Abstract 14812: Echolucency of the Carotid Artery is Associated With Short-term Plaque Progression and Positive Remodeling in Culprit Coronary Artery in AMI Survivors
Background: Rapid plaque progression and positive remodeling are recognized as vulnerable coronary plaque phenotypes. Non-invasive technique capable of assessing these subclinical features of vulnerable coronary plaque could be useful for risk assessment of recurrent events in survivors with AMI. This study examined whether serial non-invasive vascular tests in peripheral arteries may be useful for assessment of coronary plaque progression and positive remodeling, measured by serial intravascular ultrasound (IVUS), in the culprit coronary artery in AMI survivors.
Methods: Plaque volume (PV) and external elastic membrane area (EEM area) of native segment (15 ± 1.5 mm in length) beginning 5 mm proximal to the stent edge in the culprit coronary artery were measured at the emergent PCI on admission (1st test) and 6 months later (2nd test) using the volumetric IVUS in 39 AMI survivors. The patients had a repeated non-invasive vascular tests including echolucency using integrated backscatter (IBS) analysis and intima-media thickness (IMT) of the carotid artery, brachial-ankle pulse-wave velocity (baPWV) and flow-mediated dilation (FMD) of the brachial artery at 2 weeks after MI (1st test) and 6 months later (2nd test). Lower IBS reflects echolucent and lipid-rich laque.
Results: Mean changes of coronary PV and EEM area over 6 months were -2.78 ± 1.44 mm3/cm and -0.45 ± 0.32 mm2/slice, respectively. PV progression and positive remodeling (an increase in mean EEM area at 2nd test than that at 1sttest) over 6 months occurred in 17 and 12 patients, respectively. The % change in IBS values of the carotid artery over 6 months had a significant correlation with % change in the coronary PV (r = - 0.69, p < 0.001). In logistic regression analysis, the aggravated change in the carotid IBS was significantly associated with coronary PV progression (OR 0.94, 95%CI 0.90-0.99, p = 0.01) and positive remodeling (OR 0.95, 95% CI 0.90-0.99, p = 0.02) over 6 months. Carotid IMT, baPWV and FMD had no significant association with coronary plaque progression and positive remodeling.
Conclusions: Serial measurement of echolucency of the carotid artery may be useful for assessment of short-term plaque volume progression and positive remodeling in the culprit coronary artery in AMI survivors.
Author Disclosures: M. Futamata: None. S. Matsuoka: None. T. Shimizu: None. T. Yoshizaki: None. J. Obata: None. T. Nakamura: None. D. Fujioka: None. K. Kugiyama: None.
- © 2016 by American Heart Association, Inc.