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Abstract Details

Hypertriglyceridemia As A Treatment Target In Asymptomatic Carotid Stenosis
Cerebrovascular Disease and Interventional Neurology
Cerebrovascular Disease and Interventional Neurology Posters (7:00 AM-5:00 PM)
155
NA
Background: Data from the CDC show that approximately one-quarter of adults have elevated triglyceride (TG) levels. Recent trials have demonstrated that pharmacologic treatment of high TG levels, in patients already on statin therapy, reduces the rate of major vascular events such as myocardial infarction and stroke (REDUCE-IT trial). We sought to assess how often patients with asymptomatic carotid stenosis (CS) have elevated TG levels and factors associated with high TG values.
Methods: Patients enrolled in the Carotid Revascularization and Medical Management for Asymptomatic Carotid Stenosis Trial (CREST 2) were analyzed. Baseline lipid profiles were evaluated to determine high TG treatment eligibility as per the REDUCE-IT trial. We also evaluated baseline use of pharmacologic treatment for high TG levels. Demographic factors and baseline medical conditions were studied in relation to high (>150 mg/dl) TG values. Chi square and t tests were used to assess baseline factors and abnormal TG values. 
Results: As of August 10, 2020, 1655 of 1689 randomized patients (mean age 69.7 years, 61% men) had baseline lipid profiles suitable for analysis. Treatment eligibility according to REDUCE-IT (LDL 41-100 mg/dl, TG>150 mg/dl) was present in 21% (345) of subjects. In these patients, the median TG value was 205 (IQR 93) mg/dl. Fibrate medications were used at baseline in 4.5% of patients. Analysis of demographic and medical history factors and TG values greater than 150 mg/dl is found in the Table. There was significant positive correlation between baseline hemoglobin A1C and triglyceride values (p<0.0001)"
Conclusions: One in five patients in CREST 2 has TG values that potentially justify pharmacologic treatment. Elevated TG levels are most correlated with diabetes, hypertension, obesity, decreased physical activity, and heart disease. Clinicians should investigate treatment of elevated TG levels as a component of intensive medical therapy for stroke prevention.
 
Authors/Disclosures
Seemant Chaturvedi, MD, FAHA, FÂ鶹´«Ã½Ó³»­ (University of Maryland)
PRESENTER 		Dr. Chaturvedi has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Bayer. Dr. Chaturvedi has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis. Dr. Chaturvedi has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for American Heart Association. The institution of Dr. Chaturvedi has received research support from NINDS.
Tanya N. Turan, MD, FÂ鶹´«Ã½Ó³»­ (Medical University of South Carolina) Dr. Turan has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Pfizer/Merck. Dr. Turan has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Gore Inc. Dr. Turan has received publishing royalties from a publication relating to health care. Dr. Turan has received publishing royalties from a publication relating to health care.
Jenifer Voeks Jenifer Voeks has nothing to disclose.
No disclosure on file
Philip A. Teal, MD Dr. Teal has nothing to disclose.
Marc I. Chimowitz, MD (MUSC Stroke Center) An immediate family member of Dr. Chimowitz has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Gore. Dr. Chimowitz has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for NoNo Inc. The institution of Dr. Chimowitz has received research support from NIH.
Kevin M. Barrett, MD, FÂ鶹´«Ã½Ó³»­ (Mayo Clinic) Dr. Barrett has nothing to disclose.
Bart Demaerschalk, MD, MSc, FRCPC, FÂ鶹´«Ã½Ó³»­ (Mayo Clinic) Dr. Demaerschalk has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Genentech. Dr. Demaerschalk has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Shionogi. Dr. Demaerschalk has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for The Neurologist . The institution of Dr. Demaerschalk has received research support from NICHD.
Virginia J. Howard, PhD (University of Alabama At Birmingham) The institution of Dr. Howard has received research support from NIH. The institution of an immediate family member of Dr. Howard has received research support from NIH.
Ronald M. Lazar, PhD, FAHA, FÂ鶹´«Ã½Ó³»­ (University of Alabama At Birmingham) Dr. Lazar has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for DiaMedica Therapeutics Inc. . The institution of Dr. Lazar has received research support from National Institutes of Health. Dr. Lazar has received publishing royalties from a publication relating to health care.
Claudia Moy, PhD Claudia Moy, PhD has nothing to disclose.
No disclosure on file
No disclosure on file
Robert D. Brown, Jr., MD, MPH, FÂ鶹´«Ã½Ó³»­ (Mayo Clinic) Dr. Brown has received personal compensation in the range of $10,000-$49,999 for serving as an officer or member of the Board of Directors for Craig H Neilsen Foundation. The institution of Dr. Brown has received research support from National Institutes of Health/NINDS. Dr. Brown has received publishing royalties from a publication relating to health care.
James F. Meschia, MD, FÂ鶹´«Ã½Ó³»­ (Mayo Clinic) The institution of Dr. Meschia has received research support from NINDS. The institution of Dr. Meschia has received research support from NINDS.
Brajesh K. Lal (University of Maryland) Brajesh K. Lal has nothing to disclose.
George Howard, PhD (UAB School of Public Hlth) Dr. Howard has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Bayer.
Thomas G. Brott, MD, FÂ鶹´«Ã½Ó³»­ (Mayo Clinic) Dr. Brott has nothing to disclose.