title: Symptomatic patients with mild and moderate carotid stenosis: plaque features at MRI and association with cardiovascular risk factors and statin use.
abstract: 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.
authors.affiliation: Department of Radiology, Cardiovascular Research Institute Maastricht University Medical Center (MUMC), Maastricht, The Netherlands.
authors.forename: Robert M
authors.initials: RM
authors.lastname: Kwee
authors.forename: Robert J
authors.initials: RJ
authors.lastname: van Oostenbrugge
authors.forename: Martin H
authors.initials: MH
authors.lastname: Prins
authors.forename: Johannes W M
authors.initials: JW
authors.lastname: Ter Berg
authors.forename: Cees L
authors.initials: CL
authors.lastname: Franke
authors.forename: Arthur G G C
authors.initials: AG
authors.lastname: Korten
authors.forename: Bé J
authors.initials: BJ
authors.lastname: Meems
authors.forename: Jos M A
authors.initials: JM
authors.lastname: van Engelshoven
authors.forename: Joachim E
authors.initials: JE
authors.lastname: Wildberger
authors.forename: Werner H
authors.initials: WH
authors.lastname: Mess
authors.forename: M Eline
authors.initials: ME
authors.lastname: Kooi
mesh_terms: 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
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors