Type 2 diabetes is not associated with an altered plaque phenotype among patients undergoing carotid revascularization. A histological analysis of 1455 carotid plaques

Vincent P. W. Scholtes, Wouter Peeters, Guus W. van Lammeren, Dominic P. J. Howard, Jean-Paul P. M. de Vries, Gert Jan de Borst, Jessica N. Redgrave, Hans Kemperman, Casper G. Schalkwijk, Hester M. den Ruijter, Dominique P. V. de Kleijn, Frans L. Moll, Peter M. Rothwell, Gerard Pasterkamp*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

19 Citations (Web of Science)


Aims: Diabetes accelerates progression of atherosclerotic disease, but data on associations between diabetes and advanced atherosclerotic plaque composition are scarce. Methods and results: We used one of the largest biobanks, the Athero-Express study (n = 1455) at carotid endarterectomy (CEA). All plaques were subjected to histological analysis to assess lipid core size, collagen, macrophages, smooth muscle cells, micro-vessel density and calcifications. In addition, within a subset of patients cytokines and chemokines were assessed. The 295 patients (20%) with type-2 diabetes showed a higher proportion of previous cardiovascular interventions and more stringent treatment for hypertension and hypercholesterolaemia compared with patients without type-2 diabetes. Surprisingly, no associations between diabetes and histological plaque characteristics were observed. In addition, no differences were observed in the expression of inflammatory chemokines, cytokines or advanced glycation end products in plaques of diabetic and non-diabetic patients. Conclusion: In patients suffering from significant carotid artery disease, diabetes does not appear to be associated with specific atherosclerotic plaque characteristics.
Original languageEnglish
Pages (from-to)418-423
Issue number2
Publication statusPublished - Aug 2014


  • Carotid endarterectomy
  • Carotid plaque
  • Diabetes
  • Histology

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