van Velzen Twan Jowan, Stolp Jeffrey, van Dam-Nolen Dianne, Kassem Mohamed, Hendrikse Jeroen, Kooi Marianne Eline, Bos Daniel, Nederkoorn Paul J
Department of Neurology, Amsterdam UMC, Location AMC, 1105 AZ Amsterdam, The Netherlands.
Department of Radiology and Nuclear Medicine, Erasmus MC, University Medical Center Rotterdam, 3015 GD Rotterdam, The Netherlands.
J Clin Med. 2023 Feb 8;12(4):1370. doi: 10.3390/jcm12041370.
Increasing evidence suggests that inflammation inside the vessel wall has a prominent role in atherosclerosis. In carotid atherosclerosis in particular, vulnerable plaque characteristics are strongly linked to an increased stroke risk. An association between leukocytes and plaque characteristics has not been investigated before and could help with gaining knowledge on the role of inflammation in plaque vulnerability, which could contribute to a new target for intervention. In this study, we investigated the association of the leukocyte count with carotid vulnerable plaque characteristics.
All patients from the Plaque At RISK (PARISK) study whom had complete data on their leukocyte count and CTA- and MRI-based plaque characteristics were included. Univariable logistic regression was used to detect associations of the leukocyte count with the separate plaque characteristics (intra-plaque haemorrhage (IPH), lipid-rich-necrotic core (LRNC), thin or ruptured fibrous cap (TRFC), plaque ulceration and plaque calcifications). Subsequently, other known risk factors for stroke were included as covariates in a multivariable logistic regression model.
161 patients were eligible for inclusion in this study. Forty-six (28.6%) of these patients were female with a mean age of 70 [IQR 64-74]. An association was found between a higher leukocyte count and lower prevalence of LRNC (OR 0.818 (95% CI 0.687-0.975)) while adjusting for covariates. No associations were found between the leucocyte count and the presence of IPH, TRFC, plaque ulceration or calcifications.
The leukocyte count is inversely associated with the presence of LRNC in the atherosclerotic carotid plaque in patients with a recently symptomatic carotid stenosis. The exact role of leukocytes and inflammation in plaque vulnerability deserves further attention.
越来越多的证据表明，血管壁内的炎症在动脉粥样硬化中起重要作用。特别是在颈动脉粥样硬化中，易损斑块特征与中风风险增加密切相关。此前尚未研究过白细胞与斑块特征之间的关联，这可能有助于了解炎症在斑块易损性中的作用，从而为干预提供新靶点。在本研究中，我们调查了白细胞计数与颈动脉易损斑块特征之间的关联。
纳入了来自“斑块风险（PARISK）”研究的所有患者，这些患者具有白细胞计数以及基于CTA和MRI的斑块特征的完整数据。采用单变量逻辑回归来检测白细胞计数与各个斑块特征（斑块内出血（IPH）、富含脂质的坏死核心（LRNC）、薄或破裂的纤维帽（TRFC）、斑块溃疡和斑块钙化）之间的关联。随后，将其他已知的中风危险因素作为协变量纳入多变量逻辑回归模型。
161例患者符合本研究纳入标准。其中46例（28.6%）为女性，平均年龄70岁[四分位间距64 - 74岁]。在调整协变量后，发现白细胞计数较高与LRNC患病率较低之间存在关联（比值比0.818（95%置信区间0.687 - 0.975））。未发现白细胞计数与IPH、TRFC、斑块溃疡或钙化的存在之间存在关联。
在近期有症状性颈动脉狭窄的患者中，白细胞计数与动脉粥样硬化颈动脉斑块中LRNC的存在呈负相关。白细胞和炎症在斑块易损性中的确切作用值得进一步关注。
