Abstract 18512: Comparison of Carotid Intima-media Thickness, Plaque Score and Plaque Area Stenosis in Patients with Acute Myocardial Infarction with and without ST-segment Elevation
Background: Increased carotid intima-media thickness (IMT) and presence of carotid plaques are being used for estimation of subclinical atherosclerosis but their role in established coronary artery disease remains uncertain. Therefore, we aimed to evaluate whether carotid parameters are correlated with extent and complexity of coronary atherosclerosis using SYNTAX score (SS). We also sought to compare carotid parameters between ST-segment elevation myocardial infarction (STEMI) and non-STEMI (NSTEMI).
Methods: Of 1351 patients who consecutively received carotid ultrasound evaluation from Sep 2011 to May 2012, 137 patients diagnosed with STEMI (n=73) and NSTEMI (n=65) were enrolled (104 men and mean age 64.9±12.7 years). IMT, plaque score (PS) and % plaque area stenosis (AS) were compared between STEMI and NSTEMI. PS was computed according to the presence of plaque in 4 different locations. For the quantification of plaques, % AS was calculated by the ratio of the luminal stenosis area divided by the vessel area at the narrowest portion in short axis view. Clinical parameters and SS were also compared.
Results: The prevalence of hypertension and diabetes was higher in NSTEMI group than STEMI group (65.6% vs. 39.7%, p=0.002 and 42.2% vs. 19.2%, p=0.003). A higher incidence of multi-vessel disease (≥2 vessels) and diffuse lesion was observed in NSTEMI group (69.6% vs. 45.1%, p=0.007 and 65.6% vs. 46.6%, p=0.038). NSTEMI group had significant higher SS (16.0±9.2 vs. 20.0±10.2, p=0.015), IMT values, PS and % AS. SS was correlated with mean IMT values and PS (r=0.182, p=0.033 and r=0.200, p=0.019). SS was higher in NSTEMI patients with increased IMT & plaque than those with normal carotid artery (22.2±9.9 vs. 10.3±6.1, p=0.001).
Conclusion: NSTEMI was associated with increased CIMT, higher PS and % AS reflecting atherosclerotic burden. Carotid parameters provided additional information to predict the severity of coronary atherosclerosis in patients with NSTEMI.
- © 2012 by American Heart Association, Inc.