Our results demonstrate the potential of combining C-arm CBCT with iSYS1 for safe and accurate percutaneous placement of pedicle K wires in spinal interventions.
Funding Acknowledgements
Type of funding sources: None.
Background
The presence of carotid plaque has been associated with an increased risk for acute coronary events, and can be assessed with a low-cost and readily available study such as carotid ultrasound. This has a class IIa recommendation to reclassify patients with intermediate risk, but little is known about the prevalence of carotid disease in patients with acute coronary syndromes.
Methods
Observational study in patients admitted for STEMI in a tertiary care center, performing a carotid ultrasound before hospital discharge. We analyzed the differential characteristics according to the presence of carotid plaque, as well as the atherosclerotic burden assessed by the number of diseased vessels.
Results
We included 191 patients with STEMI, and 57 (29.8%) had carotid plaque. Their basal characteristics and outcomes are listed in the table. Patients with subclinical atherosclerotic disease were older, but other risk markers were similar, as was the use of aspirin and statins. The prevalence of carotid disease increased with the number of diseased vessels, as seen in the figure.
Conclusion
About 1 in 3 patients with STEMI had carotid plaque detectable by ultrasound. Most were young with an intermediate basal risk for cardiovascular disease, with only a minority treated with statins or aspirin, and could have been reclassified as high risk with a timely ultrasound. No other risk factors but age was associated with the presence of carotid plaque, emphasizing the importance of carotid ultrasound screening in older patients. Characteristics by carotid plaqueOverallCarotid plaque absentCarotid plaque presentpn17011357Age56.63 ± 10.9254.36 ± 9.9361.12 ± 11.48<0.001Males146 (85.9%)98 (86.7%)48 (84.2%)0.833Diabetes30 (17.8%)18 (16.1%)12 (21.1%)0.556Hypertension95 (55.9%)61 (54.0%)34 (59.6%)0.590Smoker122 (72.2%)85 (75.9%)37 (64.9%)0.185Obesity31 (18.2%)23 (20.4%)8 (14.0%)0.425LDL-cholesterol (mg/dl)115.97 ± 42.51117.84 ± 44.02110.78 ± 38.720.550Statin use31 (18.6%)19 (17.0%)12 (21.8%)0.585Aspirin use38 (22.6%)24 (21.2%)14 (25.5%)0.677GRACE score105.66 ± 29.30100.61 ± 27.63115.66 ± 30.250.005Stroke1 (0.6%)0 (0.0%)1 (1.8%)0.723Hospital mortality5 (3.1%)2 (1.9%)3 (5.5%)0.441Abstract Figure. Carotid plaque by diseased vessels.
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