Soluble ST2 levels are not associated with secondary cardiovascular events and vulnerable plaque phenotype in patients with carotid artery stenosis

Objective - There are few studies that denote the validity of 8F-fluorodeoxyglucose (FDG) PET to detect the inflammation of severe (>70%) carotid artery stenosis in Asian populations. This study was aimed to clarify whether 18F-FDG PET can identify inflamed and vulnerable plaque at higher risk for subsequent ischemic stroke in Japanese patients with severe carotid artery stenosis. Methods - This prospective study included 33 patients with severe carotid artery stenosis between 2006 and 2011. Of these, 12 patients were symptomatic and other 21 were asymptomatic. There were 28 males and 5 females. Their mean age was 71.1 ± 8.2 years, ranging from 48 to 85. Their clinical data were precisely collected. All 33 patients underwent 18F-FDG PET and ultrasound sonography (US) to evaluate the plaque composition prior to carotid endarterectomy (CEA). FDG uptake was quantified by maximum standardized uptake values (SUV). Following surgery, the specimens were stained with the antibodies against CD68 and MMP-9. Results - High FDG uptake (SUV>2.0) was observed in 15 (45%) of 33 operated plaques. High FDG uptake significantly correlated with the other vascular disorders (P=0.048), echolucent plaque (P=0.041), lipid-rich plaque (P<0.001), CD68 expression (P<0.001), and MMP-9 expression (P=0.002). 18F-FDG PET showed significantly higher sensitivity and specificity to identify lipid-rich and CD68-positive plaque than US. However, high FDG uptake was not related to patients’ gender, age, and the degree of stenosis. There was no significant correlation between FDG uptake and symptomatic or asymptomatic patients. Conclusion - These findings strongly suggest that 18F-FDG PET would provide more valuable information to identify the inflamed, vulnerable plaque than conventional ultrasound in Japanese patients with severe carotid artery stenosis.

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Risk of major adverse cardiovascular events in subjects with asymptomatic mild carotid artery stenosis

Scientific Reports ◽

10.1038/s41598-018-23125-8 ◽

2018 ◽

Vol 8 (1) ◽

Cited By ~ 4

Author(s):

Hyunwook Kwon ◽

Hong-Kyu Kim ◽

Sun U. Kwon ◽

Seung-Whan Lee ◽

Min-Ju Kim ◽

...

Keyword(s):

Carotid Artery ◽

Carotid Artery Stenosis ◽

Cardiovascular Events ◽

Artery Stenosis ◽

Major Adverse Cardiovascular Events

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Intraplaque Expression of C-Reactive Protein Predicts Cardiovascular Events in Patients with Severe Atherosclerotic Carotid Artery Stenosis

Mediators of Inflammation ◽

10.1155/2016/9153673 ◽

2016 ◽

Vol 2016 ◽

pp. 1-10 ◽

Cited By ~ 10

Author(s):

Aldo Bonaventura ◽

François Mach ◽

Aline Roth ◽

Sébastien Lenglet ◽

Fabienne Burger ◽

...

Keyword(s):

Carotid Artery ◽

Carotid Artery Stenosis ◽

Cardiovascular Events ◽

Inflammatory Cells ◽

Artery Stenosis ◽

Major Adverse Cardiovascular Events ◽

C Reactive Protein ◽

Carotid Plaques ◽

Reactive Protein ◽

Serum Crp

Serum c-reactive protein (CRP) was suggested for the assessment of intermediate cardiovascular (CV) risk. Here, systemic or intraplaque CRP levels were investigated as predictors of major adverse cardiovascular events (MACEs) in patients with severe carotid stenosis. CRP levels were assessed in the serum and within different portions (upstream and downstream) of carotid plaques of 217 patients undergoing endarterectomy. The association between CRP and intraplaque lipids, collagen, neutrophils, smooth muscle cells (SMC), and macrophage subsets was determined. No correlation between serum CRP and intraplaque biomarkers was observed. In upstream portions, CRP content was directly correlated with intraplaque neutrophils, total macrophages, and M1 macrophages and inversely correlated with SMC content. In downstream portions, intraplaque CRP correlated with M1 and M2 macrophages. According to the cut-off point (CRP > 2.9%) identified by ROC analysis in upstream portions, Kaplan-Meier analysis showed that patients with high CRP levels had a greater rate of MACEs. This risk of MACEs increased independently of age, male gender, serum CRP, and statin use. In conclusion, in patients with severe carotid artery stenosis, high CRP levels within upstream portions of carotid plaques directly and positively correlate with intraplaque inflammatory cells and predict MACEs at an 18-month follow-up period.

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