The Carotid Artery Plaque Size and Echogenicity are Related to Different Cardiovascular Risk Factors in the Elderly
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Carotid plaques can be characterised by ultrasound by size and echogenicity. Both size and echogenicity are predictors of cardiovascular events. The aim of this study was to examine whether traditional risk factors and markers of inflammation and oxidation were associated with plaque size and echogenicity. Computerised analysis of carotid plaque size and echogenicity (grey scale median, GSM) were performed by ultrasound in a population-based health survey in 1,016 subjects aged 70 years (PIVUS study). Information on cardiovascular risk factors was collected, together with markers of inflammation and oxidation. Increased Framingham risk score, systolic blood pressure, higher BMI and decreased HDL, lower glutathione levels were related to echolucent plaques. Previous or present smoking was common with significantly more pack-years related to the echorich plaques. Plaque size was associated with increased Framingham risk score, systolic blood pressure, blood glucose levels, smoking, ApoB/A1 ratio, OxLDL, TNF alpha, HOMA insulin resistance, leucocyte count, decreased BCD-LDL and low levels of l-selectin. Low HDL, increased BMI and decreased glutathione levels were associated with the echolucency of carotid plaques, implying metabolic factors to play a role for plaque composition. Markers of inflammation were related to plaque size alone, implying inflammation to be predominantly associated with the amount of atherosclerosis. These results suggest that plaque size and echogenicity are influenced by different risk factors.
KeywordsAtherosclerosis Ultrasound Plaque Carotid artery Risk factor Lipids Oxidation
The outstanding work at the endothelium laboratory performed by Nilla Fors, Jan Hall, Kerstin Marttala and Anna Stenborg in the collection and processing of the data is gratefully acknowledged. We also gratefully thank the staff at Analytical Biochemistry at AstraZeneca for performing the analyses of cytokines, chemokines, and adhesion molecules. The financial support from Uppsala University, Thureus foundation and AstraZeneca R&D is highly valued.
- 2.Honda O, Sugiyama S, Kugiyama K, Fukushima H, Nakamura S, Koide S, Kojima S, Hirai N, Kawano H, Soejima H, Sakamoto T, Yoshimura M, Ogawa H (2004) Echolucent carotid plaques predict future coronary events in patients with coronary artery disease. J Am Coll Cardiol 43:1177–1184PubMedCrossRefGoogle Scholar
- 13.Lind L, Fors N, Hall J, Marttala K, Stenborg A (2005) A comparison of three different methods to evaluate endothelium-dependent vasodilation in the elderly: the prospective investigation of the vasculature in Uppsala seniors (pivus) study. Arterioscler Thromb Vasc Biol 25:2368–2375PubMedCrossRefGoogle Scholar
- 15.Yu CM, Zhang Q, Lam L, Lin H, Kong SL, Chan W, Fung JW, Cheng KK, Chan IH, Lee SW, Sanderson JE, Lam CW (2007) Comparison of intensive and low-dose atorvastatin therapy in the reduction of carotid intimal-medial thickness in patients with coronary heart disease. Heart 93:933–939PubMedCrossRefGoogle Scholar
- 16.Watanabe K, Sugiyama S, Kugiyama K, Honda O, Fukushima H, Koga H, Horibata Y, Hirai T, Sakamoto T, Yoshimura M, Yamashita Y, Ogawa H (2005) Stabilization of carotid atheroma assessed by quantitative ultrasound analysis in nonhypercholesterolemic patients with coronary artery disease. J Am Coll Cardiol 46:2022–2030PubMedCrossRefGoogle Scholar
- 21.Mannami T, Konishi M, Baba S, Nishi N, Terao A (1997) Prevalence of asymptomatic carotid atherosclerotic lesions detected by high-resolution ultrasonography and its relation to cardiovascular risk factors in the general population of a Japanese city: the Suita study. Stroke 28:518–525PubMedGoogle Scholar
- 22.O’Leary DH, Polak JF, Kronmal RA, Kittner SJ, Bond MG, Wolfson SK Jr, Bommer W, Price TR, Gardin JM, Savage PJ (1992) Distribution and correlates of sonographically detected carotid artery disease in the cardiovascular health study. The chs collaborative research group. Stroke 23:1752–1760PubMedGoogle Scholar
- 29.Johnsen SH, Mathiesen EB, Fosse E, Joakimsen O, Stensland-Bugge E, Njolstad I, Arnesen E (2005) Elevated high-density lipoprotein cholesterol levels are protective against plaque progression: a follow-up study of 1952 persons with carotid atherosclerosis the Tromsø study. Circulation 112:498–504PubMedCrossRefGoogle Scholar