Clinical Impact of Carotid Plaque Score rather than Carotid Intima-Media Thickness on Recurrence of Atherosclerotic Cardiovascular Disease Events

Abstract

The official journal of the Japan Atherosclerosis Society and the Asian Pacific Society of Atherosclerosis and Vascular Diseases Original Article Aim: Carotid plaque score (cPS) reflecting throughout the carotid artery plaque burden may be a better marker than carotid intima-media thickness (cIMT) is. We aimed to compare the prognostic utility of these measurements in patients with atherosclerotic cardiovascular disease (ASCVD). Methods: We retrospectively examined 2,035 Japanese patients with ASCVD who underwent carotid ultrasonography between January 2008 and December 2015 at Kanazawa University Hospital. Median follow-up period was 4 years. We used Cox models that adjusted for established risk factors of ASCVD, including age, gender, hypertension, diabetes, smoking, and serum lipids to assess the association of cIMT as well as cPS with major adverse cardiac events (MACE). MACE was defined as all-cause mortality or rehospitalization for a cardiovascular-related illness. Results: During follow-up, 243 participants experienced MACE. After adjustment for established risk factors, cPS was associated with MACE (hazard ratio [HR] 3.38 for top quintile vs. bottom quintile of cPS; 95% confidence interval [CI] 1.82-6.27; P trend 0.001), while cIMT was not (HR=0.88, P 0.57). Addition of the cPS to established risk factors significantly improved risk discrimination (C-index 0.726 vs. 0.746; P 0.017). Conclusion: These results suggest that cPS, rather than cIMT may be a better marker to identify increased risk for recurrence of MACE among patients with secondary prevention setting. Carotid intima-media thickness (cIMT) determined by less-invasive ultrasonography has been shown to be a surrogate marker for coronary atherosclerosis 4) , and increased cIMT has been shown to be associated with future cardiovascular events 5-7). On the other hand, carotid plaque score (cPS) reflecting throughout the carotid artery plaque burden may be better marker. Our previous study has shown that the carotid plaque score (cPS), reflecting the cumulative atherosclerotic burden of the carotid artery, is a more useful parameter to predict the atherosclerotic severity of the coronary artery than cIMT in patients with familial hypercholesterolemia (FH) 8) .

IGFBP6 Is Downregulated in Unstable Carotid Atherosclerotic Plaques According to an Integrated Bioinformatics Analysis and Experimental Verification

“…Emboli from ruptured atherosclerotic plaques are the major causes of the occlusion of cerebral vessels. Stroke maybe preventable, but identifying the biomarkers of patients who are at risk of stroke and the possible therapeutic targets of atherosclerosis and unstable plaque is imperative for preventing cerebrovascular and cardiovascular adverse events 24 ) . To identify potential biomarkers, we analyzed the co-regulated DEGs in all the datasets, which included 40 human unstable and 34 stable carotid atherosclerotic plaques, from the GEO and EBI databases, using integrated bioinformatics methods.…”

Early identification of carotid vulnerable plaque in asymptomatic patients

“…The sum of plaque thickness is the carotid plaque score (CPS). Many previous studies [5,23,24]con rmed that CPS is an independent predictor of ASCCVD, and unstable plaque is the basis of the onset of ASCCVD, in other words, both high CPS and unstable plaques can easily lead to the onset of cardiovascular and cerebrovascular diseases. The CPS re ects the instability of plaques from the side.…”

The problem of cardiovascular risk stratification depending on the severity of carotid and femoral artery atherosclerosis

“…При исследовании японской когорты лиц с ранее диагностированным ССЗ атеросклеротического генеза (n=2035 в возрасте 14-95 лет) показатель суммарной высоты АСБ показал себя как ФР наступления конечной точки (смерть по любой причине, повторная госпитализация по поводу ССЗ). При этом значимые отличия в риске по сравнению с 1-м квинтилем суммарной высоты АСБ (0-2,6 мм) наблюдались при суммарной высоте АСБ, соответствующей 4-му (9,15-13,4 мм) и 5-му (13,41-33,8 мм) квинтилям -ОР=1,84; 95% ДИ 1,01-3,36 (р=0,047) и ОР=3,38; 95% ДИ 1,82-6,27 (р<0,001), соответственно [31].…”