Community-based statins and advanced carotid plaque: Role of CD163 positive macrophages in lipoprotein-associated phospholipase A 2 activity in atherosclerotic plaque.

•Our pathologic evaluation of carotid endarterectomy specimens showed comparable expression of Lp-PLA2 between statin-treated and naïve patients in a community based setting, with similar lesion apoB levels.•Lp-PLA2 expressed in symptomatic carotid plaques was significantly greater than asymptomatic lesions where overall correlations of protein expression were found for necrotic core size, extent of CD68 positive foam cells, and a unique macrophage subset characterized as CD163 positive cells, previous considered atheroprotective.•Anti-inflammatory therapeutic approaches designed to reduce lesional macrophages may decrease local production of Lp-PLA2 and necrosis beyond that afforded by statins alone.