Kim E. Dzobo, Netherlands
Amsterdam UMC, AMC Experimental Vascular MedicinePresenter of 1 Presentation
Phenotyping carotid endarterectomy plaques of patients with elevated levels of lipoprotein(a)
Abstract
Background and Aims
Elevated lipoprotein(a) [Lp(a)] levels have been demonstrated to be a causal risk factor for the development of cardiovascular disease. While previous studies have shown the atherogenicity of Lp(a) on monocyte activation and migration as well by activation of the vessel wall, the atherosclerotic plaque phenotype of individuals with elevated Lp(a) levels have not been studied up till now.
Methods
Therefore, we measured Lp(a) levels in 1506 subjects of the Athero-Express Biobank located at the University Medical Centre Utrecht, The Netherlands. Athero-Express started in 2002 and is a prospective ongoing biobank study that includes all patients undergoing carotid or iliofemoral endarterectomy in two referral hospitals in the Netherlands. From these 1506 subjects we compared the plaques from patients with extremely high (>195 mg/dl; N=57) and low (<7 mg/dl; N=106) Lp(a) levels.
Results
The plaques from Lp(a) high patients demonstrated a 33% increase in blood vessel area per plaque, indicating an increased plaque angiogenesis. Intraplaque neovascularization has been shown to drive the progression of atherosclerosis and enhance plaque instability leading to an increase in cardiovascular risk.
Conclusions
By using whole plaque RNA sequencing, combined with immunohistochemistry and targeted plasma biomarker analysis by OLINK proteomic panels, we aim to further characterise the plaque phenotype in patients with elevated levels of Lp(a) and thereby provide more insight in the atherogenic potential of Lp(a). Further analyses are currently performed and the results will be available at the EAS 2020.