The Presence of a Calcific Plaque in the Common Carotid Artery as a Predictor of Coronary Atherosclerosis

Abstract

Many contradictory reports have been published investigating the relationship between coronary artery disease (CAD) and the increased intima-media thickness (IMT) in the common carotid artery (CCA). However, only a limited number of studies evaluate the relationship between CAD and CCA disease as reflected by both the plaque morphology (fibrous and calcific plaques) and IMT. We have studied the associations between CAD and the wall morphology of CCA by B-mode ultrasound (US). One hundred and forty-four subjects, whose angiography was planned on the basis of suspected CAD, were included into the study. The patients were divided into 4 groups on the basis of B-mode US findings; Group I: normal, Group II: increased IMT (IMT >/= 0.8 mm and plaque absent), Group III: fibrous plaque, Group IV: calcific plaque. Coronary artery disease was diagnosed in 63 patients. A statistically significant correlation was found between CAD and CCA wall morphology (r =0.42, CI (95%) = 0.30-0.51, p<0.001). Positive predictive values were 45.0%, 48.4%, and 75.0% in patients with increased IMT, fibrous plaque, and calcific plaque, respectively. None of the women with normal CCA wall morphology had significant coronary artery lesion. With respect to the normal group, the risk for CAD increased by 4.3 fold with the existence of fibrous plaque (p=0.02) and by 9.9 fold with the existence of calcific plaque (p<0.001). It has been shown that the CCA wall morphology determined by B-mode US is correlated with CAD in patients with chest pain, and the presence of calcific plaque is a better predictor for CAD than that of fibrous plaque and increased IMT. Women with chest pain and normal CCA wall morphology may not need coronary angiography.

Can Carotid Plaque Histology Selectively Predict the Risk of an Acute Coronary Syndrome?

“…The survey included a fairly large number of patients (72), comparable to that of other similar studies, collected over about 4 years. Unlike most other studies, in which the common carotid artery was used 6) because it is more accessible for instrumental investigations, in our case the internal carotid artery was studied, as internal carotid atherosclerotic lesions were in a less advanced stage than common carotid lesions. The choice of using the internal carotid artery was also based on the better preservation of specimens, more appropriate for serial studies of different levels.…”

“…This result is in line with what has already been reported, namely that the echogenic grade of carotid atherosclerotic plaques (correlated with the calcium content) may reflect the total amount of calcium and the degree of atherosclerosis, including coronary artery atherosclerosis. 6,15,16) Moreover, the amount of calcium and the rapid progression of calcification at the coronary arteries level have been associated in previous works with a higher risk of cardiovascular events. [17][18][19][20][21] Therefore, carotid calcifications could reflect diffuse coronary artery disease.…”

“…1) Although the degree of stenosis remains the major risk factor for cardiovascular and cerebrovascular events, plaque morphology has recently emerged as an important contributory factor. [2][3][4][5][6][7][8] In fact, the presence of atherosclerotic unstable plaques is associated with a markedly increased risk of clinical complications. 9) Indeed, although the degree of carotid atherosclerotic stenosis is recognized as an important risk factor for stroke, it is well known that whereas many critical stenoses remain stable and never cause cerebrovascular events, others quickly lead to the onset of a serious, potentially fatal condition.…”

Retrospective Evaluation of 28 Patients Diagnosed as Acute Myo/Pericarditis: Properties of an Epidemia

“…Ağırlıklı olarak perikardın etkilendiği ve miyokardın da sürece dahil olduğu durumlar miyoperikardit veya perikarditik sendrom, miyokardit kliniğinin ön planda olduğu durumlar perimiyokardit olarak adlandırılır. [1][2][3][4][5][6][7][8][9][10] Miyokardit ve miyo/perikarditte klinik, morbidite ve mortalite etyolojiye ve altta yatan kalp hastalığına bağlı olarak değişir. Hastaların önemli bir kısmı asemptomatik olup, sadece elektrokardiyografi (EKG) anormallikleriyle tesadüfen tanı almaktadır.…”

Non-Ischemic Finding on Gated SPECT Myocardial Perfussion Imaging to Explain Symptoms: Case Report

“…[5][6][7] Pe ri car di al ef fu si on may accompany cer ta in car di ac and non car di ac di se a ses, ca u ses ha e modyna mic ab nor ma li ti es ran ging from un de tec tab le or mild, to li fe thre a te ning, and is de tec ted by ec hocar di og raphy which is the most com mon and sensi ti ve met hod. [8][9][10][11] CT and MRI may al so be used and may be mo re ac cu ra te. 12 The di ag no sis of pe ri cardi al ef fu si on using myo car di al per fu si on SPECT study is un com mon but, are as of re du ced tra cer upta ke aro und the he art re la ted to pe ri car di al ef fu sion which is unk nown be fo re the SPECT study, may be cri ti cal for pro per in ter pre ta ti on of the cardi ac scan or may le ad to im por tant di ag no ses.…”