Carotid Intraplaque neovascularization correlates with coronary atherosclerotic plaque, vulnerability detected by intracoronary optical coherence tomography

OBJECTIVE: The aim of the present study was to evaluate the relationships between carotid intraplaque neovascularization (IPN) measured by contrast-enhanced ultrasound (CEUS) and culprit coronary artery plaque vulnerability evaluated by optical coherence tomography (OCT) in patients with coronary artery disease (CAD). METHODS: A total of 131 participants were divided into the vulnerable coronary plaque (VP) and non-vulnerable coronary plaque (non-VP) group. The plaque vulnerability was determined by OCT. In CEUS, carotid IPN was assessed by semi-quantitative and quantitative evaluation, the carotid plaque with the maximum plaque height (MPH) was used for analysis. Logistic regression was used to assess risk factors of coronary plaque vulnerability. RESULTS: Patients were classified into VP group (N = 92) and non-VP group (N = 39) according to the features of plaque vulnerability in OCT. In CEUS, the IPN score between the two groups was significant different(P = 0.003). Quantitative analysis of CEUS showed that carotid plaque peak intensity (PI) (28.65 ± 4.21 dB vs. 22.51 ± 3.13 dB, P < 0.001), enhancement intensity (EI) (24.91 ± 4.05 dB vs. 19.20 ± 3.17 dB, P < 0.001), and enhanced intensity ratio of plaque/lumen (P/L ratio) (0.32 ± 0.08 vs. 0.24 ± 0.09, P < 0.001) were higher in VP group than non-VP group. Multivariate logistic regression analyses demonstrated that EI (OR = 1.473, 95 %CI: (1.039-2.086)) and P/L ratio (OR = 1.109, 95 %CI: (1.024-1.2)) were strongly associated with coronary plaque vulnerability. CONCLUSION: The CEUS parameters of carotid plaques is correlated with coronary plaque vulnerability. As a non-invasive examination, CEUS may provide valuable information to advance risk stratification and clinical treatment in patients with CAD.