Carotid artery remodeling in Acute Coronary Syndrome and Chronic Stable Angina

Acute adaptive vascular remodeling occurs in active and unstable inflammatory plaques. It has been suggested that the adaptive coronary vascular remodeling in patients with Acute Coronary Syndrome (ACS) and Chronic Stable Angina (CSA) may be systemic and may show similar vascular remodeling in the carotid arteries. A total of 135 patients who are undergoing coronary angiogram and Percutaneous Coronary Interventions (PCI) were included. High resolution B-Mode Ultrasonography was performed for Carotid Arteries in both ACS (N = 75) and Chronic Stable Angina (N = 60) (CSA) group patients. Positive remodeling was arbitrarily defined as an IMT max >1 mm and IAD >8 mm and negative remodeling as an IMT max >1 mm and IAD <7 mm. Other values were defined as “no remodeling”. The Ultrasonographic measurements of the Common Carotid Arteries of ACS and CSA group there was a statistically difference between IAD (p < 0.00) and LD (p < 0.02). Whereas there was no statistically significant difference of distribution of frequency of soft plaque, hard plaque and mixed plaque in both groups. On Univariate analysis there was no statistically significant difference in positive carotid remodeling between the two groups (p = 0.75). By regression analysis in ACS and CSA group there was a significant positive correlation between the mean Carotid IMT and the interadventitial diameter (IAD) (r = 0.21, p < 0.035, r = 0, p = 0.36), and the mean carotid IMT and the ratio of the interadventitial diameter to the luminal diameter (IAD/LD) (r = 0.24, p < 0.02, r = 0.43, p = 0.000) respectively. The common carotid arterial remodeling in ACS patients was not different from that of CSA patients suggesting the arterial remodeling due to coronary inflammatory plaques appears to take place locally rather than systemically.