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Semiautomated carotid artery plaque composition: are intraplaque CT imaging features associated with cardiovascular risk factors?

  • Diagnostic Neuroradiology
  • Published:
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Abstract

Background

Little remains known about the connection between cardiovascular (CV) risk factors and carotid plaque morphologies. This study set out to assess for any such associations.

Materials and methods

A retrospective review was completed of consecutive patients that had CTA neck imaging prior to CEA. Body mass index (BMI), tobacco and/or alcohol use, and history of diabetes and/or hypertension were collected from patients’ medical records. Lab values were dichotomized based on values: total cholesterol < 200 or ≥ 200; low-density lipoprotein (LDL) < 130 or ≥ 130, high-density lipoprotein < 35 or ≥ 35, and triglycerides < 200 or ≥ 200. A semiautomated analysis of CTA images computed maximum stenosis, intraplaque volumes of intraplaque hemorrhage, lipid-rich necrotic core (LRNC), and matrix, and intraplaque volume and proportional plaque makeup of calcifications of each carotid plaque.

Results

Of 87 included patients, 54 (62.1%) were male. Mean age was 70.1 years old. Both diabetes and hypertension were associated with greater intraplaque calcification volume (p = 0.0009 and p = 0.01, respectively), and greater proportion of calcification within a plaque (p = 0.004 and p = 0.01, respectively). Higher BMI was associated with greater intraplaque volume of LRNC (p=0.02) and matrix (0.0007). Elevated total cholesterol was associated with both larger intraplaque calcification volume (p = 0.04) and greater proportion of calcification within a plaque (p = 0.01); elevated LDL was associated with greater intraplaque calcification volume (p = 0.005).

Conclusion

Multiple CV risk factors are associated with morphological differences in carotid artery plaques. Dysregulation of both total cholesterol and LDL and higher BMI are associated with higher volumes of intraplaque LRNC, a marker of plaque vulnerability.

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Abbreviations

CV:

Cardiovascular

CEA:

Carotid endarterectomy

CTA:

Computed tomography angiography

LRNC:

Lipid rich necrotic core

IPH:

Intraplaque hemorrhage

LDL:

Low-density lipoprotein

HDL:

High-density lipoprotein

TG:

Triglycerides

TIA:

Transient ischemic attack

CAD:

Coronary artery disease

PCI:

Percutaneous coronary intervention

CABG:

Coronary artery bypass graft

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Funding

No funding was received for this study.

Author information

Authors and Affiliations

  1. Department of Radiology, Mayo Clinic, 200 1st St SW, Rochester, MN, 55905, USA

    John C. Benson & Waleed Brinjikji

  2. Department of Neurosurgery, Mayo Clinic, Rochester, MN, USA

    Giuseppe Lanzino & Luis Savastano

  3. Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA

    Valentina Nardi & Amir Lerman

Authors
  1. John C. Benson
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  2. Giuseppe Lanzino
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  3. Valentina Nardi
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  4. Luis Savastano
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  5. Amir Lerman
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  6. Waleed Brinjikji
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Corresponding author

Correspondence to John C. Benson.

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Ethics approval and consent to participate

All procedures performed in the studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Though informed consent could not be obtained from all participants due to the retrospective nature of this study, no participants opted out of their medical records being used for research purposes.

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The authors declare that they have no conflict of interest.

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Benson, J.C., Lanzino, G., Nardi, V. et al. Semiautomated carotid artery plaque composition: are intraplaque CT imaging features associated with cardiovascular risk factors?. Neuroradiology 63, 1617–1626 (2021). https://doi.org/10.1007/s00234-021-02662-6

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  • DOI: https://doi.org/10.1007/s00234-021-02662-6

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