| Objectives Acute coronary syndrome (ACS) are closely associated with coronary vulnerable plaques. Our study was undertaken to evaluate the relationship between carotid plaque neovascularization and coronary heart diseas by contrast-enhanced ultrasound imaging.Methods 40 patients (31 males and 9 females, aged 45～76 years old) with acute coronary syndrome (ACS) and 40 patients (29 males and 11 females, aged 45～76 years old) with stable coronary artery disease (sCAD) were included in our study, Inclusion criteria were at least 1 carotid atherosclerotic plaque with thickness larger than 2.0mm. Contrast-agent enhancement in the plaque was evaluated by visual interpretation and quantitative analysis.Results The percentage of soft plaque in the acute coronary syndrome group was significantly higher than that in stable coronary artery disease group (P=0.017). The proportion of contrast-agent enhancement in patients with acute coronary syndrome was significantly than in patients with stable coronary artery disease (P=0.022). The enhanced intensity in the plaque and the ratio of enhanced intensity in the plaque to that in the carotid artery lumen in patients with acute coronary syndrome were significantly larger than those in patients with stable coronary artery disease (P<0.001; P=0.026,respectively). Sensitivity and specificity were 74%and 60%, respectively, for enhanced intensity in the plaque and 86% and 67%, respectively, for ratio of enhanced intensity in the plaque to that in the lumen of the carotid artery.Conclusions The subjects with acute coronary syndrome had more intense contrast-agent enhancement than the subjects with stable coronary artery disease, suggesting that contrast-enhanced carotid ultrasound imaging may be used as a method to evaluate the relationship between carotid plaque instability and coronary heart disease. Objectives Cardiovascular and cerebrovascular events are closely related to vulnerable plaques. Generally, atherosclerosis begins with endothelial injury site, and then elevated low-density lipoprotein (LDL) cholesterol, hypertension, smoking, blood sugar and other cardiovascular risk factors aggravate the damage. Recent investigations have focus on neovascularization as an important factor contributing to atherosclerotic plaque vulnerability. The abiliy to detcet neovascularization in plaque using noninvasive method is therefore of major clinic interest. Our study was undertaken to evaluate the cardiovascular risk factors in subjects with acute coronary syndrome.Methods 74 patients (53 males and 21 females, aged 45～76 years old) with acute coronary syndrome (ACS)and 75 patients (51 males and 24 females, aged 45～81 years old) with stable coronary artery disease (sCAD) were included in our study. Contrast-agent enhancement in the plaque was evaluated by visual interpretation and quantitative analysis. All blood samples of the patients were sent to the same hospital laboratory for biochemical detection and correction.Results LDL-C of ACS group was significantly higher than that of sCAD group (P=0.002). The proportion of contrast-agent enhancement in patients with ACS was significantly larger than in patients with sCAD (P=0.039). The enhanced intensity in the plaque and the ratio of enhanced intensity in the plaque to that in the carotid artery lumen in patients with ACS were prominnently larger than those in patients with sCAD (P=0.001; P=0.035, respectively). Logistic regression analysis revealed that contrast-agent enhancement within plaque was significant predictor for patients with ACS (OR=2.687 95%CI 1.002-8.025, P=0.047)Conclusion Our study showed that LDL-C was apparently higher in ACS group. Contrast-agent enhancement within plaque was significant predictor for patients with ACS. Contrast-enhanced carotid ultrasound imaging may be used as a method to evaluate the relationship between carotid plaque neovascularization and cardiovascular risk factors and acute coronary syndrome.
|
PDF Full Text Request