Pathological quantification of carotid artery plaque instability in patients undergoing carotid endarterectomy

Takao Konishi, Naohiro Funayama, Tadashi Yamamoto, Tohru Morita, Daisuke Hotta, Ryota Nomura, Yusuke Nakagaki, Takeo Murahashi, Kenji Kamiyama, Tetsuyuki Yoshimoto, Takeshi Aoki, Hiroshi Nishihara, Shinya Tanaka

研究成果: Article

6 引用 (Scopus)

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Background: Unstable atherosclerotic carotid plaques cause cerebral thromboemboli and ischemic events. However, this instability has not been pathologically quantified, so we sought to quantify it in patients undergoing carotid endarterectomy (CEA). Methods and Results: Carotid plaques were collected during CEA from 67 symptomatic and 15 asymptomatic patients between May 2015 and August 2016. The specimens were stained with hematoxylin-eosin and elastica-Masson. Immunohistochemistry was performed using an endothelial-specific antibody to CD31, CD34 and PDGFRβ. The histopathological characteristics of the plaques were studied. By multiple-variable logistic regression analysis, plaque instability correlated with the presence of plaque rupture [odds ratio (OR), 9.75; P=0.013], minimum fibrous cap thickness (OR per 10 μm 0.70; P=0.025), presence of microcalcifications in the fibrous cap (OR 7.82; P=0.022) and intraplaque microvessels (OR 1.91; P=0.043). Receiver-operating characteristics analyses showed that these factors combined into a single score diagnosed symptomatic carotid plaques in patients with carotid artery stenosis with a high level of accuracy (area under the curve 0.92; 95% confidence interval 0.85-0.99 vs. asymptomatic). Conclusions: This analysis of carotid plaque instability strongly suggested that the diagnostic scoring of carotid plaque instability improves the understanding and treatment of carotid artery disease in patients undergoing CEA.

元の言語English
ページ(範囲)258-266
ページ数9
ジャーナルCirculation Journal
82
発行部数1
DOI
出版物ステータスPublished - 2018 1 1
外部発表Yes

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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    Konishi, T., Funayama, N., Yamamoto, T., Morita, T., Hotta, D., Nomura, R., Nakagaki, Y., Murahashi, T., Kamiyama, K., Yoshimoto, T., Aoki, T., Nishihara, H., & Tanaka, S. (2018). Pathological quantification of carotid artery plaque instability in patients undergoing carotid endarterectomy. Circulation Journal, 82(1), 258-266. https://doi.org/10.1253/circj.CJ-17-0204