Abstract 226: Statin Therapy is Associated With Decreased Neovascularization in Symptomatic Carotid Atherosclerotic Plaque: A Pathological Analysis

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Background: Statin treatment has been shown to be associated with decreased intraplaque neovascularization in human carotid arteries by various imaging modalities or in animal models by pathological analysis. However, whether statin treatment attenuates intraplaque neovascularization in human carotid plaque has not been fully described. The aim of this study was to analyze the possible relationships between statin treatment and intraplaque microvessels (MVs) in patients undergoing carotid endarterectomy (CEA). Methods: Among consecutive 79 patients with advanced carotid artery stenosis (>70%) between May 2015 and February 2017, 66 patients without statin therapy (group 1) and 13 patients with statin therapy (group 2) were analyzed. The specimens were stained with hematoxylin/eosin and elastica-Masson. Immunohistochemistry was performed, using an endothelial specific antibody to CD31, CD34 and PDGFRβ. The number of intraplaque MVs was analyzed in each specimen. MV density was defined as number of MVs per mm 2 . Results: The mean number of MVs was fewer in group 2 when compared with that in group 1 (25.8±17.6 vs. 50.8±31.8 /section, P<0.001). The mean MV density was lower in group 2 when compared with that in group 1 (1.06±0.84 vs. 2.19±1.43 /mm 2 , P<0.001). There was no significant difference in the mean concentration of low-density lipoprotein cholesterol between group 1 and group 2 (121±32 mg/dl vs. 105±37 mg/dl, P=0.118). Conclusions: This pathological analysis of carotid atherosclerotic plaque suggests that statin therapy is associated with decreased intraplaque neovascularization in symptomatic patients undergoing CEA. This plaque stability might be derived from pleiotropic effect beyond lipid lowering of statin therapy.