Abstract
Introduction
Carotid plaque intraplaque hemorrhage (IPH) is associated with future cardiovascular events. For this, we hypothesized that plasma proteins associated with carotid plaque IPH are also likely to be associated with Major Adverse Cardiovascular Events (MACE) after carotid endarterectomy (CEA).
Methods
In pre-operative blood samples from patients undergoing CEA within the Athero-Express biobank, we measured proteins involved in cardiovascular disease using three OLINK® proteomics immunoassays. We analyzed the association of proteins with IPH using logistic regression analyses. Subsequently, we analyzed the association of the IPH associated plasma proteins with the three-year postoperative risk of MACE (including stroke, myocardial infarction or cardiovascular death).
Results
Within the three-year follow-up, 130 patients (18,9%) out of 688 symptomatic and asymptomatic patients undergoing CEA developed MACE. We found that six out of 276 plasma proteins were significantly associated with IPH, from which only Lipoprotein Lipase (LPL) was associated with the postoperative risk of MACE undergoing CEA. Within the 30-day perioperative period high plasma LPL was independently associated with an increased risk for MACE (adjusted HR per SD:1.60(1.10-2.30), p=0.014). From 30-days up and till 3-years, however, high LPL was associated with a lower risk for MACE (adjusted HR per SD:0.80(0.65-0.99), p=0.036).
Conclusion
High LPL concentrations, were found to be associated with a higher risk for MACE in the first 30 postoperative days but associated with a lower risk MACE in the time period from 30 days up and till 3 years, meaning that LPL has different hazards at different time points.
Athero-Express Biobank Study
The AE started in 2002 and now includes over 3,500 patients who underwent surgery to remove atherosclerotic plaques (endarterectomy) from one (or more) of their major arteries (majority carotids and femorals); this is further described here. The study design and staining protocols are described by Verhoeven et al..
A link to the public GitHub repository can be found here: https://github.com/CirculatoryHealth/EntropyMasker.
Important notice on availability of data
The data are sensitive since they involve personal information of patients. There are also restrictions on use by commercial parties, and on sharing openly based on (inter)national laws and regulations and the written informed consent. Therefore these data (and additional clinical data) are only available upon discussion and signing a Data Sharing Agreement (see Terms of Access) and within a specially designed UMC Utrecht provided environment.
