Symptomatic patients with mild and moderate carotid stenosis: plaque features at MRI and association with cardiovascular risk factors and statin use.
OBJECTIVE
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.
Kwee
Robert M
RM
Department of Radiology, Cardiovascular Research Institute Maastricht University Medical Center (MUMC), Maastricht, The Netherlands.
van Oostenbrugge
Robert J
RJ
Prins
Martin H
MH
Ter Berg
Johannes W M
JW
Franke
Cees L
CL
Korten
Arthur G G C
AG
Meems
Bé J
BJ
van Engelshoven
Jos M A
JM
Wildberger
Joachim E
JE
Mess
Werner H
WH
Kooi
M Eline
ME
D000368:Aged; D050197:Atherosclerosis / Q000150:complications / Q000188:drug therapy* / Q000473:pathology*; D002318:Cardiovascular Diseases / Q000150:complications / Q000188:drug therapy / Q000473:pathology; D016893:Carotid Stenosis / Q000150:complications / Q000188:drug therapy* / Q000473:pathology*; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D016896:Treatment Outcome
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors