Therapeutics and Clinical Risk Management (Jul 2021)

Correlation Between Calcification Characteristics of Carotid Atherosclerotic Plaque and Plaque Vulnerability

  • Xu X,
  • Hua Y,
  • Liu B,
  • Zhou F,
  • Wang L,
  • Hou W

Journal volume & issue
Vol. Volume 17
pp. 679 – 690

Abstract

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Xiangli Xu,1 Yang Hua,2 Beibei Liu,2 Fubo Zhou,2 Lili Wang,2 Weihong Hou2 1Department of Ultrasound, the Second Hospital of Harbin, Harbin, People’s Republic of China; 2Department of Vascular Ultrasonography, Xuanwu Hospital, Capital Medical University, Beijing, People’s Republic of ChinaCorrespondence: Yang HuaDepartment of Vascular Ultrasonography, Xuanwu Hospital, Capital Medical University, No. 45 Changchun Road, Beijing, 100053, People’s Republic of ChinaTel +86-10-83198923Fax +86-10-83198967Email [email protected]: To investigate the relationship between calcification characteristics of carotid atherosclerotic plaque and lipid rich necrotic core (LRNC) and intraplaque hemorrhage (IPH).Methods: Patients with severe carotid stenosis undergoing carotid endarterectomy (CEA) were selected. Ultrasound and CT angiography (CTA) were performed to evaluate the calcification characteristics of the plaque before the surgery.Results: A total of 142 patients were included and 142 pathological specimens of postoperative plaque were obtained accordingly. There were 78 plaques (54.9%) with LRNC and 41 (28.9%) with IPH. The plaque with LRNC had higher calcification rate (93.6%) compared with the plaque with IPH (87.8%). LRNC was often found in multiple calcification (P = 0.003) and mixed type calcification (P = 0.001). Multiple calcification was more likely to combine with IPH (P = 0.008), while simple basal calcification was not likely to combine IPH (P = 0.002). Smaller granular calcification was more likely to be associated with IPH (P < 0.05). In multivariate regression analysis of IPH and calcification characteristics, simple basal calcification was still a protective factor for IPH (OR, 0.25; 95% CI, 0.09– 0.66; P = 0.005), while multiple calcification was closely related to the occurrence of IPH (OR, 3.58; 95% CI, 1.49– 8.61; P = 0.004).Conclusion: Calcification characteristics of carotid atherosclerotic plaques are closely related to the vulnerability of plaques, especially multiple calcification and mixed type calcification.Keywords: carotid artery, atherosclerotic plaque, intraplaque calcification, vulnerable plaque

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