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

• Chung H
• Kim BY
• Kim HS
• Kim HO
• Lee JM
• Woo JS
• Kim JB
• Kim WS
• Kim KS
• Kim W

• KMID: 2503245
• DOI: http://doi.org/10.3348/kjr.2019.0550

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