Garcia, Lawrence

Joner, Michael

Kolodgie, Frank

Koppara, Tobias

Mori, Hiroyoshi

Otsuka, Fumiyuki

Sanchez, Oscar

Virmani, Renu

Yahagi, Kazuyuki

Zhao, Xiaoqing

Elsevier - Publisher Connector 

Vascular Medicine
A2072
JACC March 17, 2015
Volume 65, Issue 10S
PrOgnOStic Plaque BiOmarkerS fOr the riSk StratificatiOn in PeriPheral VaScular 
diSeaSe
Poster Contributions
Poster Hall B1
Saturday, March 14, 2015, 10:00 a.m.-10:45 a.m.
Session Title: New Findings in Vascular Inflammation and Endothelial Function
Abstract Category: 45.  Vascular Medicine: Non Coronary Arterial Disease
Presentation Number: 1120-335
Authors: Tobias Koppara, Fumiyuki Otsuka, Lawrence Garcia, Xiaoqing Zhao, Kazuyuki Yahagi, Oscar Sanchez, Hiroyoshi Mori, Michael 
Joner, Frank Kolodgie, Renu Virmani, CVPATH Institute, Inc., Gaithersburg, MD, USA, St. Elizabeth’s Medical Center, Tufts University 
School of Medicine, Boston, MA, USA
Background:  Patency rates are still suboptimal in patients with peripheral artery disease (PAD) undergoing percutaneous intervention. 
Atherosclerotic plaque characteristics may be predictive of future events in patients with PAD.
methods:  Excised plaques from 113 de novo lesions of 92 symptomatic patients were evaluated following directional atherectomy 
(SilverHawk® or TurboHawk™ Peripheral Plaque Excision Systems (Covidien/ev3, Plymouth, MN) of the superficial femoral artery during 
conduction of the DEFINITIVE LE trial. Immunohistochemistry was performed to stain for macrophages (CD68, CD163), T-lymphocytes 
(CD3), HLA-DR, red blood cells (glycophorin A), endothelial cells (ulex), smooth muscle cells (HHF), Toll-like receptor 4, RAGE and 
ENRAGE. In addition, in 20 randomly selected cases RNA and protein profiling were performed for total of 90 genes and 15 proteins.
results:  Histology showed acute or organizing thrombus in 27 patients (29%). Patients with thrombus had significantly higher CD163, 
HLA-DR, and glycophorin A expression (p=0.01, p=0.02 and p=0.01) than those without thrombus. Thrombosis cases also showed 
increased expression of numerous inflammatory genes such as TNF, IL-8 and chemokines (CCL17, 26, CXCL1, 3, and 6) as well as 
increased protein levels including IL-6 and IL-8. Primary patency at 6 month in patients with presence of thrombus was significantly lower 
than in patients without thrombus (59% [10/17] vs. 87% [40/46], p=0.014), while this effect was not sustained at 12 months (61% [14/23] vs. 
67% [42/63], p=0.62).
conclusion:  The current analysis revealed that peripheral atherothrombotic plaque is associated with increased expression of 
inflammatory markers and worse patency outcome at 6 months. However, this early distinguishing feature was not found to be of predictive 
value with respect to clinical outcome at 12 months.


PROGNOSTIC PLAQUE BIOMARKERS FOR THE RISK STRATIFICATION IN PERIPHERAL VASCULAR DISEASE 

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PROGNOSTIC PLAQUE BIOMARKERS FOR THE RISK STRATIFICATION IN PERIPHERAL VASCULAR DISEASE

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