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Review
. 2020 Oct;8(19):1265.
doi: 10.21037/atm.2020.02.176.

Cholesterol, carotid artery disease and stroke: what the vascular specialist needs to know

Kosmas I Paraskevas  1 , Frank J Veith  2   3 , Hans-Henning Eckstein  4 , Jean-Baptiste Ricco  5 , Dimitri P Mikhailidis  6
Affiliations
Review

Cholesterol, carotid artery disease and stroke: what the vascular specialist needs to know

Kosmas I Paraskevas et al. Ann Transl Med. 2020 Oct.

Abstract

Hypercholesterolemia is a risk factor for carotid artery stenosis and stroke. Statins are the main drugs for the management of hypercholesterolemia and they are strongly recommended by international guidelines for the management of vascular patients. The present review will focus on the associations between cholesterol, carotid artery stenosis and stroke and will cover several topics, including the conservative and perioperative/periprocedural management of carotid patients, the effect of statins on contrast-induced nephropathy developing after endovascular carotid interventions, the role of statin loading prior to endovascular procedures, as well as the indirect beneficial effects of statin treatment on renal function. It will also discuss the topics of statin intolerance and alternative cholesterol-lowering options for statin-intolerant vascular patients. Cholesterol levels play a prognostic role in carotid patients with regards to both short- and long-term stroke and mortality rates. Physicians should keep in mind the pivotal role of cholesterol levels in determining cardiovascular outcomes and the pleiotropic beneficial effects associated with statin use and should not miss the opportunity for cardiovascular risk reduction with aggressive statin treatment.

Keywords: Cholesterol; carotid artery stenosis; statins; stroke.

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Conflict of interest statement

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/atm.2020.02.176). DPM has given talks and attended conferences sponsored by Amgen, Novonordisk and Libytec. Other authors have no conflicts of interest.

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