Endothelial dysfunction and systemic inflammation in persons with echolucent carotid plaques

Area of Science:

• Vascular Biology and Medicine
• Cardiovascular Disease Research
• Cerebrovascular Health

Background:

• Echolucent carotid plaques are linked to increased risk of ischemic cerebrovascular events.
• Systemic inflammation and endothelial dysfunction markers predict myocardial infarction and stroke.
• Understanding the relationship between plaque characteristics, inflammation, and endothelial markers is crucial for risk stratification.

Purpose of the Study:

• To investigate the associations between carotid plaque echogenicity, endothelial dysfunction markers (tissue-plasminogen activator antigen [t-PA ag] and von Willebrand factor [vWF]), and systemic inflammation.
• To determine if t-PA ag or vWF are better indicators of endothelial dysfunction in patients with carotid stenosis.
• To explore the relationship between these markers and systemic inflammation indicators like white blood cell count, fibrinogen, and high-sensitivity C-reactive protein (hs-CRP).

Main Methods:

• A cross-sectional study involving 133 individuals with carotid stenosis and 138 controls from the Tromsø Study.
• High-resolution B-mode and color Doppler ultrasonography to assess carotid arteries and plaque echogenicity.
• Measurement of plasma t-PA ag, vWF, plasminogen activator inhibitor-I (PAI-1), white blood cell count, fibrinogen, and hs-CRP.

Main Results:

• Individuals with carotid stenosis exhibited higher plasma t-PA ag and vWF concentrations compared to controls.
• A significant inverse correlation was found between t-PA ag levels and plaque echogenicity (p = 0.034).
• Higher systemic inflammation markers (WBC, fibrinogen, hs-CRP) were associated with increased plasma t-PA ag and vWF concentrations, particularly in individuals with echolucent plaques.

Conclusions:

• Plasma t-PA ag may be a more effective marker of endothelial dysfunction than vWF, as it differentiates plaque echogenicity.
• The predictive value of t-PA ag in cardiovascular disease appears independent of fibrinolysis inhibition.
• Echolucent carotid plaques are associated with a greater degree of systemic inflammation and endothelial dysfunction.