IDEAS home Printed from https://ideas.repec.org/a/gam/jijerp/v19y2022i21p13934-d954203.html
   My bibliography  Save this article

Carotid Plaque Features and Inflammatory Biomarkers as Predictors of Restenosis and Mortality Following Carotid Endarterectomy

Author

Listed:
  • Raluca Niculescu

    (Doctoral School of Medicine and Pharmacy, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology of Targu Mures, 540142 Targu Mures, Romania
    Department of Pathology, Mures Clinical County Hospital, 540011 Targu Mures, Romania
    These authors contributed equally to this work.)

  • Eliza Russu

    (Clinic of Vascular Surgery, Mures County Emergency Hospital, 540136 Targu Mures, Romania
    Department of Surgery, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Targu Mures, 540139, Targu Mures, Romania
    These authors contributed equally to this work.)

  • Emil Marian Arbănași

    (Doctoral School of Medicine and Pharmacy, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology of Targu Mures, 540142 Targu Mures, Romania
    Clinic of Vascular Surgery, Mures County Emergency Hospital, 540136 Targu Mures, Romania)

  • Réka Kaller

    (Doctoral School of Medicine and Pharmacy, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology of Targu Mures, 540142 Targu Mures, Romania
    Clinic of Vascular Surgery, Mures County Emergency Hospital, 540136 Targu Mures, Romania)

  • Eliza Mihaela Arbănași

    (Faculty of Pharmacy, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Targu Mures, 540139 Targu Mures, Romania)

  • Răzvan Marian Melinte

    (Department of Orthopedics, Regina Maria Health Network, 540098 Targu Mures, Romania
    Department of Orthopedics, Humanitas MedLife Hospital, 400664 Cluj Napoca, Romania)

  • Cătălin Mircea Coșarcă

    (Clinic of Vascular Surgery, Mures County Emergency Hospital, 540136 Targu Mures, Romania)

  • Iuliu Gabriel Cocuz

    (Doctoral School of Medicine and Pharmacy, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology of Targu Mures, 540142 Targu Mures, Romania
    Department of Pathology, Mures Clinical County Hospital, 540011 Targu Mures, Romania)

  • Adrian Horațiu Sabău

    (Doctoral School of Medicine and Pharmacy, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology of Targu Mures, 540142 Targu Mures, Romania
    Department of Pathology, Mures Clinical County Hospital, 540011 Targu Mures, Romania)

  • Andreea Cătălina Tinca

    (Doctoral School of Medicine and Pharmacy, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology of Targu Mures, 540142 Targu Mures, Romania
    Department of Pathology, Mures Clinical County Hospital, 540011 Targu Mures, Romania)

  • Adina Stoian

    (Department of Pathophysiology, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Targu Mures, 540139 Targu Mures, Romania)

  • Vlad Vunvulea

    (Department of Radiology, Mures County Emergency Hospital, 540136 Targu Mures, Romania)

  • Adrian Vasile Mureșan

    (Clinic of Vascular Surgery, Mures County Emergency Hospital, 540136 Targu Mures, Romania
    Department of Surgery, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Targu Mures, 540139, Targu Mures, Romania
    These authors contributed equally to this work.)

  • Ovidiu Simion Cotoi

    (Department of Pathology, Mures Clinical County Hospital, 540011 Targu Mures, Romania
    Department of Pathophysiology, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Targu Mures, 540139 Targu Mures, Romania
    These authors contributed equally to this work.)

Abstract

Background: Carotid endarterectomy (CEA) is the first-line surgical intervention for cases of severe carotid stenoses. Unfortunately, the restenosis rate is high after CEA. This study aims to demonstrate the predictive role of carotid plaque features and inflammatory biomarkers (monocyte-to-lymphocyte ratio (MLR), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic inflammatory index (SII), Systemic Inflammation Response Index (SIRI), and Aggregate Index of Systemic Inflammation (AISI)) in carotid restenosis and mortality at 12 months following CEA. Methods: The present study was designed as an observational, analytical, retrospective cohort study and included all patients over 18 years of age with a minimum of 70% carotid stenosis and surgical indications for CEA admitted to the Vascular Surgery Clinic, Emergency County Hospital of Targu Mures, Romania between 2018 and 2021. Results: According to our results, the high pre-operative values of inflammatory biomarkers—MLR (OR: 10.37 and OR: 6.11; p < 0.001), NLR (OR: 34.22 and OR: 37.62; p < 0.001), PLR (OR: 12.02 and OR: 16.06; p < 0.001), SII (OR: 18.11 and OR: 31.70; p < 0.001), SIRI (OR: 16.64 and OR: 9.89; p < 0.001), and AISI (OR: 16.80 and OR: 8.24; p < 0.001)—are strong independent factors predicting the risk of 12-month restenosis and mortality following CEA. Moreover, unstable plaque (OR: 2.83, p < 0.001 and OR: 2.40, p = 0.04) and MI (OR: 3.16, p < 0.001 and OR: 2.83, p = 0.005) were independent predictors of all outcomes. Furthermore, AH (OR: 2.30; p = 0.006), AF (OR: 1.74; p = 0.02), tobacco (OR: 2.25; p < 0.001), obesity (OR: 1.90; p = 0.02), and thrombotic plaques (OR: 2.77; p < 0.001) were all independent predictors of restenosis, but not for mortality in all patients. In contrast, antiplatelet (OR: 0.46; p = 0.004), statin (OR: 0.59; p = 0.04), and ezetimibe (OR:0.45; p = 0.03) therapy were protective factors against restenosis, but not for mortality. Conclusions: Our data revealed that higher preoperative inflammatory biomarker values highly predict 12-month restenosis and mortality following CEA. Furthermore, age above 70, unstable plaque, cardiovascular disease, and dyslipidemia were risk factors for all outcomes. Additionally, AH, AF, smoking, and obesity were all independent predictors of restenosis but not of mortality in all patients. Antiplatelet and statin medication, on the other hand, were protective against restenosis but not against mortality.

Suggested Citation

  • Raluca Niculescu & Eliza Russu & Emil Marian Arbănași & Réka Kaller & Eliza Mihaela Arbănași & Răzvan Marian Melinte & Cătălin Mircea Coșarcă & Iuliu Gabriel Cocuz & Adrian Horațiu Sabău & Andreea Căt, 2022. "Carotid Plaque Features and Inflammatory Biomarkers as Predictors of Restenosis and Mortality Following Carotid Endarterectomy," IJERPH, MDPI, vol. 19(21), pages 1-14, October.
    • Handle: RePEc:gam:jijerp:v:19:y:2022:i:21:p:13934-:d:954203
    as

    Download full text from publisher

    File URL: https://www.mdpi.com/1660-4601/19/21/13934/pdf
    Download Restriction: no
    File URL: https://www.mdpi.com/1660-4601/19/21/13934/
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Peter Libby, 2002. "Inflammation in atherosclerosis," Nature, Nature, vol. 420(6917), pages 868-874, December.
    2. Nicoletta Brunelli & Claudia Altamura & Carmelina Maria Costa & Riccardo Altavilla & Paola Palazzo & Paola Maggio & Marilena Marcosano & Fabrizio Vernieri, 2022. "Carotid Artery Plaque Progression: Proposal of a New Predictive Score and Role of Carotid Intima-Media Thickness," IJERPH, MDPI, vol. 19(2), pages 1-8, January.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Eliza Russu & Adrian Vasile Mureșan & Adrian Dumitru Ivănescu & Réka Kaller & Daniela Elena Nedelea & Raluca Niculescu & Bogdan Andrei Cordoș & Ovidiu Aurelian Budișcă & Eliza Mihaela Arbănași & Emil , 2023. "Polytetrafluorethylene (PTFE) vs. Polyester (Dacron ® ) Grafts in Critical Limb Ischemia Salvage," IJERPH, MDPI, vol. 20(2), pages 1-13, January.
    2. Min-Su Kim & Min Young Heo & Hyo Jin Joo & Ga Yang Shim & Jinmann Chon & Sung Joon Chung & Yunsoo Soh & Myung Chul Yoo, 2023. "Neutrophil-to-Lymphocyte Ratio as a Predictor of Short-Term Functional Outcomes in Acute Ischemic Stroke Patients," IJERPH, MDPI, vol. 20(2), pages 1-12, January.
    3. Danka Vukašinović & Miloš Maksimović & Slobodan Tanasković & Jelena M. Marinković & Đorđe Radak & Jadranka Maksimović & Isidora Vujčić & Nebojša Prijović & Hristina Vlajinac, 2023. "Body Mass Index and Late Adverse Outcomes after a Carotid Endarterectomy," IJERPH, MDPI, vol. 20(3), pages 1-10, February.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Marit Skogstad & Asgeir Mamen & Lars-Kristian Lunde & Bente Ulvestad & Dagfinn Matre & Hans Christian D. Aass & Reidun Øvstebø & Pia Nielsen & Kari N. Samuelsen & Øivind Skare & Per Anton Sirnes, 2019. "Shift Work Including Night Work and Long Working Hours in Industrial Plants Increases the Risk of Atherosclerosis," IJERPH, MDPI, vol. 16(3), pages 1-11, February.
    2. Anne Mette Fisker Hag & Sune Folke Pedersen & Christina Christoffersen & Tina Binderup & Mette Munk Jensen & Jesper Tranekjær Jørgensen & Dorthe Skovgaard & Rasmus Sejersten Ripa & Andreas Kjaer, 2012. "18F-FDG PET Imaging of Murine Atherosclerosis: Association with Gene Expression of Key Molecular Markers," PLOS ONE, Public Library of Science, vol. 7(11), pages 1-9, November.
    3. Padayachee Trishanta & Khamiakova Tatsiana & Shkedy Ziv & Burzykowski Tomasz & Salo Perttu & Perola Markus, 2019. "A multivariate linear model for investigating the association between gene-module co-expression and a continuous covariate," Statistical Applications in Genetics and Molecular Biology, De Gruyter, vol. 18(2), pages 1-13, April.
    4. Salvatore Santo Signorelli & Elisa Marino & Salvatore Scuto, 2019. "Inflammation and Peripheral Arterial Disease," J, MDPI, vol. 2(2), pages 1-10, April.
    5. Nicoletta Brunelli & Claudia Altamura & Carlo A. Mallio & Gianguido Lo Vullo & Marilena Marcosano & Marcel Bach-Pages & Bruno Beomonte Zobel & Carlo Cosimo Quattrocchi & Fabrizio Vernieri, 2022. "Cerebral Hemodynamics, Right-to-Left Shunt and White Matter Hyperintensities in Patients with Migraine with Aura, Young Stroke Patients and Controls," IJERPH, MDPI, vol. 19(14), pages 1-10, July.
    6. Cailan Lindsay Feingold & Abbas Smiley, 2022. "Healthy Sleep Every Day Keeps the Doctor Away," IJERPH, MDPI, vol. 19(17), pages 1-35, August.
    7. Wen Kong & Xun Niu & Tianshu Zeng & Meixia Lu & Lulu Chen, 2015. "Impact of Treatment with Metformin on Adipocytokines in Patients with Polycystic Ovary Syndrome: A Meta-Analysis," PLOS ONE, Public Library of Science, vol. 10(10), pages 1-20, October.
    8. Nonanzit Pérez-Hernández & Gilberto Vargas-Alarcón & Rosalinda Posadas-Sánchez & Nancy Martínez-Rodríguez & Carlos Alfonso Tovilla-Zárate & Adrián Asael Rodríguez-Cortés & Oscar Pérez-Méndez & Ruben B, 2016. "PHACTR1 Gene Polymorphism Is Associated with Increased Risk of Developing Premature Coronary Artery Disease in Mexican Population," IJERPH, MDPI, vol. 13(8), pages 1-9, August.
    9. Quefeng Li & Sijian Wang & Chiang-Ching Huang & Menggang Yu & Jun Shao, 2014. "Meta-analysis based variable selection for gene expression data," Biometrics, The International Biometric Society, vol. 70(4), pages 872-880, December.
    10. Mouna Achoui & David Appleton & Mahmood Ameen Abdulla & Khalijah Awang & Mustafa Ali Mohd & Mohd Rais Mustafa, 2010. "In Vitro and In Vivo Anti-Inflammatory Activity of 17-O-Acetylacuminolide through the Inhibition of Cytokines, NF-κB Translocation and IKKβ Activity," PLOS ONE, Public Library of Science, vol. 5(12), pages 1-13, December.
    11. Ted R Miller & Geetha M Waehrer & Debora L Oh & Sukhdip Purewal Boparai & Sheila Ohlsson Walker & Sara Silverio Marques & Nadine Burke Harris, 2020. "Adult health burden and costs in California during 2013 associated with prior adverse childhood experiences," PLOS ONE, Public Library of Science, vol. 15(1), pages 1-15, January.
    12. Jinke Tan & Yafeng Wang, 2019. "Social Integration, Social Support, and All-Cause, Cardiovascular Disease and Cause-Specific Mortality: A Prospective Cohort Study," IJERPH, MDPI, vol. 16(9), pages 1-11, April.
    13. Satoko Hayakawa & Koji Ohashi & Rei Shibata & Ryotaro Takahashi & Naoya Otaka & Hayato Ogawa & Masanori Ito & Noriyoshi Kanemura & Mizuho Hiramatsu-Ito & Nobuo Ikeda & Toyoaki Murohara & Noriyuki Ouch, 2016. "Association of Circulating Follistatin-Like 1 Levels with Inflammatory and Oxidative Stress Markers in Healthy Men," PLOS ONE, Public Library of Science, vol. 11(5), pages 1-8, May.
    14. Murasko, Jason E., 2008. "Male-female differences in the association between socioeconomic status and atherosclerotic risk in adolescents," Social Science & Medicine, Elsevier, vol. 67(11), pages 1889-1897, December.
    15. Jonas Helgertz & Tommy Bengtsson, 2019. "The Long-Lasting Influenza: The Impact of Fetal Stress During the 1918 Influenza Pandemic on Socioeconomic Attainment and Health in Sweden, 1968–2012," Demography, Springer;Population Association of America (PAA), vol. 56(4), pages 1389-1425, August.
    16. Lars-Kristian Lunde & Øivind Skare & Asgeir Mamen & Per Anton Sirnes & Hans C. D. Aass & Reidun Øvstebø & Elisabeth Goffeng & Dagfinn Matre & Pia Nielsen & Hanne Siri Amdahl Heglum & Stine Eriksen Ham, 2020. "Cardiovascular Health Effects of Shift Work with Long Working Hours and Night Shifts: Study Protocol for a Three-Year Prospective Follow-Up Study on Industrial Workers," IJERPH, MDPI, vol. 17(2), pages 1-16, January.
    17. Liang Zhou & Jianguang Cai & Gang Liu & Yuan Wei & Hui Tang, 2012. "Associations between Interleukin-1 Gene Polymorphisms and Coronary Heart Disease Risk: A Meta-Analysis," PLOS ONE, Public Library of Science, vol. 7(9), pages 1-10, September.
    18. Elżbieta Dembowska & Aleksandra Jaroń & Ewa Gabrysz-Trybek & Joanna Bladowska & Grzegorz Trybek, 2022. "Evaluation of Common Factors of Periodontitis and Cardiovascular Disease in Patients with the Acute Coronary Syndrome," IJERPH, MDPI, vol. 19(13), pages 1-14, July.
    19. Yun Hwan Kim & Min Ki Jeong & Hyuntae Park & Sang Kab Park, 2021. "Effects of Regular Taekwondo Intervention on Health-Related Physical Fitness, Cardiovascular Disease Risk Factors and Epicardial Adipose Tissue in Elderly Women with Hypertension," IJERPH, MDPI, vol. 18(6), pages 1-14, March.
    20. Mengying Wang & Siyue Wang & Xiaowen Wang & Junhui Wu & Yao Wu & Zijing Wang & Jiating Wang & Tao Wu & Yonghua Hu, 2020. "Carotid Intima-Media Thickness, Genetic Risk, and Ischemic Stroke: A Family-Based Study in Rural China," IJERPH, MDPI, vol. 18(1), pages 1-11, December.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:gam:jijerp:v:19:y:2022:i:21:p:13934-:d:954203. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: MDPI Indexing Manager (email available below). General contact details of provider: https://www.mdpi.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.