The Study On The Relationship Between Carotid Plaque Vulnerability And The Severity Of Coronary Artery Disease

ObjectiveStudying the relationship between the risk level score of carotid atherosclerotic plaque and the severity of coronary artery disease in ultrasound to explore the clinical value of carotid plaque vulnerability in predicting coronary artery disease and to achieve the purpose of “Joint prevention.treatment and rehabilitation of cardiovascular disease ”.MethodsFrom September 2014— November 2016 year in Beijing An Zhen Hospital affiliated to Capital Medical University Department of Cardiology,cardiac surgery ward,the patients who are examined with selective coronary angiography and carotid ultrasonography were divided into three groups:mild,moderate and severe coronary artery stenosis;according to the lesion in the left anterior descending artery,left circumflex and right coronary artery were divided into single vessel disease group,double vessel disease group and three vessel disease group.The application of conventional ultrasound detection of carotid atherosclerotic plaques in patients with echo type,shape and size and the degree of carotid artery stenosis;Superb Micro vascular Imaging combined with contrast-enhanced ultrasound detect carotid atherosclerotic plaques.according to the nature of carotid atherosclerotic plaques,the patients were divided into stable plaque group and vulnerable plaque group and comparing the Gensini score between the two groupse which can assess coronary artery stenosis.Evaluate carotid atherosclerosis stroke risk level for each patient and compare coronary artery stenosis whether exist difference betweencarotid atherosclerosis stroke risk level group.Results1、Carotid artery plaque detection: 117 cases of coronary heart disease are examined by carotid artery ultrasound.There were 45 vulnerable carotid plaques,including plaque with neovascularization 40,plaque with juxtaluminal black hypoechoic area 5 plaques,ulcer plaque 8,jellyfish plaque 3,fibrous cap rupture plaques1,plaque surface with small thrombosis 1.The detection rate of vulnerable plaques in the mild,moderate and severe coronary artery stenosis group was21.05%%,26.92%,and 47.22%,respectively.The detection rate of vulnerable plaque in single,double and three branches of coronary artery was 25.71%,28.57%,and 55.31%,respectively.2 、 The Gensini score of coronary artery stenosis of vulnerable carotid plaques group was significantly higher than that of the stable carotid plaque(P < 0.05).3、There was no significant difference in the severity of coronary artery stenosis between the different carotid stenosis group.4、Ultrasound evaluation the stroke risk level of carotid atherosclerotic plaque,and coronary Gensini score of carotid plaque high risk group is significantly higher than the low and moderate risk group,with statistical significance(P < 0.05).ConclusionThe severity of coronary artery lesions count more weight,the more the carotid artery plaque occurrence rate is high;ultrasound assessment of carotid atherosclerotic plaque stroke risk level is higher,more severe coronary artery disease.Carotid artery atherosclerosis and plaque level risk of ischemic stroke can speculate the severity of coronary artery stenosis in a certain extent,indicates that the occurrence and development of acute coronary syndrome increased risk.