Low levels of high-density lipoprotein cholesterol are associated with echolucent carotid artery plaques: the tromsø study.
OBJECTIVE
Ultrasound-assessed plaque morphology is an independent predictor of ischemic stroke. The purpose of this population-based cross-sectional nested case-control study was to examine the risk factors associated with carotid plaque morphology.


METHODS
Ultrasonography of the right carotid artery was conducted on 6727 participants in a population health survey (response rate 79%). Plaque echogenicity, defined as reflectance of the emitted ultrasound signal, was scored as echolucent, predominantly echolucent, predominantly echogenic, or echogenic. Information on cardiovascular risk factors in all 216 participants who had carotid stenosis and in 223 control subjects matched by age and sex who did not have carotid stenosis was obtained from measurements of blood pressure, weight, height, and nonfasting blood samples and from a self-administered questionnaire.


RESULTS
In both univariate and multivariate analyses, low levels of HDL cholesterol and increasing degree of stenosis were independently associated with an increased risk of having an echolucent plaque. For 1-SD increase in HDL cholesterol, the adjusted odds of being in a lower plaque echogenicity category decreased by approximately 30% (OR 0.69, 95% CI 0.52 to 0.93).


CONCLUSIONS
These findings indicate that low levels of HDL cholesterol are associated with an increased risk of having echolucent, rupture-prone atherosclerotic plaques.
Mathiesen
E B
EB
Institute of Community Medicine, University of Tromsø, Tromsø, Norway. Ellisiv.Mathiesen@ism.uit.no
Bønaa
K H
KH
Joakimsen
O
O
D000328:Adult; D000368:Aged; D001794:Blood Pressure; D002339:Carotid Arteries / Q000000981:diagnostic imaging; D016893:Carotid Stenosis / Q000097:blood / Q000145:classification / Q000175:diagnosis* / Q000453:epidemiology*; D016022:Case-Control Studies; D008076:Cholesterol, HDL / Q000097:blood*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007009:Hypolipoproteinemias / Q000097:blood / Q000453:epidemiology*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009664:Norway / Q000453:epidemiology; D016017:Odds Ratio; D018570:Risk Assessment; D012307:Risk Factors; D014463:Ultrasonography; D014654:Vascular Patency
D008076:Cholesterol, HDL