Symptomatic Patients With Mild and Moderate Carotid Stenosis. Plaque Features at MRI and Association With Cardiovascular Risk Factors and Statin Use

R.M. Kwee, R.J. van Oostenbrugge, M.H. Prins, J.W. Ter Berg, CL. Franke, A.G. Korten, B.J. Meems, J.M. van Engelshoven, J.E. Wildberger, W.H. Mess, M.E. Kooi

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Abstract

BACKGROUND AND PURPOSE: The objectives of this study were to assess plaque characteristics in symptomatic patients with mild and moderate carotid stenosis and to explore associations with cardiovascular risk factors and statin use. METHODS: One hundred patients with transient ischemic attack or stroke with ipsilateral mild and moderate carotid stenosis underwent MR plaque imaging. RESULTS: Patients with moderate stenosis had plaques with a higher prevalence of intraplaque hemorrhage (48.7% versus 19.7%, P=0.002) and a thin and/or ruptured fibrous cap (61.5% versus 36.1%, P=0.013), and larger lipid-rich necrotic core percentage (12.3% versus 6.8%, P=0.042) and smaller fibrous tissue percentage (82.7% versus 88.4%, P=0.024). Increasing age was positively associated with intraplaque hemorrhage (OR [per year]=1.08; 95% CI, 1.02 to 1.14; P=0.011). Statin use was negatively associated with intraplaque hemorrhage (OR=0.30; 95% CI, 0.10 to 0.93; P=0.038), a thin and/or ruptured fibrous cap (OR=0.34; 95% CI, 0.13 to 0.89; P=0.028), and with lipid-rich necrotic core percentage (B=-7.91; 95% CI, -13.60 to -2.22; P=0.007). Statin use was positively associated with fibrous tissue percentage (B=7.77; 95% CI, 2.40 to 13.14; P=0.005). CONCLUSIONS: We found that symptomatic patients with moderate stenosis have a higher prevalence of complicated plaques than patients with mild stenosis. Exploratory analysis showed that increasing age was positively associated with intraplaque hemorrhage, whereas statin use was negatively associated with complicated plaque features.
Original languageEnglish
Pages (from-to)1389-1393
Number of pages5
JournalStroke
Volume41
Issue number7
DOIs
Publication statusPublished - Jul 2010

Keywords

  • cardiovascular risk factors
  • carotid atherosclerosis
  • MRI
  • statins
  • stroke
  • AMERICAN-HEART-ASSOCIATION
  • INTRAPLAQUE HEMORRHAGE
  • ARTERY STENOSIS
  • ATHEROSCLEROTIC LESIONS
  • COMPUTED-TOMOGRAPHY
  • ENDARTERECTOMY
  • ULTRASOUND
  • EVENTS
  • SURGERY
  • TRIALS

Cite this

Kwee, R. M., van Oostenbrugge, R. J., Prins, M. H., Ter Berg, J. W., Franke, CL., Korten, A. G., Meems, B. J., van Engelshoven, J. M., Wildberger, J. E., Mess, W. H., & Kooi, M. E. (2010). Symptomatic Patients With Mild and Moderate Carotid Stenosis. Plaque Features at MRI and Association With Cardiovascular Risk Factors and Statin Use. Stroke, 41(7), 1389-1393. https://doi.org/10.1161/STROKEAHA.109.575670