Key result
High levels of ADAMTS-7 in carotid atherosclerotic plaques were associated with a 76% increased risk of future postoperative cardiovascular events (HR 1.76) compared to low levels.
Cohort (n=201)
No
Hazard Ratio: 1.76 (95% CI 1.02–3.06)
p-value: p=0.04
ADAMTS-7 expression is associated with a vulnerable plaque phenotype and serves as an independent risk factor for future cardiovascular events in patients with symptomatic carotid atherosclerosis.
Does not support routine plaque ADAMTS-7 testing yet; leaves open its value for risk stratification and targeted therapy.
Several large-scale genome-wide association studies have identified single-nucleotide polymorphisms in the genomic region of A Disintegrin And Metalloproteinase with ThromboSpondin type 1 repeats (ADAMTS)-7 and associations to coronary artery disease. Experimental studies have provided evidence for a functional role of ADAMTS-7 in both injury-induced vascular neointima formation and development of atherosclerotic lesions. However, whether ADAMTS-7 is associated with a specific plaque phenotype in humans has not been investigated. Carotid plaques (n = 206) from patients with and without cerebrovascular symptoms were analyzed for expression of ADAMTS-7 by immunohistochemistry and correlated to components associated with plaque vulnerability. Plaques from symptomatic patients showed increased levels of ADAMTS-7 compared with lesions from asymptomatic patients. High levels of ADAMTS-7 correlated with high levels of CD68-staining and lipid content, but with low smooth muscle cell and collagen content, which together are characteristics of a vulnerable plaque phenotype. ADAMTS-7 levels above median were associated with increased risk for postoperative cardiovascular events. Our data show that ADAMTS-7 is associated with a vulnerable plaque phenotype in human carotid lesions. These data support previous observations of a potential proatherogenic role of ADAMTS-7.
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Bengtsson et al. (2017) conducted a cohort in Carotid atherosclerosis (n=201). High ADAMTS-7 levels in carotid plaques (above median) vs. Low ADAMTS-7 levels (below median) was evaluated on Postoperative cardiovascular events (acute myocardial infarction, stroke, transient ischemic attack, amaurosis fugax, or CV-death) (HR 1.76, 95% CI 1.02-3.06, p=0.04). High levels of ADAMTS-7 in carotid atherosclerotic plaques were associated with a 76% increased risk of future postoperative cardiovascular events (HR 1.76) compared to low levels.
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