Age and coumarin-type anticoagulation are associated with the occurrence of intraplaque hemorrhage, while statins are associated less with intraplaque hemorrhage: A large histopathological study in carotid and femoral plaques
Age and coumarin-type anticoagulation are associated with the occurrence of intraplaque hemorrhage, while statins are associated less with intraplaque hemorrhage: A large histopathological study in carotid and femoral plaques
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DOI：
10.1016/j.atherosclerosis.2010.10.022
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发表时间：
2011-01-01
期刊：
影响因子：
5.3
通讯作者：
Vink, Aryan
中科院分区：
文献类型：
--
作者：
Derksen, Wouter J. M.;Peeters, Wouter;Vink, Aryan
简介：斑块内出血（IPH）是动脉粥样硬化斑块进展和不稳定的重要决定因素。我们最近证明，IPH 是颈动脉内膜切除术后未来心血管事件的独立预测因子。迄今为止，尚不清楚临床患者特征（例如药物使用）是否与 IPH 的发生相关。本研究的目的是检查 IPH 与临床患者特征的关联。方法和结果：纳入了 1070 名连续接受颈动脉 (n = 794) 或股动脉 (n = 276) 动脉内膜切除术的患者。对动脉内膜切除术标本进行组织病理学检查。在 644/794 (81%) 颈动脉斑块和 175/276 (63%) 股骨斑块中观察到 IPH。颈动脉 IPH 与高龄（69 岁 [IQR：62-75] 对比 65 岁 [IQR：57-73]；P = 0.002）和术前使用香豆素类抗凝药物呈正相关（使用香豆素衍生物为 104/116 [90%]，不使用香豆素衍生物为 540/678 [80%]；P = 0.01）。在动脉内膜切除术前使用他汀类药物的患者中，颈动脉 IPH 的发生率较低（使用他汀类药物的患者为 468/595 [79%]，而未使用他汀类药物的患者为 176/199 [88%]；P = 0.002）。在多变量分析中，年龄、香豆素类抗凝药物的使用和他汀类药物的使用与颈动脉IPH独立相关。股骨IPH与临床患者特征之间没有观察到关联。结论：高龄和香豆素类抗凝药物的使用与IPH的发生相关，而他汀类药物的使用与IPH的减少相关。 (C) 2010 Elsevier Ireland Ltd. 保留所有权利。
Introduction: Intraplaque hemorrhage (IPH) is an important determinant of progression and destabilization of atherosclerotic plaque. We recently demonstrated that IPH is an independent predictor of future cardiovascular events after carotid endarterectomy. Thus far, it is unknown whether clinical patient characteristics, such as medication use, are associated with the occurrence of IPH. The purpose of this study was to examine the association of IPH with clinical patient characteristics.Methods and results: 1070 consecutive patients who underwent a carotid (n = 794) or femoral (n = 276) endarterectomy were included. Endarterectomy specimens were subjected to histopathological examination. IPH was observed in 644/794 (81%) carotid and 175/276 (63%) femoral plaques. Carotid IPH was positively correlated with advanced age (69 years [IQR: 62-75] vs. 65 years [IQR: 57-73]; P = 0.002) and coumarin-type anticoagulation use prior to operation (104/116 [90%] with coumarin derivatives vs. 540/678 [80%] without coumarin derivatives; P = 0.01). Carotid IPH was less frequently observed in patients that used statins prior to endarterectomy (468/595 [79%] with statin vs. 176/199 [88%] without statin; P = 0.002). In multivariate analysis, age, coumarin-type anticoagulation use and statin use were independently correlated with carotid IPH. No association was observed between femoral IPH and clinical patient characteristics.Conclusion: Advanced age and coumarin-type anticoagulation use are associated with the occurrence of IPH, while statin use is associated with less IPH. (C) 2010 Elsevier Ireland Ltd. All rights reserved.