Different Characteristics and Interleukin-6 Ratios of Scattering-Type Aortic Plaques

Sei Komatsu; Chikao Yutani; Satoru Takahashi; Tomoki Ohara; Nobuzo Iwa; Mitsuhiko Takewa; Hirotaka Noda; Kazuhisa Kodama

doi:10.7759/cureus.52949

Different Characteristics and Interleukin-6 Ratios of Scattering-Type Aortic Plaques

Cureus. 2024 Jan 25;16(1):e52949. doi: 10.7759/cureus.52949. eCollection 2024 Jan.

Authors

Sei Komatsu¹, Chikao Yutani², Satoru Takahashi¹, Tomoki Ohara¹, Nobuzo Iwa², Mitsuhiko Takewa¹, Hirotaka Noda³, Kazuhisa Kodama¹

Affiliations

¹ Department of Cardiology, Osaka Gyoumeikan Hospital, Osaka, JPN.
² Department of Pathology, Osaka Gyoumeikan Hospital, Osaka, JPN.
³ Department of Medical Technology, Morinomiya University of Medical Sciences, Osaka, JPN.

Abstract

Background Cholesterol crystals (CCs) are related to innate inflammation in spontaneously ruptured aortic plaques (SRAPs), and variability exists in the CCs and interleukin (IL)-6 ratio in SRAPs. Methods The prevalence of scattering-type ruptures that glittered against the light of angioscopic fibers (puff-chandelier ruptures) and those that did not (puff ruptures) was analyzed in 848 patients with suspected coronary artery disease. Overall, 177 puff-chandelier ruptures and 105 puff ruptures were sampled using nonobstructive general angioscopy (NOGA). The sampled plaques were analyzed by direct detection of CCs with polarized light microscopy. The characteristics of the plaque fragments from puff and puff-chandelier ruptures were compared. The Interleukin-6 (IL-6) ratios were calculated for 100 puff-chandelier ruptures and 100 puff ruptures. Results CCs were detected in 54% of puff-chandelier ruptures and 20% of puff ruptures. The longer and shorter dimensions of the puff ruptures were smaller than those of the puff-chandelier ruptures. CCs were more prevalent in puff chandeliers than in puff ruptures (54% vs. 20%, respectively; p<0.0001). The number of CCs was higher in puff chandeliers than in puff ruptures with CCs (median 12,727 (interquartile range (IQR) 3,636-25,909)/10 mL vs. median 3,182 ( IQR 909-9,318)/10 mL) in CC-positive samples (p=0.0120). The IL-6 ratio of puff-chandelier ruptures was higher than that of puff ruptures (p=0.0014). Conclusions Examination of plaque fragments from puff-chandelier and puff ruptures revealed a higher prevalence of CCs in puff-chandelier ruptures compared to puff ruptures. Puff chandeliers exhibited a significantly greater number of CCs, suggesting a potential correlation with inflammatory levels. The IL-6 ratio was also higher in puff-chandelier ruptures. Direct detection of CCs and hematoxylin and eosin staining for SRAPs demonstrated variations in CC degree and dimensions between puff-chandelier and puff ruptures. Puff-chandelier ruptures exhibited more CCs associated with innate inflammation and larger fragments than puff ruptures. NOGA proved effective in detecting diverse characteristics and inflammation levels, as indicated by IL-6, in scattering-type SRAPs.

Keywords: aorta; cholesterol crystals; interleukin-6; nonobstructive general angioscopy; spontaneously ruptured aortic plaque.