Dataset Information

Age-Related Differences in the Association between Plasma High-Sensitivity C-Reactive Protein and Noncalcified or Mixed Coronary Atherosclerotic Plaques.

ABSTRACT: Background:Previous studies have demonstrated that plasma high-sensitivity C-reactive protein (hsCRP) was the predictor for unstable coronary plaque. Patients with noncalcified plaque (NCP) or mixed plaque (MP) have a higher risk of poor outcomes. However, the association between hsCRP and the presence of NCP or MP (NCP/MP) in old adults remains unclear, and if present, whether there exist differences between young and old adults remain unknown. Thus, the aim of this study was to investigate the role of hsCRP in predicting the presence of NCP/MP and evaluate whether age has any impact on this association. Methods:A total of 951 subjects were included in this study. Complete clinical and laboratory data were collected. According to the characteristics of the most stenotic plaque, we divided them into 2 groups: calcified plaque (CP) and NCP/MP. Subjects with no plaque were classified as the control group (CR). Subjects with age ? 60 years were defined as older adults, and those with age < 60 years were classified as nonelderly people. Results:Patients with NCP/MP had significantly higher hsCRP level compared with subjects with CR or CP in older adults but not in nonelderly people. The proportion of NCP/MP was significantly increased from 27.0% in the hsCRP < 1.25?mg/L group to 42.7% in the hsCRP > 2.70?mg/L group in older adults. Multiple logistic regression analysis showed that hsCRP was an independent risk factor for the presence of NCP/MP (odds?ratio?(OR) = 1.093, 95% CI 1.032-1.157, P = 0.001) only in older adults. Conclusions:hsCRP is independently associated with the presence of NCP/MP in older adults but not in nonelderly people. These results suggest the potential significance of hsCRP-lowering regimens in older adults with NCP/MP.

SUBMITTER: Li T

PROVIDER: S-EPMC7204134 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Age-Related Differences in the Association between Plasma High-Sensitivity C-Reactive Protein and Noncalcified or Mixed Coronary Atherosclerotic Plaques.

Li Tiewei T Chen Ning N Liu Zhengan Z Shan Zhiming Z Dong Geng G Yang Junmei J Qi Minglu M

Mediators of inflammation 20200428

<h4>Background</h4>Previous studies have demonstrated that plasma high-sensitivity C-reactive protein (hsCRP) was the predictor for unstable coronary plaque. Patients with noncalcified plaque (NCP) or mixed plaque (MP) have a higher risk of poor outcomes. However, the association between hsCRP and the presence of NCP or MP (NCP/MP) in old adults remains unclear, and if present, whether there exist differences between young and old adults remain unknown. Thus, the aim of this study was to investi ...[more]

PMID: 32410858

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Project description:ObjectiveHigh-risk intracranial arterial plaques are the most common cause of ischemic stroke and their characteristics vary between male and female patients. However, sex differences in intracranial plaques among symptomatic patients have rarely been discussed. This study aimed to evaluate sex differences in intracranial atherosclerotic plaques among Chinese patients with cerebral ischemia.MethodsOne hundred and ten patients who experienced ischemic events underwent 3T cardiovascular magnetic resonance vessel wall scanning for the evaluation of intracranial atherosclerotic disease. Each plaque was classified according to its likelihood of causing a stroke (as culprit, uncertain, or non-culprit). The outer wall area (OWA) and lumen area of the lesion and reference sites were measured, and the wall and plaque areas, remodeling ratio, and plaque burden (characterized by a normalized wall index) were further calculated. The composition (T1 hyperintensity, enhancement) and morphology (surface irregularity) of each plaque were analyzed. Sex differences in intracranial plaque characteristics were compared between male and female patient groups.ResultsOverall, 311 plaques were detected in 110 patients with ischemic stroke (81 and 29 male and female patients, respectively). The OWA (P < 0.001) and wall area (P < 0.001) of intracranial arterial lesions were significantly larger in male patients. Regarding culprit plaques, the plaque burden in male patients was similar to that in female patients (P = 0.178, odds ratio [OR]: 0.168, 95% confidence interval [CI]: -0.020 to 0.107). However, the prevalence of plaque T1 hyperintensity was significantly higher than that in female patients (P = 0.005, OR: 15.362, 95% CI: 2.280-103.49). In the overall ischemic stroke sample, intracranial T1 hyperintensity was associated with male sex (OR: 13.480, 95% CI: 2.444-74.354, P = 0.003), systolic blood pressure (OR: 1.019, 95% CI: 1.002-1.036, P = 0.031), and current smoker (OR: 3.245, 95% CI: 1.097-9.598, P = 0.033).ConclusionFor patients with ischemic stroke, the intracranial plaque burden in male patients was similar to that in female patients; however, the plaque characteristics in male patients are associated with higher risk, especially in culprit plaques.

Project description:This study sought to determine whether the classification of human coronary atherosclerotic plaques with T1, T2, and ultrashort echo time (UTE) cardiac magnetic resonance (CMR) would correlate well with atherosclerotic plaque classification by histology.CMR has been extensively used to classify carotid plaque, but its ability to characterize coronary plaque remains unknown. In addition, the detection of plaque calcification by CMR remains challenging. Here, we used T1, T2, and UTE CMR to evaluate atherosclerotic plaques in fixed post-mortem human coronary arteries. We hypothesized that the combination of T1, T2, and UTE CMR would allow both calcified and lipid-rich coronary plaques to be accurately detected.Twenty-eight plaques from human donor hearts with proven coronary artery disease were imaged at 9.4-T with a T1-weighted 3-dimensional fast low-angle shot (FLASH) sequence (250-?m resolution), a T2-weighted rapid acquisition with refocused echoes (RARE) sequence (in-plane resolution 0.156 mm), and an UTE sequence (300-?m resolution). Plaques showing selective hypointensity on T2-weighted CMR were classified as lipid-rich. Areas of hypointensity on the T1-weighted images, but not the UTE images, were classified as calcified. Hyperintensity on the T1-weighted and UTE images was classified as hemorrhage. Following CMR, histological characterization of the plaques was performed with a pentachrome stain and established American Heart Association criteria.CMR showed high sensitivity and specificity for the detection of calcification (100% and 90%, respectively) and lipid-rich necrotic cores (90% and 75%, respectively). Only 2 lipid-rich foci were missed by CMR, both of which were extremely small. Overall, CMR-based classification of plaque was in complete agreement with the histological classification in 22 of 28 cases (weighted ? = 0.6945, p < 0.0001).The utilization of UTE CMR allows plaque calcification in the coronary arteries to be robustly detected. High-resolution CMR with T1, T2, and UTE contrast enables accurate classification of human coronary atherosclerotic plaque.

Dataset Information

Age-Related Differences in the Association between Plasma High-Sensitivity C-Reactive Protein and Noncalcified or Mixed Coronary Atherosclerotic Plaques.

Publications

Age-Related Differences in the Association between Plasma High-Sensitivity C-Reactive Protein and Noncalcified or Mixed Coronary Atherosclerotic Plaques.

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