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Title: The effect of reconstituted high density lipoprotein (rHDL) infusion on patients with symptomatic carotid disease
Author: Nasr, Hosaam Hassan
Awarding Body: St George's, University of London
Current Institution: St George's, University of London
Date of Award: 2013
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Background - Elevation of plasma HDL concentration reduces cardiovascular mortality and morbidity. HDLs have been shown to possess acute anti -inflammatory, anti -oxidant and anti -thrombotic properties. We hypothesise that HDL therapy can acutely alter local and systemic manifestations of plaque instability, Methods and Results - Forty patients with early symptomatic carotid disease were randomised to either receive reconstituted HDL (rI-IDL) - 40mg/kg (11=20), or placebo (11=20). Carotid endarterectomies (CEAs) were performed 24 hours later. Plaques were obtained intra-operatively and used for measurement of thrombomodulatory genes expression. Plasma samples were collected prior to the infusion, 24 and 48 hours later to measure changes in systemic markers of plaque instability. No significant differences were noted in thrombomodulatory genes expression between the two groups. Systemic levels of TF, MMP-9 and MCP-l were significantly reduced in the rHDL group. However, the effects on MMP-9 and MCP-I were abolished in the immediate post-operative period. Although rHDL did not affect plasma IL-6levcls 24 hours following the infusion, it prevented the significant postoperative elevation seen in the placebo group. A similar, but non-significant trend was demonstrated with CRP levels. Conclusion - A single infusion of rHDL can acutely alter plasma biomarkers associated with plaque instability and cardiovascular morbidity.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (M.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available