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High sensitivity C-reactive protein and vascular endothelial growth factor as indicators of carotid plaque vulnerability.
- Source :
-
The Journal of cardiovascular surgery [J Cardiovasc Surg (Torino)] 2016 Dec; Vol. 57 (6), pp. 861-871. Date of Electronic Publication: 2014 Mar 19. - Publication Year :
- 2016
-
Abstract
- Background: Carotid atherosclerotic plaques are one of the causes of cerebral stroke. The risk is higher for the vulnerable plaques but there are no specific markers to identify them. The aim of our study was to identify vulnerable carotid plaques by the mean of atherosclerotic serological markers in patients undergoing carotid revascularization by endarterectomy (CEA) or stenting (CAS).<br />Methods: High sensitivity C-reactive protein (hsCRP) and vascular-endothelial-growth-factor (VEGF) levels were assessed preoperatively in patients undergoing carotid revascularization. Carotid plaques vulnerability were investigated in two different methods: the "biological vulnerability" with the histological evaluation of the plaques from CEA, scoring five parameters (microvessel density, fibrous-cap-thickness, calcification, inflammatory infiltrate and lipid core), and the "structural vulnerability" with the evaluation of the plaques debris detached during CAS and captured by the cerebral protection filter, in terms of percentage of filter pores occlusion (OP). Results were correlated using χ2, Fisher's, Mann-Whitney, Student's t-tests and regression analysis.<br />Results: The histological analysis was performed in 40 specimens, vulnerable plaques (30%) were correlated with higher hsCRP levels (>5mg/l; OR, 2.5; CI 95%, 1.1-5.5; P=0.01) and VEGF levels (VEGF>500 pg/l; OR 3.0, CI 95%, 1.1-7.7; P=0.01). All the filters (N.40) contained microscopic debris (mean OP 26.6%±9.9); higher hsCRP levels (>5mg/l) were correlated with greater than 25% OP (OR, 2.6; CI 95%, 1.2-5.7). An increase in the percentage of OP was also observed in patients with VEGF>500 pg/l (OR, 2.9; CI, 95% 1.3-6.3).<br />Conclusions: This study suggests that serological determinants are useful in recognizing the structural and biological vulnerability of carotid plaques.
- Subjects :
- Aged
Aged, 80 and over
Angioplasty instrumentation
Biomarkers blood
Carotid Arteries diagnostic imaging
Carotid Artery Diseases diagnostic imaging
Carotid Artery Diseases pathology
Carotid Artery Diseases therapy
Chi-Square Distribution
Endarterectomy, Carotid
Female
Humans
Linear Models
Male
Odds Ratio
Predictive Value of Tests
Prospective Studies
Risk Factors
Rupture, Spontaneous
Serologic Tests
Stents
Treatment Outcome
Up-Regulation
C-Reactive Protein analysis
Carotid Arteries pathology
Carotid Artery Diseases blood
Plaque, Atherosclerotic
Vascular Endothelial Growth Factor A blood
Subjects
Details
- Language :
- English
- ISSN :
- 1827-191X
- Volume :
- 57
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- The Journal of cardiovascular surgery
- Publication Type :
- Academic Journal
- Accession number :
- 24647324