Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University.
Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University.
J Atheroscler Thromb. 2024 Aug 1;31(8):1225-1237. doi: 10.5551/jat.64394. Epub 2024 Mar 9.
Vascular calcification is observed in advanced atherosclerotic lesions. Vascular calcification is considered to increase the risk of intraplaque hemorrhage and subsequent plaque destabilization; however, there is limited pathohistoological evidence of the association between vascular calcification and intraplaque hemorrhage. The aim of this study was to investigate the association between vascular calcification and intraplaque hemorrhage in the coronary arteries.
We examined 374 coronary arteries obtained from the autopsy samples of 126 deceased individuals. The vascular calcification levels of each artery were categorized into no calcification and quintiles of calcification area size among the arteries with calcification. Macrophage infiltration and neovascularization were also evaluated. The association of the calcification area, macrophage area, or number of vessels with the presence of intraplaque hemorrhage in the coronary arteries was estimated using a logistic regression analysis.
Calcification lesions were observed in 149 coronary arteries. Arteries in the fourth quintile of calcification area size had a significantly greater likelihood of intraplaque hemorrhage than the arteries without calcification, after adjusting for confounders: odds ratio 13.13 (95% confidence interval: 2.97-58.16). After evaluating the influence of macrophage infiltration, the highest odds ratio of intraplaque hemorrhage was associated with the combination of large macrophage area and moderately sized calicification areas. The odds ratio of intraplaque hemorrhage additively increased with the combination of calcification and the number of vessels.
The present findings suggest that vascular calcification is significantly associated with intraplaque hemorrhage. The association between vascular calcification and intraplaque hemorrhage may decrease above a certain size of the calcification area.
血管钙化可见于晚期动脉粥样硬化病变中。血管钙化被认为会增加斑块内出血和随后斑块不稳定的风险；然而，血管钙化与斑块内出血之间的关联的病理组织学证据有限。本研究旨在探讨冠状动脉中血管钙化与斑块内出血之间的关系。
我们检查了 126 名已故个体尸检样本中获得的 374 条冠状动脉。将每条动脉的血管钙化程度分为无钙化和有钙化的动脉中钙化面积大小的五分位数。还评估了巨噬细胞浸润和新生血管形成。使用逻辑回归分析估计冠状动脉中钙化面积、巨噬细胞面积或血管数量与斑块内出血之间的关联。
在 149 条冠状动脉中观察到钙化病变。在调整混杂因素后，钙化面积五分位数值第四的动脉发生斑块内出血的可能性明显大于无钙化的动脉：优势比 13.13（95%置信区间：2.97-58.16）。在评估巨噬细胞浸润的影响后，与斑块内出血最大优势比相关的是大巨噬细胞面积和中等大小钙化面积的组合。斑块内出血的优势比随着钙化和血管数量的组合而相加增加。
本研究结果表明，血管钙化与斑块内出血显著相关。血管钙化与斑块内出血之间的关联可能在钙化面积达到一定大小时降低。
