| Objective：To investigate the relationship of carotid atherosclerosis and the clinical subsetsof Coronary Atherosclerotic Heart Disease (CAD), we evaluated the carotidatherosclerosis in patients from different clinical subtypes of CAD—Stable AnginaPectoris (SAP) and Acute Coronary Syndrome (ACS) with High-resolutionUltrasound. Simultaneously, we detected the concentration of serum inflammatorymarker—High Sensitive C-Reactive Protein (hs-CRP) to analyze the correlation withthe stability of carotid atherosclerosis plaque, and demonstrate the association withclinical subtypes of CAD. Identify the independent risk factors which could predictpresence of of ACS at Multiple Binary Logistic analysis.Methods：121hospitalized patients (85male,36female, the range of age:47～68years,mean age:56.58±6.16years) with typical chest pain who were suspected CADunderwent coronary angiography, carotid ultrasound and detected the concentration ofserum inflammatory marker—High Sensitive C-Reactive Protein (hs-CRP) inCardiovascular Medicine Division, the Second Affiliated Hospital of NanchangUniversity, from January2011to March2012. Based on the results of coronaryangiography,the patients were categorized into two groups：Non-CAD group andCAD group. In addition, on the basis of the diagnostic criteria for CAD clinicalsubtypes,the patients from CAD group were classified into two subgroups: SAPgroup and ACS group.Observational makers were mainly four categories:(1) assess severity ofcoronary artery disease: judge the number of vessels which was involved byatherosclerosis lesions.(2) Ultrasonic makers for carotid atherosclerosis:①measuredIntima Media Thickness②calculated total prevalence of plaques, incidence ofmultiple plaques and unstable plaques, and sum up Plaque Score③evaluatedstability of plaque.(3) detected the concentration of hs-CRP；(4) collected thebaseline characteristics of the study population: Body Mass Index, history of past illness (Hypertension, Diabetes Mellitus, ect), smoking history, and serum lipids(TC, TG, HDL-C and LDL-C).Results：1.Coronary angiography showed that: the severity of coronary artery in ACSgroup is severe than SAP group, mainly reflected in:(1)Generally,53.19%of patientshad a coronary disease localized in three vessels in ACS group, whereas42.86%showed the involvement of one vessel,33.33%two vessels in SAP group.(2)Therewas a statistical difference between two groups in proportion to the number ofinvolved vessels(P＜0.05).2. The thickest IMT was in ACS group, then SAP group, and Non-CAD group,[(0.88±0.14mm)vs(0.97±0.15mm)vs(1.06±0.17mm),P＜0.01].3. Total prevalence of plaques and Plaque Score were：ACS group＞SAP group＞Non-CAD group(P＜0.05). Prevalence of multiple plaques in ACS group washigher than SAP group(P＜0.01).4The concentration of hs-CRP went up from Non-CAD group, SAP group toACS group,[(1.26±0.40mg/L)vs(3.45±1.16mg/L)vs(6.02±2.05mg/L),P＜0.01].5. In the wake of an increase of hs-CRP concentration, prevalence of unstableplaque gradually raised among three groups: Non-CAD group, SAP group, and ACSgroup:[6.25%(2/32)]vs[26.19%(11/42)]vs[55.32%(26/42)],P＜0.05.6. The Multiple Binary Logistic Regression analysis identified unstable plaqueand hs-CRP＞3mg/L as the most important independent risk factors of ACS(unstableplaque-OR：3.234,95%CI：1.105～9.463,P=0.032；hs-CRP＞3mg/L-OR：3.902,95%CI：1.171～13.001,P=0.027).Conclusions：1. Patients from CAD subgroups had their own characteristics of carotidatherosclerosis. Carotid and coronary atherosclerotic agreed in the severity.2. Inflammatation which was represented with hs-CRP may influence carotidplaque stability.3. It was a possible link between atherosclerosis and inflammatation. Wheninflammation aggravated, the risk for acute coronary events would raised. 4. Carotid unstable plaque and hs-CRP were useful to predicting ACS. |
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