Back to Journals » Vascular Health and Risk Management » Volume 4 » Issue 6

Managing hypercholesterolemia and its correlation with carotid plaque morphology in patients undergoing carotid endarterectomy

Authors Rerkasem K, Gallagher PJ, Grimble RF, Calder PC, Shearman CP

Published 5 December 2008 Volume 2008:4(6) Pages 1259—1264


Review by Single anonymous peer review

Peer reviewer comments 3

Download Article [PDF] 

Kittipan Rerkasem1, Patrick J Gallagher2, Robert F Grimble3, Philip C Calder3, Clifford P Shearman4

1Department of Surgery, Faculty of Medicine, Chiang Mai University, Thailand; 2Department of Pathology, Southampton General Hospital, Southampton, UK; 3Institute of Human Nutrition, University of Southampton, Southampton, UK; 4Department of Vascular Surgery, Southampton General Hospital, Southampton, UK

Purpose: Hypercholesterolemia is a critical problem in patients with carotid atherosclerosis. The adequacy of attention to lipid risk factors in patients with carotid stenosis awaiting carotid endarterectomy (CEA) has rarely been studied. We also assessed patient awareness of hypercholesterolemia and carotid plaque morphology.

Methods: A prospective study was conducted of 141 consecutive patients admitted electively for CEA. Each patient’s medical history was taken. Plasma cholesterol concentrations were determined. Plaque histology was scored according to American Heart Association criteria and their modification.

Results: Of patients who were aware of their hypercholesterolemia and who were receiving treatment, 28.6% had total cholesterol levels ≥5 mmol/L. Among those patients who had been told that they had no problem with hypercholesterolemia, 32.5% had plasma cholesterol concentrations ≥5 mmol/L. Among those patients who had never had their plasma cholesterol measured, 48.4% had total cholesterol levels ≥5 mmol/L. Patients in this last group tended to have more severe types of plaque pathology than those in other groups (12.9% plaque rupture).

Conclusions: Hypercholesterolemia does not seem to be well managed in patients awaiting CEA.

Keywords: cholesterol, carotid endarterectomy, hypercholesterolemia, atherosclerotic plaque

Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

Download Article [PDF]