• Vascular Annual Meeting
• General Information
• Call for Abstracts
• Exhibitor Information
• Future Meeting Dates
• Past Meeting Information
• Contact Us

Novel Markers Of Carotid Plaque Vulnerability

Nikolaos P Kadoglou¹, Thomas Gerasimidis², Spyretta Golemati³, Alkistis Kapelouzou⁴, Anestis Moumtzouoglou⁵, Ioulia Vitta⁶, Elias Kaperonis¹, Panagiotis Karayannacos⁴, Christos D Liapis.^1
1Department of Vascular Surgery, Medical School, University of Athens, Athens, Greece; ²Fifth Surgical Department, Aristotle's University of Thessaloniki, Thessaloniki, Greece; ³School of Electrical and Computer Engineering, National Technical University of Athens, Athens, Greece; ⁴Foundation of Biomedical Research, Center for Experimental Surgery, Academy of Athens, Athens, Greece5Laboratory of Radiology, “Ippokratio” General Hospital of Thessaloniki, Thessaloniki, Greece; ⁶Laboratory of Biochemistry, “Ippokratio” General Hospital of Thessaloniki, Thessaloniki, Greece.

OBJECTIVES: Osteopontin (OPN) and osteoprotegerin (OPG) are related with inhibition of vascular calcification, inflammation and thus, cardiovascular events. The aim of this ongoing, open, prospective study is to assess carotid atherosclerotic plaque echogenicity and serum levels of OPN and OPG in patients with carotid artery stenosis in relation to cerebrovascular ischemic events, and to test their use as novel markers of plaque vulnerability.

METHODS: 81 patients (47 males), aged 55-80 with at least 50% ICA (NASCET) stenosis and 44 age- and sex-matched healthy individuals were included in the study. Patients with renal failure, hypothyroidism, osteoporosis and on lipid-lowering therapy were excluded. High-resolution color duplex ultrasound of the carotids was performed and the gray scale median (GSM) was calculated. Brain CT and /or MRI, when CT was questionable, were performed in all patients. Among patients with carotid stenosis 52 had history of ipsilateral stroke or TIA and positive CT/MRI findings (group A) and 29 had negative CT/MRI (group B). Healthy subjects served as controls (group C). Blood pressure, lipid and glycemic indexes, hsCRP, serum OPN and OPG were also measured. Independent and paired t-test samples, one-way ANOVA and Pearson correlation were used for statistical analysis.

RESULTS: Compared with group C, patients of both groups A and B had worse lipid profile and elevated levels of blood pressure, hsCRP, OPN and OPG (p<0.05). Groups A and B were comparable in anthropometric data. No significant differences were observed between groups A and B for glycemic and lipid parameters. Patients with cerebral events (group A) showed statistically significant lower levels of GSM (p=0.008) and higher hsCRP, OPN and OPG levels, compared to group B and group C (table 1). Notably OPN and OPG were significantly correlated with GSM values in patients with carotid plaques in univariate (r=-0.543;p=0.030, r=-0.372;p=0.036, respectively) and multiple regression analysis.

CONCLUSIONS: Carotid symptomatology correlates with elevated OPN and OPG levels, while plaque GSM is inversely associated with cerebral events. OPN and OPG levels in combination with GSM can be used as early markers of vulnerable carotid plaques.