Abstract 14812: Echolucency of the Carotid Artery is Associated With Short-term Plaque Progression and Positive Remodeling in Culprit Coronary Artery in AMI Survivors

• Published in: Circulation (New York, N.Y.) N.Y.), 2016-11, Vol.134 (Suppl_1 Suppl 1), p.A14812-A14812
• Main Authors: Futamata, Mika, Matsuoka, Satoshi, Shimizu, Takuya, Yoshizaki, Toru, Obata, Jun-ei, Nakamura, Takamitsu, Fujioka, Daisuke, Kugiyama, Kiyotaka
• Format: Article
• Language: English
• ISSN: 0009-7322; 1524-4539

BackgroundRapid 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.MethodsPlaque 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 (1 test) and 6 months later (2 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 (1 test) and 6 months later (2 test). Lower IBS reflects echolucent and lipid-rich laque.ResultsMean changes of coronary PV and EEM area over 6 months were -2.78 ± 1.44 mm/cm and -0.45 ± 0.32 mm/slice, respectively. PV progression and positive remodeling (an increase in mean EEM area at 2 test than that at 1test) 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.ConclusionsSerial 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.