RELATIONSHIPS BETWEEN RISK-FACTORS AND MORPHOLOGICAL PATTERNS OF HUMAN CAROTID ATHEROSCLEROTIC PLAQUES - A MULTIVARIATE DISCRIMINANT-ANALYSIS

The histological characterization of the fibroatheromatous plaques and their histogenesis are still to be defined. Factors responsible for t he evolution of intimal components and the mechanisms and stages of fi broatheromatous plaque formation are still largely obscure. Focusing o n symptomatic plaques, the aim of this study is to determine whether p laque heterogeneity is the result of a haphazard clustering of various components or an organized pattern in response to risk factors. To th is end, 180 carotid plaques from patients affected by transient ischem ic attacks (TIA) or by stroke, with angiographic stenosis greater than 50%, were studied after endoarterectomy. Clinical and morphological d ata were collected by means of a pre-defined protocol, quantified and correlated, by using the discriminant analysis, with age, sex, hyperte nsion, diabetes, hypercholesterolemia and smoking habit. Our results s how that the relationships between plaque components are non-random an d consistent with the knowledge derived from studies on human and expe rimental plaques. Moreover, some plaque patterns can be significantly correlated with single risk factors. The fibrous plaque was correlated with aging and diabetes; the granulomatous plaque, rich in giant cell s, with the female sex and hypertension; the xanthomatous plaque, rich in foam cells and with extensive alcianophilia, with hypercholesterol emia. In the smokers, finally, the plaques were frequently complicated by mural thrombosis.