Peripheral Artery Disease Events Linked to Lipid-Rich Necrotic Core

HealthDay News – Lipid-rich necrotic core (LRNC) in the proximal superficial femoral artery (SFA) is associated with higher rates of peripheral artery disease (PAD) events, according to a study published online in JACC: Cardiovascular Imaging.

Mary M. McDermott, MD, from the Northwestern University Feinberg School of Medicine in Chicago, and colleagues followed patients with ankle brachial index (ABI) <1.00 annually to examine the correlation between the presence of LRNC in the SFA and PAD event rates. SFA atherosclerotic plaques were characterized at baseline using magnetic resonance imaging.

The researchers found that 24% of the 254 PAD participants had LRNC and 59% had calcium in the SFA at baseline. At 47-month follow-up, SFA LRNC was associated with increased incidence of the combined outcome of lower extremity amputation, critical limb ischemia, ABI decline of ≥0.15, and revascularization (hazard ratio [HR]: 2.18), after adjustment for age, sex, race, comorbidities, baseline ABI, and other confounding variables. 

Even when this combined outcome excluded lower extremity revascularization, the association of SFA LRNC with PAD events was maintained (HR: 2.58). There was no correlation for LRNC in the SFA with all-cause mortality, acute coronary events, or stroke.

“Among people with PAD, LRNC in the SFA was associated with higher rates of clinical PAD events and this association was independent of the ABI,” the authors wrote.

Disclosures: Several authors disclosed financial ties to the health care and pharmaceutical industries.

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  1. McDermott MM, Kramer CM, Tian Lu, et al. Plaque composition in the proximal superficial femoral artery and peripheral artery disease events. JACC Cardiovasc Imag. 2016 Nov 9. doi:10.1016/j.jcmg.2016.08.012 [Epub ahead of print].
  2. Mustapha JA, Diaz-Sandoval LJ. Plaque composition in the proximal SFA and clinical outcomes in patients with claudication. Have we found the answer? JACC Cardiovasc Imag. 2016 Nov 9. doi:10.1016/j.jcmg.2016.09.009.