Abstract 14685: Independent Predictors of Inflammation in Carotid Plaques in Patients With Coronary Artery Disease
Background: Inflammation plays an important role in the natural history of atherosclerosis. Microwave radiometry (MR) can quantify the inflammatory status in carotid vessel wall by measuring the internal temperature of tissues. In this study we aimed to identify the systemic and local independent factors of inflammatory activation in patients with coronary artery disease.
Methods: We included 271 patients with significant coronary artery disease (≥50% stenosis in at least one major epicardial vessel). All patients underwent carotid artery ultrasound and MR. During ultrasound study, plaque texture, surface and echogenicity were analyzed. Thermal heterogeneity (ΔT) by MR was assigned as maximal temperature along the carotid artery minus minimum. ΔT ≥ 0.90°C was assigned as high ΔT. By vessel- and patient-based multivariate logistic regression analysis, we determined those factors, which independently predict the unilateral or bilateral presence of high local inflammation as measured by ΔT.
Results: In 58 (24.07%) patients bilateral high ΔT (≥0.90 °C) was observed, in 77 (28.41%) patients high ΔT was detected only in one carotid artery and 136 (47.52%) patients had low ΔT bilaterally. In multivariate vessel-based analysis, plaque texture (p=0.02, OR: 3.89, 95% CI 1.24-12.17), plaque surface (p<0.001, OR: 0.14, 95% CI: 0.08-0.26), plaque echogenicity (p=0.04, OR: 0.35, 95% CI 0.13-0.95), diabetes (p=0.05, OR=1.56, 95% CI 1.00-2.53) and hypertension (p<0.01, OR: 2.45, 95% CI 1.36-4.42) were independent predictors for carotid high ΔT. In multivariate patient-based analysis, male sex (p<0.01, OR: 0.35, 95% CI 0.17-0.71), presence of carotid plaques bilaterally (p=0.05, OR: 1.87, 95% CI 1.00-3.89), diabetes mellitus (p=0.05, OR: 1.85, 95% CI 1.00-3.44) and number of vessels with significant stenosis (p<0.01, OR=1.75, 95% CI 1.17-2.63) were independent predictors for bilateral high ΔT.
Conclusions: Both bilateral and unilateral high inflammatory activation of carotid artery plaques seem to be determined by systemic factors, including arterial hypertension and diabetes mellitus.
- © 2013 by American Heart Association, Inc.