title: Low carotid calcium score is associated with higher levels of glycosaminoglycans, tumor necrosis factor-alpha, and parathyroid hormone in human carotid plaques.
abstract: OBJECTIVE
  Computed tomography (CT) is used to study coronary artery plaques, but little is known about its potential to characterize plaque composition. This study assesses the relation between carotid calcium score (CCS) by CT and plaque composition, namely extracellular matrix, inflammatory mediators, and calcium metabolites.
  
  
  METHODS
  Thirty patients with significant carotid stenosis underwent preoperative CT. CCS was quantified by Agaston calcium score. Plaque components were studied histologically and biochemically (collagen, elastin, and glycosaminoglycans). Fraktalkine, interferon-γ, interleukin-10, interleukin-12 p70, interleukin-1β, interleukin-6, monocyte chemoattractant protein-1, platelet-derived growth factor-AB/BB, RANTES and tumor necrosis factor-α, and parathyroid hormone were measured using Luminex technology.
  
  
  RESULTS
  Plaques with CCS ≥400 had more calcium (P=0.012), less glycosaminoglycan (P=0.002), tumor necrosis factor-α (P=0.013), and parathyroid hormone (P=0.028) than those with CCS <400. CCS correlated with plaque content of calcium (r=0.62; P<0.001) and inversely with glycosaminoglycan (r=-0.49; P=0.006) and tumor necrosis factor-α (r=-0.56; P=0.001).
  
  
  CONCLUSIONS
  Human carotid plaques with high CCS are richer in calcium and have lower amounts of glycosaminoglycan, parathyroid hormone, and tumor necrosis factor-α, which is one of the main proinflammatory cytokines involved in atherosclerosis. This suggests that CCS not only reflects the degree of calcification, but also other important biological components relevant for stability such as inflammation.
authors.affiliation: Experimental Cardiovascular Research Unit, Clinical Research Center, Lund University, and Department of Radiology, Entrance 72, House 91:12, Malmö University Hospital, SE-20502 Malmö, Sweden. Andreas.Edsfeldt@med.lu.se
authors.forename: Andreas
authors.initials: A
authors.lastname: Edsfeldt
authors.forename: Nuno
authors.initials: N
authors.lastname: Dias
authors.forename: Barbara
authors.initials: B
authors.lastname: Elmståhl
authors.forename: Markus F
authors.initials: MF
authors.lastname: Müller
authors.forename: Katarina
authors.initials: K
authors.lastname: Berg
authors.forename: Mihaela
authors.initials: M
authors.lastname: Nitulescu
authors.forename: Ana
authors.initials: A
authors.lastname: Persson
authors.forename: Olle
authors.initials: O
authors.lastname: Ekberg
authors.forename: Isabel
authors.initials: I
authors.lastname: Gonçalves
mesh_terms: D000328:Adult; D050197:Atherosclerosis / Q000378:metabolism* / Q000473:pathology / Q000601:surgery; D002118:Calcium / Q000378:metabolism*; D002339:Carotid Arteries / Q000378:metabolism* / Q000473:pathology / Q000601:surgery; D016893:Carotid Stenosis / Q000378:metabolism / Q000473:pathology / Q000601:surgery; D016894:Endarterectomy, Carotid; D006025:Glycosaminoglycans / Q000378:metabolism*; D006801:Humans; D010281:Parathyroid Hormone / Q000378:metabolism*; D058226:Plaque, Atherosclerotic / Q000378:metabolism* / Q000473:pathology / Q000601:surgery; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism*
chemical_list: D006025:Glycosaminoglycans; D010281:Parathyroid Hormone; D014409:Tumor Necrosis Factor-alpha; D002118:Calcium