Carotid Plaque Morphology in Asymptomatic Patients with and without Metabolic Syndrome

Ann Vasc Surg. 2017 Feb:39:173-181. doi: 10.1016/j.avsg.2016.05.092. Epub 2016 Aug 12.

Abstract

Background: The aim of this study was to determine the impact of metabolic syndrome (MetS) on the morphology of carotid plaques, as evaluated using duplex ultrasound (DUS) with computer-assisted analysis.

Methods: In this cross-sectional observational study, we analyzed 148 carotid artery plaques in asymptomatic patients. Data were obtained via clinical and laboratory examinations, and DUS was performed by a single operator. All plaques were scanned in a longitudinal fashion, and the best segment was selected, recorded, and evaluated using dedicated software. The main software-based analyses included gray-scale median (GSM) measurements and carotid plaque morphology histograms.

Results: MetS was identified in 51.8% of patients. Comparisons of patients with MetS and patients without MetS indicated that the former patients used more classes of antihypertensive drugs (2.49 vs. 1.93; P = 0.004) and were treated with statins for a longer period (71.08 vs. 49.17 months; P = 0.003). Most patients of both types exhibited moderate carotid artery stenosis ranging from 50% to 69% (n = 62; 37.3%), and MetS was not associated with an increased prevalence of severe carotid artery stenosis. The mean GSM was greater in the MetS group than in the non-MetS group (74.18 vs. 61.63; P = 0.012). The histogram analysis revealed that there were lower quantities of blood and fat (2.91 vs. 3.88; P = 0.006; 10.21 vs. 15.08; P = 0.004, respectively) and more fibrous tissue (19.93 vs. 14.55; P = 0.015) in the carotid plaques of patients with MetS than in the carotid plaques of patients without MetS.

Conclusions: The present study demonstrated that MetS did not affect the stenosis grade or did it lead to unstable carotid plaques.

Publication types

  • Observational Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Asymptomatic Diseases
  • Carotid Arteries / diagnostic imaging*
  • Carotid Arteries / pathology
  • Carotid Stenosis / complications
  • Carotid Stenosis / diagnostic imaging*
  • Carotid Stenosis / pathology
  • Cross-Sectional Studies
  • Female
  • Fibrosis
  • Humans
  • Image Interpretation, Computer-Assisted
  • Male
  • Metabolic Syndrome / complications*
  • Metabolic Syndrome / diagnosis
  • Middle Aged
  • Plaque, Atherosclerotic*
  • Predictive Value of Tests
  • Prognosis
  • Risk Factors
  • Rupture, Spontaneous
  • Severity of Illness Index
  • Software
  • Ultrasonography, Doppler, Duplex*