Key result
Unstable carotid plaques were associated with significantly lower calcium content, higher spectral curve slopes, and elevated serum Hs-CRP and MCP-1 levels compared to stable plaques.
Why the study?
Vulnerable carotid plaque rupture is an important cause of stroke, but few studies have investigated gemstone spectral imaging (GSI) for assessing vulnerable carotid plaque.
Do Gemstone Spectral Imaging parameters (calcium content, spectral curve slope) and serum biomarkers (Hs-CRP, MCP-1) accurately differentiate vulnerable from stable carotid plaques in patients with asymptomatic carotid atherosclerosis?
Observational (n=61)
No
Do Gemstone Spectral Imaging parameters (calcium content, spectral curve slope) and serum biomarkers (Hs-CRP, MCP-1) accurately differentiate vulnerable from stable carotid plaques in patients with asymptomatic carotid atherosclerosis?
Absolute Event Rate: 47.53% vs 147.85%
p-value: p=<0.001
Gemstone spectral imaging parameters (calcium content and spectral curve slope) and serum biomarkers (Hs-CRP and MCP-1) can accurately differentiate vulnerable from stable carotid plaques, offering potential non-invasive biomarkers for stroke risk assessment.
May aid noninvasive identification of unstable plaques; hypothesis-generating and requires prospective validation before practice change.
Growing evidence indicates that vulnerable carotid plaque rupture is an important cause of stroke. However, fewer studies have been conducted to investigate the role of a novel gemstone spectral imaging (GSI) in assessment of vulnerable carotid plaque. In this study, we analyzed GSI data including calcium content of carotid atherosclerotic plaque and spectral curve slope, as well as serum high-sensitivity C-reactive protein (Hs-CRP), monocyte chemotactic protein-1 (MCP-1) levels in patients with carotid atherosclerotic plaque using the GSI-computed tomographic angiography (CTA) and immunoturbidimetry. The patients with unstable plaques demonstrated a significantly lower calcium content and higher spectral curve slope than the stable plaques group. In addition, the patients with unstable plaque showed an increase in Hs-CRP levels and MCP-1 levels compared with the stable plaque and normal controls (NC) group. The alternation in GSI calcium content and spectral curve slope reflects a close link between calcification and plaque instability, while derangement of Hs-CRP and MCP-1 is involved in the formation or development of vulnerable plaques. Taken together, our results strongly support the feasibility of using these serological and newly discovered imaging parameters as multiple potential biomarkers relevant to plaque vulnerability or stroke progression.
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Fan et al. (2021) conducted an observational in Asymptomatic carotid atherosclerosis (n=61). Unstable carotid plaque vs. Stable carotid plaque was evaluated on Calcium content in carotid atherosclerotic plaque (g/L) (p=<0.001). Unstable carotid plaques were associated with significantly lower calcium content, higher spectral curve slopes, and elevated serum Hs-CRP and MCP-1 levels compared to stable plaques.
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