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Miura et al. Vessel Plus 2019;3:1 Vessel Plus
DOI: 10.20517/2574-1209.2018.69

Review Open Access

Dyslipidemia and atherosclerotic carotid artery
stenosis

Yoichi Miura, Hidenori Suzuki
Department of Neurosurgery, Mie University Graduate School of Medicine, Tsu 514-8507, Japan.

Correspondence to: Dr. Hidenori Suzuki, Department of Neurosurgery, Mie University Graduate School of Medicine, 2-174
Edobashi, Tsu 514-8507, Japan. E-mail: suzuki02@clin.medic.mie-u.ac.jp

How to cite this article: Miura Y, Suzuki H. Dyslipidemia and atherosclerotic carotid artery stenosis. Vessel Plus 2019;3:1. http://
dx.doi.org/10.20517/2574-1209.2018.69

Received: 21 Oct 2018 First Decision: 18 Dec 2018 Revised: 31 Dec 2018 Accepted: 31 Dec 2018 Published: 21 Jan 2019
Science Editor: Alexander N. Orekhov Copy Editor: Cui Yu Production Editor: Huan-Liang Wu

Abstract
Carotid artery atherosclerosis or stenosis is frequently present at the carotid bifurcation or the internal carotid artery,
accounting for at least 20% of all ischemic strokes. High levels of serum total cholesterol and low-density lipoprotein
cholesterol are established risk factors for genesis and progression of atherosclerotic lesions through various mechanisms.
In addition, accumulating evidence has shown that a high level of triglyceride is associated with increased atherosclerosis
risks. The so-called “vulnerable plaque” with a large lipid core, thin fibrous cap and intra-plaque hemorrhage tends to
cause subsequent thromboembolic ischemic events. Statins are known not only to lower serum cholesterol levels but also
to promote plaque stabilization via pleiotropic effects such as reducing subclinical systemic inflammation, endothelial
activation, leukocyte intra-plaque infiltration, and increasing intimal smooth muscle cell migration. This article discusses
the mechanisms of atherosclerosis formation induced by dyslipidemia and the role of lipid-lowering agents including
statins in patients with symptomatic and asymptomatic atherosclerotic carotid artery stenosis.

Keywords: Atherosclerosis, carotid artery stenosis, lipid-lowering agent

INTRODUCTION
Carotid artery (CA) stenosis is caused by local thickening of CA wall due to atherosclerosis, and has a
predilection for the CA bifurcation or the internal CA. The prevalence of significant CA stenosis is reported
[1]
to be 7%-9% in the general population . The high prevalence was observed in association with acute
[2]
ischemic stroke (60%), coronary heart disease (18%), and atherosclerosis (11%) . A thromboembolism from
[3]
CA atherosclerotic plaque causes at least 20% of all ischemic strokes . The progression of CA atherosclerosis
was promoted by dyslipidemia, hypertension, smoking, diabetes, and certain hemodynamic features

© The Author(s) 2019. Open Access This article is licensed under a Creative Commons Attribution 4.0
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