Time-dependent differences in femoral artery plaque characteristics of peripheral arterial disease patients.
Peripheral arterial disease (PAD) is a common manifestation of atherosclerosis with an increasing incidence worldwide. The disease is still associated with high morbidity and mortality risks. Previous research in carotid arteries indicates that atherosclerotic plaque characteristics have stabilized over time in patients considered for surgery. It is currently unknown whether this time-dependent stabilization occurs in ilio-femoral arteries as well. Our objective was to analyze whether local ilio-femoral atherosclerotic plaque characteristics have changed over time.



497 patients within the Athero-Express biobank who underwent primary endarterectomy of the iliac or femoral artery between 2002 and 2013 were analyzed. We investigated six histological plaque characteristics: calcification, collagen, fat content, intraplaque haemorrhage, macrophages and smooth muscle cells.



Over the course of 10 years, we observed a lower percentage of all plaque characteristics that are considered indicators of a vulnerable plaque, such as: plaques with a large lipid core from 37.9% to 14.9% and plaques with intraplaque haemorrhage from 69.0% to 34.8% when the two-year cohorts 2003-2004 and 2011-2012 were compared, respectively. Multivariable analyses showed that time-dependent changes occurred independently of changing procedural and patient characteristics.



In this cohort of peripheral arterial disease patients undergoing primary endarterectomy, we observed a time dependent shift of plaque characteristics towards a less lipid rich lesion with less intraplaque haemorrhage. These findings indicate research in cardiovascular disease would benefit from contemporary patient characteristics and plaque specimens to optimize translational potential.
Laboratory of Experimental Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands.
Saskia
S
Haitjema
Department of Vascular Surgery, University Medical Center Utrecht, Utrecht, The Netherlands.
Steven T W
STW
van Haelst
Department of Vascular Surgery, St. Antonius Hospital, Nieuwegein, The Netherlands.
Jean-Paul P M
JPM
de Vries
Department of Vascular Surgery, University Medical Center Utrecht, Utrecht, The Netherlands.
Frans L
FL
Moll
Laboratory of Experimental Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands.
Hester M
HM
den Ruijter
Department of Vascular Surgery, University Medical Center Utrecht, Utrecht, The Netherlands.
Gert J
GJ
de Borst
Laboratory of Experimental Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands; Laboratory of Clinical Chemistry and Haematology, University Medical Center Utrecht, Utrecht, The Netherlands. Electronic address: g.pasterkamp@umcutrecht.nl.
Gerard
G
Pasterkamp
D000368:Aged; D001706:Biopsy; D003094:Collagen / Q000032:analysis; D004691:Endarterectomy; D005260:Female; D005263:Femoral Artery / Q000737:chemistry / Q000473:pathology* / Q000601:surgery; D006470:Hemorrhage / Q000473:pathology; D006801:Humans; D007083:Iliac Artery / Q000737:chemistry / Q000473:pathology* / Q000601:surgery; D008055:Lipids / Q000032:analysis; D008264:Macrophages / Q000473:pathology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D032389:Myocytes, Smooth Muscle / Q000473:pathology; D009426:Netherlands; D016017:Odds Ratio; D058729:Peripheral Arterial Disease / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D058226:Plaque, Atherosclerotic; D011446:Prospective Studies; D012307:Risk Factors; D013997:Time Factors; D014015:Tissue Banks; D061205:Vascular Calcification / Q000473:pathology
D008055:Lipids; D003094:Collagen
Atherosclerosis; Femoral artery plaque; Peripheral arterial disease; Time-dependent differences