Value Of Carotid Ultrasound In Predicting The Risk Of Acute Coronary Events

Objective: By comparing the Intima-media thickness (IMT) of the common carotid and the number and ultrasonic manifestations of carotid plaque between the acute myocardial infarction patients (AMI group) and stable angina pectoris patients (control group), to research the stability of carotid plaque, and then further explore the carotid ultrasound in predicting the risk of acute coronary events by combining with the serum lipid levels and Gensini score.Method: Retrospective analysis of the ultrasonic manifestations of carotid plaque of 82 cases with acute myocardial infarction and 83 cases with stable angina pectoris, they all had been receiving percutaneous coronary intervention and carotid ultrasound examination when hospitalized at department of cardiology in Peking University Shenzhen hospital from June 2007 to December 2009. IMT of the bilateral common carotid artery, bilateral carotid plaque number, plaque surface and plaque echogenicity of the carotid were investigated. Bilateral carotid plaque occurrence was divided into single or multiple plaque. Plaque surface was classified as regular or irregular . Plaque echogenicity was assessed as echolucent, predominantly echolucent, predominantly echogenic, or echogenic. Gensini score of the coronary angiography, serum levels of fasting total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) were recorded.Result: Both of the LIMT and RIMT of common carotid in AMI group were thicken,and thicker than in control group(P <0.05), both of the LIMT and RIMT of common carotid in control group without thicken. The occurrence of bilateral carotid plaque in AMI group was no significant difference compared with the control group (P >0.05). Plaques in AMI group were echolucent or predominantly echolucent, whereas those of the control group were predominantly echogenic or echogenic plaques(P <0.05). Irregular plaques were frequently found in AMI patients, while regular plaques were frequently detected in control group(P <0.05). Gensini score of the coronary angiography were significantly higher in AMI group than in control group(P <0.01). Serum levels of fasting TC and LDL-C were higher in AMI patients than that in control group(P <0.05).Conclusions:Carotid ultrasound can accurate assess the IMT of the common carotid and morphology of the carotid plaque. In ultrasound manifestations of AMI group patients, the IMT of common carotids were thicken,and most carotid plaques were vulnerable. It prompted that carotid ultrasound as an effective, non-invasive detection may help predicting the risk of acute coronary events. Carotid ultrasound combines the serum lipid levels and Gensini score could be more precise to diagnosis.