Sustained Acceleration in Carotid Atherosclerotic Plaque Progression With Intraplaque Hemorrhage
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Results From 14 subjects who exhibited IPH at 54 months, 12 arteries were found to have developed IPH during the study period. The progression rates were –20.5 ± 13.1, 20.5 ± 13.6, and 16.5 ± 10.8 mm3/year before, during, and after IPH development, respectively. The progression rate during IPH development tended to be higher than the period before (p = 0.080) but comparable to the period after (p = 0.845). The progression rate in the combined period during/after IPH development was 18.3 ± 6.5 mm3/year, which indicated significant progression (p = 0.008 compared with a slope of 0) and was higher than the period before IPH development (p = 0.018). No coincident ischemic events were noted for new IPH.
Conclusions The development of IPH posed an immediate and long-term promoting effect on plaque progression. IPH seems to alter the biology and natural history of carotid atherosclerosis. Early identification of patients with IPH may prove invaluable in optimizing management to minimize future sequelae.
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As placas de Carótidas são diferentes em sua composição e progressão.
O componente de hemorragia intraplaca (IPH) é importantíssimo.
Estudo revelou até 40% do colesterol da placa proveniente das hemaceas aprisionadas nas hemorragias.
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Isso justifica, em parte, o tratamento do colesterol circulante não ser tão eficiciente para Carótidas.
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Quando a hemorragia é detectada, por qualquer método, a chance de progressão da placa e de eventos desfavoráveis é maior.
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Agora, não se apresse em determinar a figura acima como hemorragia intraplaca ou colesterol, pode ser simplesmente elastina.
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