The Relevance of Vascular Endothelial Growth Factor, Hypoxia Inducible Factor-1 Alpha, and Clusterin in Carotid Plaque Instability

Jelena Basic, Stefan Stojkovic, Afshin Assadian, Sabine Rauscher, Nikolaus Duschek, Christoph Kaun, Johann Wojta, Jürgen Falkensammer

Research output: Journal article (peer-reviewed)Journal article

14 Citations (Scopus)


BACKGROUND: Stroke is one of the leading causes of morbidity and mortality. Thromboembolism, as a major cause of carotid artery-related stroke, can be caused by plaque rupture which is associated with neoangiogenesis within the carotid plaque.

AIM: We sought to investigate a possible correlation between angiogenesis-related factors and preoperative neurological manifestations in patients with internal carotid artery stenosis, for a better understanding of thromboembolism in internal carotid artery stenosis-related stroke.

METHODS: This study included 54 patients (asymptomatic, n = 20 and symptomatic, n = 34) undergoing carotid endarterectomy for high-grade internal carotid artery stenosis. In the retrieved carotid plaques, angiogenesis-related factors (vascular endothelial growth factor [VEGF], hypoxia inducible factor-1 alpha [HIF-1α], and Clusterin) were measured by immunohistochemistry and quantified by real-time polymerase chain reaction.

RESULTS: We demonstrated the expression of VEGF, HIF-1α, and Clusterin by endothelial cells and smooth muscle cells in the carotid plaques. Noteworthy, mRNA VEGF levels were .7-fold higher in symptomatic patients (P = .017) compared to asymptomatic patients. In contrast, mRNA Clusterin levels were 1.8-fold lower (P = .021). Levels of mRNA HIF-1α were 1.5-fold higher in asymptomatic patients, but no statistical significance was reached between the 2 groups.

CONCLUSIONS: Our results show an association between VEGF and Clusterin and neurological symptoms of patients with high-grade carotid artery stenosis.

Original languageEnglish
Pages (from-to)1540-1545
Number of pages6
JournalJournal of Stroke and Cerebrovascular Diseases
Issue number6
Publication statusPublished - Jun 2019


  • Aged
  • Aged, 80 and over
  • Asymptomatic Diseases
  • Carotid Artery, Internal/chemistry
  • Carotid Stenosis/complications
  • Clusterin/analysis
  • Female
  • Gene Expression Regulation
  • Humans
  • Hypoxia-Inducible Factor 1, alpha Subunit/analysis
  • Male
  • Middle Aged
  • Neovascularization, Pathologic
  • Plaque, Atherosclerotic
  • Prospective Studies
  • RNA, Messenger/genetics
  • Rupture, Spontaneous
  • Severity of Illness Index
  • Stroke/etiology
  • Vascular Endothelial Growth Factor A/analysis


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