Quantitative and Qualitative Characteristics of Atherosclerotic Plaques on Carotid Arteries in Patients with Antiphospholipid Syndrome: The Role of MDCT Angiography
Introduction: Antiphospholipid syndrome (APS) is an autoimmune disease characterised by arterious and venous thrombosis, miscarriage, and the presence of antiphospholipid antibodies (aPL) in the blood. As we know, APS is also characterised by accelerated atherosclerotic degeneration with an increase...
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MDPI AG
2023-09-01
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| author | Jovica Saponjski Ljudmila Stojanovich Natasa Stanisavljevic Aleksandra Djokovic Radisa Vojinovic Svetlana Kocic Simon Nikolic Predrag Matic Branka Filipovic Vuk Djulejic Vladan Colovic Nikola Bogosavljevic Dejan Aleksandric Dejan Kostic Biljana Brkic Georgijevski Miroslav Misovic Nikola Colic Dusan Saponjski |
| author_facet | Jovica Saponjski Ljudmila Stojanovich Natasa Stanisavljevic Aleksandra Djokovic Radisa Vojinovic Svetlana Kocic Simon Nikolic Predrag Matic Branka Filipovic Vuk Djulejic Vladan Colovic Nikola Bogosavljevic Dejan Aleksandric Dejan Kostic Biljana Brkic Georgijevski Miroslav Misovic Nikola Colic Dusan Saponjski |
| author_sort | Jovica Saponjski |
| collection | DOAJ |
| description | Introduction: Antiphospholipid syndrome (APS) is an autoimmune disease characterised by arterious and venous thrombosis, miscarriage, and the presence of antiphospholipid antibodies (aPL) in the blood. As we know, APS is also characterised by accelerated atherosclerotic degeneration with an increased risk of thrombosis in all blood vessels, including the carotid arteries. Carotid artery stenosis can manifest in many different ways. The aim of this study is to present the results of our multidetector computerised tomography angiography (MDCTA) analysis of the carotid arteries in patients with primary and secondary APS compared with a control group. Materials and Methods: This study examined 50 patients with primary antiphospholipid syndrome (PAPS) and 50 patients with secondary antiphospholipid syndrome (SAPS). The results were compared with a control group also comprising 50 patients. The groups were analysed with respect to age, sex and the presence of well-established risk factors for vascular disease. The study was conducted using MDCTA, where we analysed the quantitative and qualitative (morphologic) characteristics of carotid artery lesions. Results: Patients from the control group had significantly elevated levels of cholesterol and triglycerides in comparison with patients with PAPS and SAPS (<i>p</i> < 0.001 and <i>p</i> < 0.05). The results show that carotid artery lesions were significantly more common in patients with APS (PAPS, <i>n</i> = 40, CI95: 0.50–0.75, <i>p</i> = 0.0322 and SAFS, <i>n</i> = 54, CI95: 0.59–0.80, <i>p</i> = 0.0004) than within the control group (<i>n</i> = 23). There was a statistically significant difference between patients with APS and the control group with respect to lesions in the distal segments (<i>n</i> = 27, CI95: 0.67–0.95, <i>p</i> = 0.0001), bulbi and proximal segments (<i>n</i> = 21, CI95: 0.84–1.00, <i>p</i> = 0.000005). The number of patients with one lesion (L) (<i>n</i> = 27) was significantly greater than the number of those with three (<i>n</i> = 10, CI95: 0.56–0.86, <i>p</i> = 0.0051) or four (<i>n</i> = 3, CI95: 0.73–0.98, <i>p</i> = 0.00001) lesions. There were also more patients with two lesions (<i>n</i> = 24) than those with four (<i>n</i> = 3) (CI95: 0.71–0.97, <i>p</i> = 0.00005). Carotid artery stenosis was shown as a percentage of the carotid artery lumen diameter (%DS). Stenosis of up to 30%, was more common in patients in the PAPS group (<i>n</i> = 12) than in the control group (<i>n</i> = 3) (CI95: 0.52–0.96, <i>p</i> = 0.0201), while the SAPS group (<i>n</i> = 17) had an even larger disparity (CI95: 0.62–0.97, <i>p</i> = 0.0017). We observed a highly significant difference in the frequency of stenoses between 30% and 50% DS between the PAPS group (<i>n</i> = 24) and the control group (<i>n</i> = 7) (CI95: 0.59–0.90, <i>p</i> = 0.0023), as well as the SAPS group (<i>n</i> = 30) (CI95: 0.65–0.92, <i>p</i> = 0.0002). A qualitative analysis of plaque morphology revealed that patients with PAPS had significantly more soft tissue lesions (<i>n</i> = 23) compared with calcified lesions (<i>n</i> = 2) (CI95: 0.74–0.99, <i>p</i> = 0.00003), as well as more mixed plaques (<i>n</i> = 9) and calcified plaques (<i>n</i> = 2) (CI95: 0.48–0.98, <i>p</i> = 0.0348). Patients within the SAPS group had significantly more soft tissue (<i>n</i> = 35) than calcified lesions (<i>n</i> = 3) (CI95: 0.79–0.98, <i>p</i> = 0.00000021), as well as more mixed lesions (<i>n</i> = 21) compared with calcified (<i>n</i> = 3) (CI95: 0.68–0.97, <i>p</i> = 0.0002). Conclusions: Our study shows that subclinical manifestations of carotid artery lesions were more common in patients with APS. We came to the conclusion that MDCTA is an accurate diagnostic method because it is a safe method that provides us with a great quantity of accurate information about the characteristics of atheromatous plaques, which aids us in the further planning of treatment for patients with APS. |
| first_indexed | 2024-03-08T20:51:07Z |
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| institution | Directory Open Access Journal |
| issn | 2079-9721 |
| language | English |
| last_indexed | 2024-03-08T20:51:07Z |
| publishDate | 2023-09-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diseases |
| spelling | doaj.art-d2c464ea9a5842278e1e998f0cfe9edf2023-12-22T14:03:29ZengMDPI AGDiseases2079-97212023-09-0111413110.3390/diseases11040131Quantitative and Qualitative Characteristics of Atherosclerotic Plaques on Carotid Arteries in Patients with Antiphospholipid Syndrome: The Role of MDCT AngiographyJovica Saponjski0Ljudmila Stojanovich1Natasa Stanisavljevic2Aleksandra Djokovic3Radisa Vojinovic4Svetlana Kocic5Simon Nikolic6Predrag Matic7Branka Filipovic8Vuk Djulejic9Vladan Colovic10Nikola Bogosavljevic11Dejan Aleksandric12Dejan Kostic13Biljana Brkic Georgijevski14Miroslav Misovic15Nikola Colic16Dusan Saponjski17Faculty of Medicine, University of Belgrade, 11000 Belgrade, SerbiaUniversity Clinical Center of Serbia, 11000 Belgrade, SerbiaUniversity Hospital Medical Center “Bezanijska Kosa”, 11080 Belgrade, SerbiaUniversity Clinical Center of Serbia, 11000 Belgrade, SerbiaFaculty of Medical Science, University of Kragujevac, 34000 Kragujevac, SerbiaClinical Hospital Center Zemun, 11080 Belgrade, SerbiaFaculty of Medicine, University of Kosovksa Mitrovica, 11000 Belgrade, SerbiaInstitute for Cardiovascular Diseases “Dedinje”, 111040 Belgrade, SerbiaUniversity Hospital “Dragisa Misovic”, 11000 Belgrade, SerbiaFaculty of Medicine, University of Belgrade, 11000 Belgrade, SerbiaUniversity Clinical Center of Serbia, 11000 Belgrade, SerbiaFaculty of Medicine, University of Belgrade, 11000 Belgrade, SerbiaInstitute for Orthopedic Diseases “Banjica”, 11000 Belgrade, SerbiaMilitary Medical Academy, 11040 Belgrade, SerbiaSpecial Hospital for Cerebrovascular Diseases “Saint Sava”, 11000 Belgrade, SerbiaMilitary Medical Academy, 11040 Belgrade, SerbiaUniversity Clinical Center of Serbia, 11000 Belgrade, SerbiaFaculty of Medicine, University of Belgrade, 11000 Belgrade, SerbiaIntroduction: Antiphospholipid syndrome (APS) is an autoimmune disease characterised by arterious and venous thrombosis, miscarriage, and the presence of antiphospholipid antibodies (aPL) in the blood. As we know, APS is also characterised by accelerated atherosclerotic degeneration with an increased risk of thrombosis in all blood vessels, including the carotid arteries. Carotid artery stenosis can manifest in many different ways. The aim of this study is to present the results of our multidetector computerised tomography angiography (MDCTA) analysis of the carotid arteries in patients with primary and secondary APS compared with a control group. Materials and Methods: This study examined 50 patients with primary antiphospholipid syndrome (PAPS) and 50 patients with secondary antiphospholipid syndrome (SAPS). The results were compared with a control group also comprising 50 patients. The groups were analysed with respect to age, sex and the presence of well-established risk factors for vascular disease. The study was conducted using MDCTA, where we analysed the quantitative and qualitative (morphologic) characteristics of carotid artery lesions. Results: Patients from the control group had significantly elevated levels of cholesterol and triglycerides in comparison with patients with PAPS and SAPS (<i>p</i> < 0.001 and <i>p</i> < 0.05). The results show that carotid artery lesions were significantly more common in patients with APS (PAPS, <i>n</i> = 40, CI95: 0.50–0.75, <i>p</i> = 0.0322 and SAFS, <i>n</i> = 54, CI95: 0.59–0.80, <i>p</i> = 0.0004) than within the control group (<i>n</i> = 23). There was a statistically significant difference between patients with APS and the control group with respect to lesions in the distal segments (<i>n</i> = 27, CI95: 0.67–0.95, <i>p</i> = 0.0001), bulbi and proximal segments (<i>n</i> = 21, CI95: 0.84–1.00, <i>p</i> = 0.000005). The number of patients with one lesion (L) (<i>n</i> = 27) was significantly greater than the number of those with three (<i>n</i> = 10, CI95: 0.56–0.86, <i>p</i> = 0.0051) or four (<i>n</i> = 3, CI95: 0.73–0.98, <i>p</i> = 0.00001) lesions. There were also more patients with two lesions (<i>n</i> = 24) than those with four (<i>n</i> = 3) (CI95: 0.71–0.97, <i>p</i> = 0.00005). Carotid artery stenosis was shown as a percentage of the carotid artery lumen diameter (%DS). Stenosis of up to 30%, was more common in patients in the PAPS group (<i>n</i> = 12) than in the control group (<i>n</i> = 3) (CI95: 0.52–0.96, <i>p</i> = 0.0201), while the SAPS group (<i>n</i> = 17) had an even larger disparity (CI95: 0.62–0.97, <i>p</i> = 0.0017). We observed a highly significant difference in the frequency of stenoses between 30% and 50% DS between the PAPS group (<i>n</i> = 24) and the control group (<i>n</i> = 7) (CI95: 0.59–0.90, <i>p</i> = 0.0023), as well as the SAPS group (<i>n</i> = 30) (CI95: 0.65–0.92, <i>p</i> = 0.0002). A qualitative analysis of plaque morphology revealed that patients with PAPS had significantly more soft tissue lesions (<i>n</i> = 23) compared with calcified lesions (<i>n</i> = 2) (CI95: 0.74–0.99, <i>p</i> = 0.00003), as well as more mixed plaques (<i>n</i> = 9) and calcified plaques (<i>n</i> = 2) (CI95: 0.48–0.98, <i>p</i> = 0.0348). Patients within the SAPS group had significantly more soft tissue (<i>n</i> = 35) than calcified lesions (<i>n</i> = 3) (CI95: 0.79–0.98, <i>p</i> = 0.00000021), as well as more mixed lesions (<i>n</i> = 21) compared with calcified (<i>n</i> = 3) (CI95: 0.68–0.97, <i>p</i> = 0.0002). Conclusions: Our study shows that subclinical manifestations of carotid artery lesions were more common in patients with APS. We came to the conclusion that MDCTA is an accurate diagnostic method because it is a safe method that provides us with a great quantity of accurate information about the characteristics of atheromatous plaques, which aids us in the further planning of treatment for patients with APS.https://www.mdpi.com/2079-9721/11/4/131antiphospholipid syndromecarotid arteryvascular manifestationsMDCTA |
| spellingShingle | Jovica Saponjski Ljudmila Stojanovich Natasa Stanisavljevic Aleksandra Djokovic Radisa Vojinovic Svetlana Kocic Simon Nikolic Predrag Matic Branka Filipovic Vuk Djulejic Vladan Colovic Nikola Bogosavljevic Dejan Aleksandric Dejan Kostic Biljana Brkic Georgijevski Miroslav Misovic Nikola Colic Dusan Saponjski Quantitative and Qualitative Characteristics of Atherosclerotic Plaques on Carotid Arteries in Patients with Antiphospholipid Syndrome: The Role of MDCT Angiography Diseases antiphospholipid syndrome carotid artery vascular manifestations MDCTA |
| title | Quantitative and Qualitative Characteristics of Atherosclerotic Plaques on Carotid Arteries in Patients with Antiphospholipid Syndrome: The Role of MDCT Angiography |
| title_full | Quantitative and Qualitative Characteristics of Atherosclerotic Plaques on Carotid Arteries in Patients with Antiphospholipid Syndrome: The Role of MDCT Angiography |
| title_fullStr | Quantitative and Qualitative Characteristics of Atherosclerotic Plaques on Carotid Arteries in Patients with Antiphospholipid Syndrome: The Role of MDCT Angiography |
| title_full_unstemmed | Quantitative and Qualitative Characteristics of Atherosclerotic Plaques on Carotid Arteries in Patients with Antiphospholipid Syndrome: The Role of MDCT Angiography |
| title_short | Quantitative and Qualitative Characteristics of Atherosclerotic Plaques on Carotid Arteries in Patients with Antiphospholipid Syndrome: The Role of MDCT Angiography |
| title_sort | quantitative and qualitative characteristics of atherosclerotic plaques on carotid arteries in patients with antiphospholipid syndrome the role of mdct angiography |
| topic | antiphospholipid syndrome carotid artery vascular manifestations MDCTA |
| url | https://www.mdpi.com/2079-9721/11/4/131 |
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