Atherosclerotic plaque characteristics are not associated with future cardiovascular events in patients undergoing iliofemoral endarterectomy

Steven T. W. van Haelst, Saskia Haitjema, Wouter Derksen, Ian van Koeverden, Jean-Paul P. M. de Vries, Frans L. Moll, Hester M. den Ruijter, Gerard Pasterkamp, Gert J. de Borst

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Background: Plaque characteristics such as intraplaque hemorrhage (IPH) have been associated with secondary cardiovascular events (CVE) in patients undergoing carotid endarterectomy. In addition, carotid plaques containing macrophage infiltration or a large lipid core size were associated with less restenosis. It is currently unknown whether iliofemoral plaque histopathologic characteristics are predictive for secondary CVE in patients with peripheral arterial disease undergoing iliofemoral endarterectomy. The aim of this study was to examine the association between iliofemoral atherosclerotic plaque characteristics and secondary CVE in patients undergoing iliofemoral endarterectomy. Methods: There were 497 patients with iliofemoral atherosclerotic disease who underwent primary endarterectomy of the iliac or femoral artery from 2002 to 2013 included. All specimen were uptaken in the Athero Express biobank and 7 histologic plaque characteristics were analyzed: calcification, collagen, fat content, IPH, macrophages, smooth muscle cells, and vessel density. The composite CVE consisted of myocardial infarction, cerebrovascular accident, peripheral (re-)interventions, and cardiovascular death. Multivariate Cox regression models were used to examine the association between plaque and the composite end point during a follow-up period of 3 years. Results: Of the 497 patients, 225 (46.4%) experienced a composite CVE within 3 years after the initial surgery. Calcified plaques were univariably associated with composite CVE (hazard ratio [HR], 1.32; 95% confidence interval [CI], 1.00-1.73; P =.049). After correction for confounders, multivariable analyses showed no association between calcified plaques and composite CVE (HR, 1.13; 95% CI, 0.85-1.50; P =.413). IPH was not predictive of secondary CVE (HR, 1.02; 95% CI, 0.79-1.33; P =.867). Conclusions: In this cohort of patients with peripheral arterial disease undergoing iliofemoral endarterectomy, investigated atherosclerotic plaque characteristics were not independently associated with secondary CVE during follow-up.
Original languageEnglish
Pages (from-to)809-816.e1
JournalJournal of Vascular Surgery
Volume67
Issue number3
DOIs
Publication statusPublished - 2018
Externally publishedYes

Cite this

van Haelst, S. T. W., Haitjema, S., Derksen, W., van Koeverden, I., de Vries, J-P. P. M., Moll, F. L., ... de Borst, G. J. (2018). Atherosclerotic plaque characteristics are not associated with future cardiovascular events in patients undergoing iliofemoral endarterectomy. Journal of Vascular Surgery, 67(3), 809-816.e1. https://doi.org/10.1016/j.jvs.2017.07.112
van Haelst, Steven T. W. ; Haitjema, Saskia ; Derksen, Wouter ; van Koeverden, Ian ; de Vries, Jean-Paul P. M. ; Moll, Frans L. ; den Ruijter, Hester M. ; Pasterkamp, Gerard ; de Borst, Gert J. / Atherosclerotic plaque characteristics are not associated with future cardiovascular events in patients undergoing iliofemoral endarterectomy. In: Journal of Vascular Surgery. 2018 ; Vol. 67, No. 3. pp. 809-816.e1.
@article{b9bc7c80c9b545d4966d31cf473507c7,
title = "Atherosclerotic plaque characteristics are not associated with future cardiovascular events in patients undergoing iliofemoral endarterectomy",
abstract = "Background: Plaque characteristics such as intraplaque hemorrhage (IPH) have been associated with secondary cardiovascular events (CVE) in patients undergoing carotid endarterectomy. In addition, carotid plaques containing macrophage infiltration or a large lipid core size were associated with less restenosis. It is currently unknown whether iliofemoral plaque histopathologic characteristics are predictive for secondary CVE in patients with peripheral arterial disease undergoing iliofemoral endarterectomy. The aim of this study was to examine the association between iliofemoral atherosclerotic plaque characteristics and secondary CVE in patients undergoing iliofemoral endarterectomy. Methods: There were 497 patients with iliofemoral atherosclerotic disease who underwent primary endarterectomy of the iliac or femoral artery from 2002 to 2013 included. All specimen were uptaken in the Athero Express biobank and 7 histologic plaque characteristics were analyzed: calcification, collagen, fat content, IPH, macrophages, smooth muscle cells, and vessel density. The composite CVE consisted of myocardial infarction, cerebrovascular accident, peripheral (re-)interventions, and cardiovascular death. Multivariate Cox regression models were used to examine the association between plaque and the composite end point during a follow-up period of 3 years. Results: Of the 497 patients, 225 (46.4{\%}) experienced a composite CVE within 3 years after the initial surgery. Calcified plaques were univariably associated with composite CVE (hazard ratio [HR], 1.32; 95{\%} confidence interval [CI], 1.00-1.73; P =.049). After correction for confounders, multivariable analyses showed no association between calcified plaques and composite CVE (HR, 1.13; 95{\%} CI, 0.85-1.50; P =.413). IPH was not predictive of secondary CVE (HR, 1.02; 95{\%} CI, 0.79-1.33; P =.867). Conclusions: In this cohort of patients with peripheral arterial disease undergoing iliofemoral endarterectomy, investigated atherosclerotic plaque characteristics were not independently associated with secondary CVE during follow-up.",
author = "{van Haelst}, {Steven T. W.} and Saskia Haitjema and Wouter Derksen and {van Koeverden}, Ian and {de Vries}, {Jean-Paul P. M.} and Moll, {Frans L.} and {den Ruijter}, {Hester M.} and Gerard Pasterkamp and {de Borst}, {Gert J.}",
year = "2018",
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van Haelst, STW, Haitjema, S, Derksen, W, van Koeverden, I, de Vries, J-PPM, Moll, FL, den Ruijter, HM, Pasterkamp, G & de Borst, GJ 2018, 'Atherosclerotic plaque characteristics are not associated with future cardiovascular events in patients undergoing iliofemoral endarterectomy' Journal of Vascular Surgery, vol. 67, no. 3, pp. 809-816.e1. https://doi.org/10.1016/j.jvs.2017.07.112

Atherosclerotic plaque characteristics are not associated with future cardiovascular events in patients undergoing iliofemoral endarterectomy. / van Haelst, Steven T. W.; Haitjema, Saskia; Derksen, Wouter; van Koeverden, Ian; de Vries, Jean-Paul P. M.; Moll, Frans L.; den Ruijter, Hester M.; Pasterkamp, Gerard; de Borst, Gert J.

In: Journal of Vascular Surgery, Vol. 67, No. 3, 2018, p. 809-816.e1.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Atherosclerotic plaque characteristics are not associated with future cardiovascular events in patients undergoing iliofemoral endarterectomy

AU - van Haelst, Steven T. W.

AU - Haitjema, Saskia

AU - Derksen, Wouter

AU - van Koeverden, Ian

AU - de Vries, Jean-Paul P. M.

AU - Moll, Frans L.

AU - den Ruijter, Hester M.

AU - Pasterkamp, Gerard

AU - de Borst, Gert J.

PY - 2018

Y1 - 2018

N2 - Background: Plaque characteristics such as intraplaque hemorrhage (IPH) have been associated with secondary cardiovascular events (CVE) in patients undergoing carotid endarterectomy. In addition, carotid plaques containing macrophage infiltration or a large lipid core size were associated with less restenosis. It is currently unknown whether iliofemoral plaque histopathologic characteristics are predictive for secondary CVE in patients with peripheral arterial disease undergoing iliofemoral endarterectomy. The aim of this study was to examine the association between iliofemoral atherosclerotic plaque characteristics and secondary CVE in patients undergoing iliofemoral endarterectomy. Methods: There were 497 patients with iliofemoral atherosclerotic disease who underwent primary endarterectomy of the iliac or femoral artery from 2002 to 2013 included. All specimen were uptaken in the Athero Express biobank and 7 histologic plaque characteristics were analyzed: calcification, collagen, fat content, IPH, macrophages, smooth muscle cells, and vessel density. The composite CVE consisted of myocardial infarction, cerebrovascular accident, peripheral (re-)interventions, and cardiovascular death. Multivariate Cox regression models were used to examine the association between plaque and the composite end point during a follow-up period of 3 years. Results: Of the 497 patients, 225 (46.4%) experienced a composite CVE within 3 years after the initial surgery. Calcified plaques were univariably associated with composite CVE (hazard ratio [HR], 1.32; 95% confidence interval [CI], 1.00-1.73; P =.049). After correction for confounders, multivariable analyses showed no association between calcified plaques and composite CVE (HR, 1.13; 95% CI, 0.85-1.50; P =.413). IPH was not predictive of secondary CVE (HR, 1.02; 95% CI, 0.79-1.33; P =.867). Conclusions: In this cohort of patients with peripheral arterial disease undergoing iliofemoral endarterectomy, investigated atherosclerotic plaque characteristics were not independently associated with secondary CVE during follow-up.

AB - Background: Plaque characteristics such as intraplaque hemorrhage (IPH) have been associated with secondary cardiovascular events (CVE) in patients undergoing carotid endarterectomy. In addition, carotid plaques containing macrophage infiltration or a large lipid core size were associated with less restenosis. It is currently unknown whether iliofemoral plaque histopathologic characteristics are predictive for secondary CVE in patients with peripheral arterial disease undergoing iliofemoral endarterectomy. The aim of this study was to examine the association between iliofemoral atherosclerotic plaque characteristics and secondary CVE in patients undergoing iliofemoral endarterectomy. Methods: There were 497 patients with iliofemoral atherosclerotic disease who underwent primary endarterectomy of the iliac or femoral artery from 2002 to 2013 included. All specimen were uptaken in the Athero Express biobank and 7 histologic plaque characteristics were analyzed: calcification, collagen, fat content, IPH, macrophages, smooth muscle cells, and vessel density. The composite CVE consisted of myocardial infarction, cerebrovascular accident, peripheral (re-)interventions, and cardiovascular death. Multivariate Cox regression models were used to examine the association between plaque and the composite end point during a follow-up period of 3 years. Results: Of the 497 patients, 225 (46.4%) experienced a composite CVE within 3 years after the initial surgery. Calcified plaques were univariably associated with composite CVE (hazard ratio [HR], 1.32; 95% confidence interval [CI], 1.00-1.73; P =.049). After correction for confounders, multivariable analyses showed no association between calcified plaques and composite CVE (HR, 1.13; 95% CI, 0.85-1.50; P =.413). IPH was not predictive of secondary CVE (HR, 1.02; 95% CI, 0.79-1.33; P =.867). Conclusions: In this cohort of patients with peripheral arterial disease undergoing iliofemoral endarterectomy, investigated atherosclerotic plaque characteristics were not independently associated with secondary CVE during follow-up.

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UR - https://www.ncbi.nlm.nih.gov/pubmed/29017805

U2 - 10.1016/j.jvs.2017.07.112

DO - 10.1016/j.jvs.2017.07.112

M3 - Article

VL - 67

SP - 809-816.e1

JO - Journal of Vascular Surgery

JF - Journal of Vascular Surgery

SN - 0741-5214

IS - 3

ER -