Use of Carotid Plaque Neovascularization at Contrast-enhanced US to Predict Coronary Events in Patients with Coronary Artery Disease

Abstract Background This study examined whether combined ultrasound assessment of plaque size and intraplaque neovascularization in the carotid artery had an additive effect for predicting coronary events in patients with coronary artery disease (CAD). Methods CEUS of the carotid plaques using perfluorobutane microbubbles as an ultrasound contrast agent and Ultrasound assessment of carotid plaque maximum intima-media thickness (max IMT) was performed in 221 patients with CAD and carotid plaque IMT over 2mm. Intraplaque neovascularization was identified on the basis of microbubbles within the carotid plaque and graded as: G0, not visible; G1, moderate; or G2, extensive microbubbles. All study patients were followed up prospectively for 5 years or until the occurrence of a cardio-vascular event. Result During the follow-up period, 53 coronary events (9 cardiac deaths, 44 ACSs) were occurred. Multivariate Cox hazards analysis showed that max IMT and CEUS grade were independent predictors of coronary events (HR 1.59, 95% CI 1.15–2.21 p=0.005 and HR 2.26, 95% CI 1.52–3.36 p<0.01) that were independent of age, gender, diabetes and LDL-C levels. C-statistics for logistic models predicting future coronary events using conventional risk factors with or without the addition of max IMT alone, CEUS grade alone, and both max IMT and CEUS grade in combination (area under the ROC curve; 0.55,0.61,0.69 and 0.71, respectively). The addition of the plaque enhanced intensity to traditional risk factors resulted in net reclassification improvement (NRI) and integrated discrimination improvement (IDI) (NRI 0.42, p=0.002; and IDI 0.04, p=0.002). CEUS grade and ROC curve for 3models Conclusions Combined ultrasound assessment of carotid plaque IMT and intraplaque neovascularization has an additive value on the prediction of coronary events.

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Carotid intraplaque neovascularization predicts coronary artery disease and cardiovascular events

European Heart Journal - Cardiovascular Imaging ◽

10.1093/ehjci/jez070 ◽

2019 ◽

Vol 20 (11) ◽

pp. 1239-1247 ◽

Cited By ~ 9

Author(s):

Laura E Mantella ◽

Kayla N Colledanchise ◽

Marie-France Hétu ◽

Steven B Feinstein ◽

Joseph Abunassar ◽

...

Keyword(s):

Coronary Artery Disease ◽

Coronary Artery ◽

Carotid Plaque ◽

Significant Coronary Artery Disease ◽

High Sensitivity ◽

Coronary Plaque ◽

Plaque Vulnerability ◽

Kaplan Meier ◽

Contrast Enhanced ◽

Artery Disease

Abstract Aims It is thought that the majority of cardiovascular (CV) events are caused by vulnerable plaque. Such lesions are rupture prone, in part due to neovascularization. It is postulated that plaque vulnerability may be a systemic process and that vulnerable lesions may co-exist at multiple sites in the vascular bed. This study sought to examine whether carotid plaque vulnerability, characterized by contrast-enhanced ultrasound (CEUS)-assessed intraplaque neovascularization (IPN), was associated with significant coronary artery disease (CAD) and future CV events. Methods and results We investigated carotid IPN using carotid CEUS in 459 consecutive stable patients referred for coronary angiography. IPN was graded based on the presence and location of microbubbles within each plaque (0, not visible; 1, peri-adventitial; and 2, plaque core). The grades of each plaque were averaged to obtain an overall score per patient. Coronary plaque severity and complexity was also determined angiographically. Patients were followed for 30 days following their angiogram. This study found that a higher CEUS-assessed carotid IPN score was associated with significant CAD (≥50% stenosis) (1.8 ± 0.4 vs. 0.5 ± 0.6, P < 0.0001) and greater complexity of coronary lesions (1.7 ± 0.5 vs. 1.3 ± 0.8, P < 0.0001). Furthermore, an IPN score ≥1.25 could predict significant CAD with a high sensitivity (92%) and specificity (89%). The Kaplan–Meier analysis demonstrated a significantly higher proportion of participants having CV events with an IPN score ≥1.25 (P = 0.004). Conclusion Carotid plaque neovascularization was found to be predictive of significant and complex CAD and future CV events. CEUS-assessed carotid IPN is a clinically useful tool for CV risk stratification in high-risk cardiac patients.

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Plaque surface irregularity and calcification length within carotid plaque predict secondary events in patients with coronary artery disease

Atherosclerosis ◽

10.1016/j.atherosclerosis.2016.11.008 ◽

2017 ◽

Vol 256 ◽

pp. 29-34 ◽

Cited By ~ 9

Author(s):

Shinichi Nonin ◽

Shinichi Iwata ◽

Kenichi Sugioka ◽

Suwako Fujita ◽

Naoki Norioka ◽

...

Keyword(s):

Coronary Artery Disease ◽

Coronary Artery ◽

Carotid Plaque ◽

Surface Irregularity ◽

Artery Disease

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High-sensitivity C-reactive protein in the prediction of coronary events in patients with premature coronary artery disease

American Heart Journal ◽

10.1067/mhj.2002.124353 ◽

2002 ◽

Vol 144 (3) ◽

pp. 449-455 ◽

Cited By ~ 43

Author(s):

Walter S. Speidl ◽

Senta Graf ◽

Stefan Hornykewycz ◽

Mariam Nikfardjam ◽

Alexander Niessner ◽

...

Keyword(s):

Coronary Artery Disease ◽

Coronary Artery ◽

High Sensitivity ◽

Premature Coronary Artery Disease ◽

C Reactive Protein ◽

Reactive Protein ◽

Coronary Events ◽

Artery Disease

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Exercise-induced changes in miRNA expression in coronary artery disease

Clinical Chemistry and Laboratory Medicine (CCLM) ◽

10.1515/cclm-2021-0164 ◽

2021 ◽

Vol 0 (0) ◽

Author(s):

Barbara Mayr ◽

Edith E. Müller ◽

Christine Schäfer ◽

Silke Droese ◽

Martin Schönfelder ◽

...

Keyword(s):

Coronary Artery Disease ◽

Coronary Artery ◽

Mirna Expression ◽

Long Term Effects ◽

Rna Molecules ◽

Coronary Events ◽

Artery Disease ◽

And Gender ◽

Exercise Induced ◽

Mirnas Expression

Abstract Objectives Micro ribonucleic acids (miRNAs) are small non-coding RNA molecules that control gene expression by translational inhibition. Exercise has been shown to affect several miRNAs’ expression in healthy subjects, but this has not yet been studied in patients with coronary artery disease (CAD). Since exercise training confers beneficial long-term effects and may also trigger acute coronary events, it is of utmost interest to be able to identify those who are risk for untoward effects. Therefore, we set out to assess miRNA expression in response to maximal ergospirometry in patients with CAD. Methods Total RNA was extracted from blood drawn immediately before and 5 min after maximal cycle-ergospirometry (10 male and 10 female CAD patients). A qRT-PCR was performed for 187 target miRNAs associated with endothelial function/dysfunction, cardiovascular disease, myocardial infarction, and sudden cardiac death. Results In response to a maximal ergospirometry, 33 miRNAs significantly changed their expression levels. Of these miRNAs 16 were significantly differently expressed between gender. Using multi-variance analysis, nine miRNAs (let-7e-5p; miR-1; miR-19b-1-5p; miR-103a-3p; miR-148b-3p; miR-181b-5p; miR-188-5p; miR-423-5p; miR-874-3p) showed significantly different responses to maximal ergospirometry between genders. Conclusions We report for the first time that in patients with CAD, miRNA expression is amenable to maximal ergospirometry and that the extent of changes differs between genders. Affected by exercise and gender were miRNAs that are associated, among others, with pathways for glucose metabolism, oxidative stress, and angiogenesis. Future studies should assess whether disease-specific miRNA expression in response to maximal exercise might serve as a marker for patient outcome.

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Leisure sport activity as a trigger for acute coronary events in men without known coronary artery disease

Herz ◽

10.1007/s00059-011-3518-4 ◽

2011 ◽

Vol 36 (8) ◽

pp. 728-729

Author(s):

M.R. Ege ◽

A. Cuneo

Keyword(s):

Coronary Artery Disease ◽

Coronary Artery ◽

Sport Activity ◽

Coronary Events ◽

Artery Disease

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