Low levels of high-density lipoprotein cholesterol are associated with echolucent carotid artery plaques - The Tromso study

Background and Purpose-Ultrasound-assessed plaque morphology is an independ ent predictor of ischemic stroke. The purpose of this population-based cros s-sectional nested case-control study was to examine the risk factors assoc iated with carotid plaque morphology. Methods-Ultrasonography of the right carotid artery was conducted on 6727 p articipants in a population health survey (response rate 79%). Plaque echog enicity, defined as reflectance of the emitted ultrasound signal, was score d as echolucent, predominantly echolucent. predominantly echogenic, or echo genic. information on cardiovascular risk factors in all 216 participants w ho had carotid stenosis and in 223 control subjects matched by age and sex who did not have carotid stenosis was obtained from measurements of blood p ressure. weight, height, and nonfasting blood samples and from a self-admin istered questionnaire. Results-In both univariate and multivariate analyses, low levels of HDL cho lesterol and increasing degree of stenosis were independently associated wi th an increased risk of having an echolucent plaque. For 1-SID increase in HDL cholesterol, the adjusted odds of being in a lower plaque echogenicity category decreased by approximate to 30% (OR 0.69, 95% CI 0.52 to 0.93). Conclusions-These findings indicate that low levels of HDL cholesterol are associated with an increased risk of having echolucent, rupture-prone ather osclerotic plaques.