; 13(11):e0208040. PMC: 6258562. DOI: 10.1371/journal.pone.0208040. View

Benjamin L, Corbett E, Connor M, Mzinganjira H, Kampondeni S, Choko A . HIV, antiretroviral treatment, hypertension, and stroke in Malawian adults: A case-control study. Neurology. 2015; 86(4):324-33. PMC: 4776088. DOI: 10.1212/WNL.0000000000002278. View

10.

Gresele P, Falcinelli E, Sebastiano M, Baldelli F . Endothelial and platelet function alterations in HIV-infected patients. Thromb Res. 2011; 129(3):301-8. DOI: 10.1016/j.thromres.2011.11.022. View

11.

Kamtchum-Tatuene J, Mwandumba H, Al-Bayati Z, Flatley J, Griffiths M, Solomon T . HIV is associated with endothelial activation despite ART, in a sub-Saharan African setting. Neurol Neuroimmunol Neuroinflamm. 2019; 6(2):e531. PMC: 6340379. DOI: 10.1212/NXI.0000000000000531. View

12.

Benjamin L, Allain T, Mzinganjira H, Connor M, Smith C, Lucas S . The Role of Human Immunodeficiency Virus-Associated Vasculopathy in the Etiology of Stroke. J Infect Dis. 2017; 216(5):545-553. PMC: 5853476. DOI: 10.1093/infdis/jix340. View

13.

Touboul P, Hennerici M, Meairs S, Adams H, Amarenco P, Bornstein N . Mannheim carotid intima-media thickness and plaque consensus (2004-2006-2011). An update on behalf of the advisory board of the 3rd, 4th and 5th watching the risk symposia, at the 13th, 15th and 20th European Stroke Conferences, Mannheim, Germany,.... Cerebrovasc Dis. 2012; 34(4):290-6. PMC: 3760791. DOI: 10.1159/000343145. View

14.

Gerdes V, Kremer Hovinga J, ten Cate H, Brandjes D, Buller H . Soluble thrombomodulin in patients with established atherosclerosis. J Thromb Haemost. 2004; 2(1):200-1. DOI: 10.1111/j.1538-7836.2004.0562f.x. View

15.

Olivot J, Labreuche J, Aiach M, Amarenco P . Soluble thrombomodulin and brain infarction: case-control and prospective study. Stroke. 2004; 35(8):1946-51. DOI: 10.1161/01.STR.0000133340.37712.9b. View

16.

Herrington W, Lacey B, Sherliker P, Armitage J, Lewington S . Epidemiology of Atherosclerosis and the Potential to Reduce the Global Burden of Atherothrombotic Disease. Circ Res. 2016; 118(4):535-46. DOI: 10.1161/CIRCRESAHA.115.307611. View

17.

Arildsen H, Sorensen K, Ingerslev J, Ostergaard L, Laursen A . Endothelial dysfunction, increased inflammation, and activated coagulation in HIV-infected patients improve after initiation of highly active antiretroviral therapy. HIV Med. 2012; 14(1):1-9. DOI: 10.1111/j.1468-1293.2012.01027.x. View