Summary
Echolucent carotid plaques are associated with high risk for future ischemic cerebrovascular
events independent of the degree of stenosis. Elevated levels of markers of systemic
inflammation and endothelial dysfunction are predictors for future myocardial infarction
and stroke.The present study was undertaken to investigate the relations between plaque
morphology, endothelial dysfunction assessed by tissue-plasminogen activator antigen
(t-PA ag) and von Willebrand factor (vWF), and systemic inflammation in persons with
carotid stenosis.We conducteda crosssectional study including 133 persons with carotid
stenosis and 138 controls without stenosis recruited from the populationbased Tromsø
Study. High-resolution B-mode and colour Doppler/pulsed-wave Doppler ultrasonography
of both carotid arteries was performed, and plaque morphology in terms of echogenicity
was assessed. Persons with carotid stenosis had significantly higher plasma t-PA and
vWF concentrations than controls. There was a significant inverse relationship between
t-PA ag and plaque echogenicity (p=0.034).The increased plasma t-PA ag in persons
with carotid stenosis was not associated with increased plasminogen activator inhibitor-I
(PAI-1).Persons with echolucent carotid plaques had higher degree of systemic inflammation,
and plasma t-PA and vWF concentration increased significantly across quartiles of
WBC, fibrinogen, and hs-CRP. Our findings may suggest that plasma t-PA may be superior
to vWF asa marker for endothelial dysfunction due to its ability to discriminate between
various plaque echogenicity, and that the predictive role of t-PA ag in cardiovascular
disease is independent of inhibited fibrinolysis.
Keywords
Atherosclerosis - ultrasound / diagnosis - von Willebrand factor - plasminogen activators
- cerebrovascular disease
