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Comparative Study
. 2021 May 6;20(1):98.
doi: 10.1186/s12933-021-01277-8.

The risk of carotid plaque instability in patients with metabolic syndrome is higher in women with hypertriglyceridemia

Francesca Servadei #  1 , Lucia Anemona #  1 , Marina Cardellini #  2 , Manuel Scimeca  1   3   4 , Manuela Montanaro  1 , Valentina Rovella  5 , Francesca Di Daniele  6 , Erica Giacobbi  1 , Iacopo Maria Legramante  2 , Annalisa Noce  2 , Rita Bonfiglio  1   7 , Patrizia Borboni  2 , Nicola Di Daniele  2 , Arnaldo Ippoliti  8 , Massimo Federici  2 , Alessandro Mauriello  9   10
Affiliations
Comparative Study

The risk of carotid plaque instability in patients with metabolic syndrome is higher in women with hypertriglyceridemia

Francesca Servadei et al. Cardiovasc Diabetol. .

Abstract

Background: Metabolic syndrome certainly favors growth of carotid plaque; however, it is uncertain if it determines plaque destabilization. Furthermore, it is likely that only some components of metabolic syndrome are associated with increased risk of plaque destabilization. Therefore, we evaluated the effect of different elements of metabolic syndrome, individually and in association, on carotid plaques destabilization.

Methods: A total of 186 carotid endarterectomies from symptomatic and asymptomatic patients were histologically analysed and correlated with major cardiovascular risk factors.

Results: Metabolic syndrome, regardless of the cluster of its components, is not associated with a significant increase in risk of plaque destabilization, rather with the presence of stable plaques. The incidence of unstable plaques in patients with metabolic syndrome is quite low (43.9 %), when compared with that seen in the presence of some risk factors, but significantly increases in the subgroup of female patients with hypertriglyceridemia, showing an odds ratio of 3.01 (95% CI, 0.25-36.30).

Conclusions: Our data may help to identify patients with real increased risk of acute cerebrovascular diseases thus supporting the hypothesis that the control of hypertriglyceridemia should be a key point on prevention of carotid atherosclerotic plaque destabilization, especially in post-menopausal female patients.

Keywords: Carotid; Histology; Hypertriglyceridemia; Metabolic syndrome; Post‐menopause.

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Conflict of interest statement

The authors declare that they have no competing interests. The study is original, and the manuscript has not been published yet and is not being considered for publication.

Figures

Fig. 1
Fig. 1
Histology of carotid plaques. a, b Stable plaque characterized by a thick fibrous cap and a large lipidic necrotic core with few inflammatory cells (Movat, 2x); c, d Unstable plaque constituted by a thrombotic plaque associated to the cap rupture (Movat, 2x). *Cap: fibrous cap; Ath: lipidic necrotic core; Thr: acute thrombus; Rup: site of cap rupture
See this image and copyright information in PMC

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