Key result
ACS in elderly patients is associated with a ~4-fold higher frequency of unstable atherosclerotic plaques.
Why the study?
Features of atherosclerosis and signs of plaque instability in the carotid arteries by ultrasound duplex scanning among elderly patients with myocardial infarction or unstable angina needed to be studied.
Are signs of carotid atherosclerotic plaque instability more common in elderly patients with acute coronary syndrome compared to those without?
Observational (n=165)
Are signs of carotid atherosclerotic plaque instability more common in elderly patients with acute coronary syndrome compared to those without?
Elderly patients with acute coronary syndrome have a significantly higher prevalence of unstable carotid atherosclerotic plaques compared to those without ACS.
Association between ACS and unstable carotid plaques in elderly is hypothesis-generating; should not yet change practice or guide screening.
Aim. To study features of atherosclerosis and signs of instability of atherosclerotic plaque in the carotid arteries by ultrasound duplex scanning of elderly patients with myocardial infarction or unstable angina. Material and methods. The study included 87 patients with ACS and 78 patients without ACS aged 75 and over. Ultrasound duplex scanning of carotid arteries was carried out with Philips EPIQ5 ultrasound system and L12–3 linear array transducer on the 2–5 day from the moment of hospitalization. Quantitative and structural indicators of atherosclerosis of the carotid arteries were assessed . Results. The frequency of detection of atherosclerotic plaques in carotid arteries in elderly patients with ACS was signifi cantly higher than in patients without ACS – 78 and 67 % (p=0,179). Patients with ACS compared with the group without ACS more often had signs of instability of atherosclerotic plaque: heterogenous structure – 28,8 and 19,3 % (p=0,017), hypoechogenic component – 39,2 and 9,9 % (p<0,001), irregular surface – 46,3 and 8,2 % (р<0,001), local calcifi cation –14,2 and 7 % (р=0,001). At the same time, ulcerated atherosclerotic plaques were found only in the group of patients with ACS – 1,9 % (р=0,412). The incidence of atherosclerotic plaques in carotid arteries among men was higher in the group with ACS compared to patients without ACS – 36,2 and 23,4 % (р=0,003); among women the data are higher in the group without ACS compared with the group of patients with ACS – 76,6 and 63,8 % (р=0,003). Conclusion. Atherosclerotic plaques in carotid arteries among elderly patients are more common in the group of patients with ACS. As the same time, among this group atherosclerotic plaques with signs of instability were significantly more common found.
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Sagatelyan et al. (2022) conducted an observational in Acute Coronary Syndrome (n=165). Acute Coronary Syndrome (Exposure) vs. Patients without ACS was evaluated on Frequency of detection of atherosclerotic plaques in carotid arteries (p=0.179). Elderly patients with ACS had a significantly higher frequency of atherosclerotic plaques with signs of instability, such as a hypoechogenic component (39.2% vs 9.9%, p<0.001), compared to those without ACS.
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