Youssef, FA;
(2006)
The effects of lipid lowering treatment on the arterial wall and renal function in patients with peripheral arterial disease.
Doctoral thesis , UCL (University College London).
Preview |
Text
Youssef_thesis.Redacted.pdf Download (13MB) | Preview |
Abstract
Background: Peripheral arterial disease (PAD) is common condition and associated with an increased vascular risk and impaired renal function. Studies have shown a reduction in vascular risk following lipid lowering with a statin in patients with PAD, which may be attributed to a decrease in intima media thickness (IMT) and regression of atherosclerosis. Aims: To study the effect of lipid lowering treatment with statin on patients with peripheral arterial disease. This included monitoring carotid and femoral IMT, renal function and distribution of the enodthelin-1 (ET-1) and its receptors in the arterial wall of patients with advanced PAD.;Materials and Methods: Duplex ultrasound was used to measure the arterial IMT and renal function and renal blood flow (RBF) indices in hyperlipidaemic claudicants before and after short-term atorvastatin treatment. Radioimmunoassay and immunostaining were applied to study ET-1 receptors in segments of popliteal arteries obtained from amputated legs.;Results: There was regression in the carotid and femoral IMT and an improvement in both serum creatinine and urate levels after eight weeks of atorvastatin 20 mg/day (n=25). This improvement in renal function was confirmed after treatment with a different statin (simvastatin) (n=103). Cystatin C, a more sensitive marker, decreased in addition to creatinine and urate in a prospective study (18 patients) after two months of atorvastatin treatment. However, the RBF indices did not change. The distribution of ET-1 receptors in the popliteal arteries from both normo- and hyperlipidaemic patients with advanced PAD (n=12) was also documented.;Conclusions: I am presenting evidence that statin can cause early regression in the IMT and protect renal function. This treatment may also reduce the inflammatory markers in atherosclerotic popliteal arteries.
| Type: | Thesis (Doctoral) |
|---|---|
| Title: | The effects of lipid lowering treatment on the arterial wall and renal function in patients with peripheral arterial disease |
| Identifier: | PQ ETD:593621 |
| Open access status: | An open access version is available from UCL Discovery |
| Language: | English |
| Additional information: | Thesis digitised by ProQuest. Third party copyright material has been removed from the ethesis. Images identifying individuals have been redacted or partially redacted to protect their identity. |
| URI: | https://discovery.ucl.ac.uk/id/eprint/1446282 |
Archive Staff Only
 |
View Item |
