Page 19 - Read Online

Miura et al. Vessel Plus 2019;3:1 I http://dx.doi.org/10.20517/2574-1209.2018.69 Page 11 of 15

CONCLUSION
Dyslipidemia is a major player in the formation and progression of CA atherosclerosis. Statins can improve
serum lipid profiles and are beneficial for both of the primary and secondary prevention of ischemic stroke.
In addition, statins exert beneficial effects on CA plaque stability as well as regression of CA IMT and plaque
volume, causing reduction in the risk of perioperative complications related with CAS and CEA. Non-
statin lipid-lowering agents may have adjunctive effects as an add-on treatment to statin, and are expected
further to suppress atherosclerotic CA diseases and to reduce stroke risks. However, the widespread effects
of lipid-lowering agents on serum lipid profile and atherogenesis have not been fully elucidated. Further
investigations to reveal the mechanisms of the effects and the randomized clinical trials to test the safety and
efficacy of lipid-lowering agents are needed in patients with CA stenosis.

DECLARATIONS
Authors’ contributions
Conception and design of the study, wrote the original draft: Miura Y
Provided administrative support, reviewed and edited the manuscript: Suzuki H

Availability of data and materials
Not applicable.

Financial support and sponsorship
None.

Conflicts of interest
All authors declared that there are no conflicts of interest.

Ethical approval and consent to participate
Not applicable.

Consent for publication
Not applicable.

Copyright
© The Author(s) 2019.

REFERENCES
1. Fine-Edelstein JS, Wolf PA, O’Leary DH, Poehlman H, Belanger AJ, et al. Precursors of extracranial carotid atherosclerosis in the
Framingham study. Neurology 1994;44:1046-50.
2. Rockman CB, Hoang H, Guo Y, Maldonado TS, Jacobowitz GR, et al. The prevalence of carotid artery stenosis varies significantly by
race. J Vasc Surg 2013;57:327-37.
3. The Intercollegiate Working Party for Stroke. National clinical guidelines for stroke. 2th ed. London: Royal College of Physicians;
2004.
4. Markl M, Wegent F, Zech T, Bauer S, Strecker C, et al. In vivo wall shear stress distribution in the carotid artery: effect of bifurcation
geometry, internal carotid artery stenosis, and recanalization therapy. Circ Cardiovasc Imaging 2010;3:647-55.
5. Spence JD. Asymptomatic carotid stenosis. Circulation 2013;127:739-42.
6. Marquardt L, Geraghty OC, Mehta Z, Rothwell PM. Low risk of ipsilateral stroke in patients with asymptomatic carotid stenosis on best
medical treatment: a prospective, population-based study. Stroke 2010;41:e11-7.
7. Raman G, Moorthy D, Hadar N, Dahabreh IJ, O’Donnell TF, et al. Management strategies for asymptomatic carotid stenosis: a
systematic review and meta-analysis. Ann Intern Med 2013;158:676-85.
8. Blauw GJ, Lagaay AM, Smelt AH, Westendorp RG. Stroke, statins, and cholesterol. A meta-analysis of randomized, placebo-controlled,
double-blind trials with HMG-CoA reductase inhibitors. Stroke 1997;28:946-50.