Department of Radiology, Erasmus MC, University Medical Center Rotterdam, the Netherlands; Department of Neurology, Erasmus MC, University Medical Center Rotterdam, the Netherlands.
Department of Hematology, Erasmus MC, University Medical Center Rotterdam, the Netherlands.
Thromb Res. 2019 May;177:130-135. doi: 10.1016/j.thromres.2019.02.030. Epub 2019 Feb 27.
Von Willebrand Factor (VWF), ADAMTS13, fibrinogen and fibrinogen γ' are associated with an increased risk of ischemic stroke. Carotid atherosclerosis is an important risk factor for ischemic stroke. Characteristics of the vulnerable plaque; intraplaque hemorrhage (IPH), plaque ulceration and lipid-rich necrotic core (LRNC) can be visualized with imaging techniques. Since atherosclerosis might attribute to the association between coagulation factors and ischemic stroke risk, the aim of this study is to investigate the association between coagulation factors and atherosclerotic plaque characteristics in more detail.
In 182 patients of the Plaque-At-RISK study (prospective multicenter cohort study) with a recent transient ischemic attack (TIA) or ischemic stroke and a symptomatic mild-to-moderate carotid artery stenosis, we measured VWF antigen (VWF:Ag), ADAMTS13 activity, fibrinogen (Clauss), and fibrinogen γ'. Presence of plaque ulceration, IPH volume and LRNC volume were determined by Multidetector-Row Computed Tomography (MDCTA, n = 160) and Magnetic Resonance Imaging (MRI, n = 172). Linear regression analysis was used to assess the association between imaging biomarkers and coagulation factors.
VWF:Ag or ADAMTS13 levels were not significantly associated with plaque ulceration, IPH and LRNC. We found an inverse association between fibrinogen and fibrinogen γ' and IPH volume (B = -23.40 mm/g/L, p = 0.01 and B = -161.73 mm/g/L, p = 0.01) and between fibrinogen and fibrinogen γ' and LRNC volume (B = -38.89 mm g/L, p < 0.01 and B = -227.06 mm g/L, p = 0.01). Additional adjustments for C-reactive protein (CRP) did not change the results.
Fibrinogen and fibrinogen γ' are inversely associated with IPH volume and LRNC volume, independent of inflammation.
clinicaltrials.govNCT01208025.
血管性血友病因子（VWF）、ADAMTS13、纤维蛋白原和纤维蛋白原 γ' 与缺血性卒中风险增加相关。颈动脉粥样硬化是缺血性卒中的一个重要危险因素。易损斑块的特征；斑块内出血（IPH）、斑块溃疡和富含脂质的坏死核心（LRNC）可以通过影像学技术进行可视化。由于动脉粥样硬化可能与凝血因子和缺血性卒中风险之间存在关联，因此本研究的目的是更详细地研究凝血因子与动脉粥样硬化斑块特征之间的关系。
在 182 名近期短暂性脑缺血发作（TIA）或缺血性卒中和症状性轻中度颈动脉狭窄的 Plaque-At-RISK 研究（前瞻性多中心队列研究）患者中，我们测量了血管性血友病因子抗原（VWF：Ag）、ADAMTS13 活性、纤维蛋白原（Clauss）和纤维蛋白原 γ'。通过多排螺旋计算机断层扫描（MDCTA，n=160）和磁共振成像（MRI，n=172）确定斑块溃疡、IPH 体积和 LRNC 体积。线性回归分析用于评估影像学标志物和凝血因子之间的关系。
VWF：Ag 或 ADAMTS13 水平与斑块溃疡、IPH 和 LRNC 无显著相关性。我们发现纤维蛋白原和纤维蛋白原 γ'与 IPH 体积（B=-23.40mm/g/L，p=0.01 和 B=-161.73mm/g/L，p=0.01）和纤维蛋白原和纤维蛋白原 γ'与 LRNC 体积（B=-38.89mmg/L，p<0.01 和 B=-227.06mmg/L，p=0.01）呈负相关。对 C 反应蛋白（CRP）进行额外调整并未改变结果。
纤维蛋白原和纤维蛋白原 γ'与 IPH 体积和 LRNC 体积呈负相关，与炎症无关。
clinicaltrials.govNCT01208025。
