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Updated: Jul 7, 2026

A Magnetic Resonance Imaging-based Computational Protocol for Analysis of Plaque Morphology and Hemodynamics in Patients with Carotid Artery Stenosis
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A Magnetic Resonance Imaging-based Computational Protocol for Analysis of Plaque Morphology and Hemodynamics in Patients with Carotid Artery Stenosis

Published on: August 12, 2025

Markers of instability in high-risk carotid plaques are reduced by statins

Hagen Kunte1, Nicola Amberger, Markus Alexander Busch

  • 1Department of Neurology, Charité-Universitätsmedizin Berlin, Berlin, Germany. hagen.kunte@charite.de

Journal of Vascular Surgery
|February 26, 2008
PubMed

Insights

Statins appear to stabilize carotid atherosclerotic plaques by reducing macrophage infiltration and matrix metalloproteinase-9 (MMP-9) expression, key indicators of plaque instability. This study confirms these markers and supports statins

Area of Science:

  • Cardiovascular Research
  • Immunology
  • Biomedical Engineering

Background:

  • Macrophage infiltration and matrix metalloproteinase-9 (MMP-9) expression are established markers of high-risk, unstable atherosclerotic carotid plaques.
  • Statins are associated with reduced stroke risk and improved plaque stability, but the underlying mechanisms remain debated.

Purpose of the Study:

  • To investigate the association between statin use and markers of carotid plaque instability, specifically macrophage infiltration and MMP-9 expression.
  • To elucidate the mechanism by which statins may confer plaque stability in patients with carotid artery stenosis.

Main Methods:

  • Retrospective analysis of 94 patients with internal carotid artery stenosis undergoing carotid endarterectomy.
  • Quantitative immunohistochemical analysis of excised plaques to determine macrophage and MMP-9 area percentages.
  • Univariate and multivariate analyses to examine associations between plaque markers, statin use, and cerebrovascular disease.

Main Results:

  • Symptomatic carotid plaques showed significantly higher macrophage and MMP-9 area percentages compared to asymptomatic plaques (P < .0005).
  • Statin-treated patients exhibited significantly lower macrophage and MMP-9 area percentages than untreated patients (P = .01 and P < .0005, respectively).
  • These associations remained significant after controlling for symptomatic disease and other confounders in multivariable analysis.

Conclusions:

  • Macrophage and MMP-9 area percentages are confirmed as reliable indicators of carotid plaque instability.
  • The findings provide robust evidence that statins stabilize atherosclerotic plaques by reducing inflammatory markers, supporting their role in preventing stroke.
Abstract

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