Higher Leukocyte Count Is Associated with Lower Presence of Carotid Lipid-Rich Necrotic Core: A Sub-Study in the Plaque at RISK (PARISK) Study

Twan Jowan van Velzen*, Jeffrey Stolp, Dianne van Dam-Nolen, Mohamed Kassem, Jeroen Hendrikse, Marianne Eline Kooi, Daniel Bos, Paul J. Nederkoorn

*Corresponding author for this work

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Abstract

Background: 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. Methods: 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. Results: 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. Conclusions: 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.

Original languageEnglish
Article number1370
JournalJournal of Clinical Medicine
Volume12
Issue number4
DOIs
Publication statusPublished - 8 Feb 2023

Bibliographical note

Funding Information:
PARISK was performed in the context of the Center for Translational Molecular Medicine project PARISK (Plaque At RISK; grant 01C-202) and the Dutch Heart Foundation (grant DHF2008-T094). TJvV and PJN are supported by the Netherlands Organisation of Scientific Research (ZonMw; project number 843004107).

Publisher Copyright:
© 2023 by the authors.

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