Tamar S Polonsky1, Kiang Liu2, Lu Tian3, James Carr4, Timothy J Carroll5, Jarett Berry6, Michael H Criqui7, Luigi Ferrucci8, Jack M Guralnik9, Melina R Kibbe10, Christopher M Kramer11, Feiyu Li12, Dongxiang Xu13, Xihao Zhao14, Chun Yuan15, Mary M McDermott16. 1. Department of Medicine, University of Chicago, Chicago, IL, USA. Electronic address: tpolonsky@medicine.bsd.uchicago.edu. 2. Department of Preventive Medicine, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA. Electronic address: kiangliu@northwestern.edu. 3. Department of Health Research and Policy, Stanford University School of Medicine, Palo Alto, CA, USA. Electronic address: lutian@stanford.edu. 4. Department of Biomedical Engineering and Radiology, Northwestern University, Chicago, IL, USA. Electronic address: jcarr@northwestern.edu. 5. Department of Biomedical Engineering and Radiology, Northwestern University, Chicago, IL, USA. Electronic address: t-carroll@northwestern.edu. 6. Department of Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA. Electronic address: Jarett.Berry@UTSouthwestern.edu. 7. Department of Family and Preventive Medicine, University of California at San Diego, San Diego, CA, USA. Electronic address: mcriqui@ucsd.edu. 8. Laboratory of Clinical Epidemiology, National Institute on Aging, Bethesda, MD, USA. Electronic address: FerrucciLu@grc.nia.nih.gov. 9. Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, USA. Electronic address: JGuralnik@epi.umaryland.edu. 10. Division of Vascular Surgery, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA. Electronic address: mkibbe@nmh.org. 11. Department of Radiology and Medicine, University of Virginia Health System, Charlottesville, VA, USA. Electronic address: ckramer@virginia.edu. 12. Department of Radiology, University of Washington, Seattle, WA, USA. Electronic address: redwindowlfy@yahoo.com.cn. 13. Department of Radiology, University of Washington, Seattle, WA, USA. Electronic address: xdx@uw.edu. 14. Department of Radiology, University of Washington, Seattle, WA, USA. Electronic address: xihao.zhao@gmail.com. 15. Department of Radiology, University of Washington, Seattle, WA, USA. Electronic address: cyuan@u.washington.edu. 16. Department of Preventive Medicine, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA; Department of Medicine, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA. Electronic address: mdm608@northwestern.edu.
Abstract
OBJECTIVE: We used magnetic resonance imaging (MRI) to study the prevalence and associated clinical characteristics of high-risk plaque (defined as presence of lipid-rich necrotic core [LRNC] and intraplaque hemorrhage) in the superficial femoral arteries (SFA) among people with peripheral artery disease (PAD). BACKGROUND: The prevalence and clinical characteristics associated with high-risk plaque in the SFA are unknown. METHODS: Three-hundred-three participants with PAD underwent MRI of the proximal SFA using a 1.5 T S platform. Twelve contiguous 2.5 mm cross-sectional images were obtained. RESULTS: LRNC was present in 68 (22.4%) participants. Only one had intra-plaque hemorrhage. After adjusting for age and sex, smoking prevalence was higher among adults with LRNC than among those without LRNC (35.9% vs. 21.4%, p = 0.02). Among participants with vs. without LRNC there were no differences in mean percent lumen area (31% vs. 33%, p = 0.42), normalized mean wall area (0.71 vs. 0.70, p = 0.67) or maximum wall area (0.96 vs. 0.92, p = 0.54) in the SFA. Among participants with LRNC, cross-sectional images containing LRNC had a smaller percent lumen area (33% ± 1% vs. 39% ± 1%, p < 0.001), greater normalized mean wall thickness (0.25 ± 0.01 vs. 0.22 ± 0.01, p < 0.001), and greater normalized maximum wall thickness (0.41 ± 0.01 vs. 0.31 ± 0.01, p < 0.001), compared to cross-sectional images without LRNC. CONCLUSIONS: Fewer than 25% of adults with PAD had high-risk plaque in the proximal SFA using MRI. Smoking was the only clinical characteristic associated with presence of LRNC. Further study is needed to determine the prognostic significance of LRNC in the SFA. CLINICAL TRIAL REGISTRATION-URL: http://www.clinicaltrials.gov. Unique identifier: NCT00520312.
OBJECTIVE: We used magnetic resonance imaging (MRI) to study the prevalence and associated clinical characteristics of high-risk plaque (defined as presence of lipid-rich necrotic core [LRNC] and intraplaque hemorrhage) in the superficial femoral arteries (SFA) among people with peripheral artery disease (PAD). BACKGROUND: The prevalence and clinical characteristics associated with high-risk plaque in the SFA are unknown. METHODS: Three-hundred-three participants with PAD underwent MRI of the proximal SFA using a 1.5 T S platform. Twelve contiguous 2.5 mm cross-sectional images were obtained. RESULTS: LRNC was present in 68 (22.4%) participants. Only one had intra-plaque hemorrhage. After adjusting for age and sex, smoking prevalence was higher among adults with LRNC than among those without LRNC (35.9% vs. 21.4%, p = 0.02). Among participants with vs. without LRNC there were no differences in mean percent lumen area (31% vs. 33%, p = 0.42), normalized mean wall area (0.71 vs. 0.70, p = 0.67) or maximum wall area (0.96 vs. 0.92, p = 0.54) in the SFA. Among participants with LRNC, cross-sectional images containing LRNC had a smaller percent lumen area (33% ± 1% vs. 39% ± 1%, p < 0.001), greater normalized mean wall thickness (0.25 ± 0.01 vs. 0.22 ± 0.01, p < 0.001), and greater normalized maximum wall thickness (0.41 ± 0.01 vs. 0.31 ± 0.01, p < 0.001), compared to cross-sectional images without LRNC. CONCLUSIONS: Fewer than 25% of adults with PAD had high-risk plaque in the proximal SFA using MRI. Smoking was the only clinical characteristic associated with presence of LRNC. Further study is needed to determine the prognostic significance of LRNC in the SFA. CLINICAL TRIAL REGISTRATION-URL: http://www.clinicaltrials.gov. Unique identifier: NCT00520312.
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