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Calcium-Scoring CT ScanA calcium-scoring CT scan, also known as coronary artery calcium (CAC) scan, detects calcium deposits in the coronary arteries. This test assesses the risk of coronary artery disease (CAD), which can lead to cardiovascular events such as angina, heart failure, and sudden cardiac arrest.A calcium-scoring CT scan is generally recommended for individuals at intermediate risk of CAD without symptoms. It includes:Men aged 40-75 and women aged 50-75: Especially those with a...
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Association between plaque vulnerability and neutrophil extracellular traps (NETs) levels: The Plaque At RISK study.

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Carotid plaque vulnerability is linked to neutrophil extracellular traps (NETs) in patients not taking statins or antithrombotics. This association highlights NETs

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Area of Science:

  • Cardiovascular Research
  • Immunology
  • Stroke Medicine

Background:

  • Carotid atherosclerotic plaque rupture is a primary cause of ischemic stroke.
  • Plaque vulnerability and immune system activation, including neutrophil extracellular traps (NETs), influence stroke risk.
  • Understanding the link between plaque characteristics and NETs is crucial for stroke prevention strategies.

Purpose of the Study:

  • To investigate the association between carotid plaque vulnerability and plasma levels of NETs.
  • To determine if this association differs in patients based on medication use (statins, antithrombotics).

Main Methods:

  • 182 patients from the Plaque At RISK (PARISK) study underwent carotid imaging.
  • Plaque characteristics (ulceration, cap integrity, hemorrhage, necrotic core, calcifications, volume) were measured.
  • A 'vulnerability index' was calculated; myeloperoxidase-DNA complex (NETs marker) was measured in plasma.
  • Logistic regression analyzed the association between the vulnerability index and NETs levels.

Main Results:

  • No significant association between plaque vulnerability and NETs was found in the total patient population.
  • A statistically significant positive association was observed in patients naive to statins or antithrombotic medication.
  • This association in medication-naive patients was primarily driven by intraplaque hemorrhage, lipid-rich necrotic core, and ulceration.

Conclusions:

  • Carotid plaque vulnerability is positively associated with plasma NETs levels, but only in patients not on statins or antithrombotic therapy.
  • These findings suggest a specific role for NETs in the pathogenesis of vulnerable plaques in certain patient subgroups.
  • Further research is warranted to explore therapeutic targeting of NETs for stroke prevention in at-risk individuals.