Korean J Radiol.  2020 Jul;21(7):900-907. 10.3348/kjr.2019.0550.

Long-Term Clinical Effects of Carotid Intraplaque Neovascularization in Patients with Coronary Artery Disease

Affiliations
  • 1Cardiovascular Division, Department of Internal Medicine, Kyung Hee University Medical Center, Kyung Hee University, Seoul, Korea

Abstract


Objective
To investigate the predictive value of intraplaque neovascularization (IPN) for cardiovascular outcomes.
Materials and Methods
We evaluated 217 patients with coronary artery disease (CAD) (158 men; mean age, 68 ± 10 years) with a maximal carotid plaque thickness ≥ 1.5 mm for the presence of IPN using contrast-enhanced ultrasonography. We compared patients with (n = 116) and without (n = 101) IPN during the follow-up period and investigated the predictors of major adverse cardiovascular events (MACE), including cardiac death, myocardial infarction, coronary artery revascularization, and transient ischemic accident/stroke.
Results
During the mean follow-up period of 995 ± 610 days, the MACE rate was 6% (13/217). Patients with IPN had a higher maximal thickness than those without IPN (2.86 ± 1.01 vs. 2.61 ± 0.84 mm, p = 0.046). Common carotid artery-peak systolic velocity, left ventricular mass index (LVMI), and ventricular-vascular coupling index were significantly correlated with MACE. However, on multivariate Cox regression analysis, increased LVMI was independently related to MACE (p < 0.05). The presence of IPN could not predict MACE.
Conclusion
The presence of IPN was related to a higher plaque thickness but could not predict cardiovascular outcomes better than conventional clinical factors in patients with CAD.

Keyword

Carotid intraplaque neovascularization; Contrast-enhanced ultrasound; Cardiovascular outcome
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