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Echolucent carotid plaques predict future coronary events in patients with coronary artery disease

Osamu Honda, MD^*, Seigo Sugiyama, MD, PhD^*,*, Kiyotaka Kugiyama, MD, PhD, Hironobu Fukushima, MD^*, Shinichi Nakamura, MD^*, Shunichi Koide, MD^*, Sunao Kojima, MD^*, Nobutaka Hirai, MD^*, Hiroaki Kawano, MD, PhD^*, Hirofumi Soejima, MD, PhD^*, Tomohiro Sakamoto, MD, PhD^*, Michihiro Yoshimura, MD, PhD^* and Hisao Ogawa, MD, PhD^*

^* Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
Second Department of Internal Medicine, Graduate School of Yamanashi University, Yamanashi, Japan

View larger version (78K): [in a new window]   Figure 1 Representative ultrasound images of atherosclerotic carotid plaques with low and high calibrated integrated backscatter (IBS) values. The red dotted line indicates region of interest in the plaque (intima-media complex), and the blue dotted line indicates region of interest in the adventitia using a manual outline definition mode. (Left) Low IBS plaque is identified by arrows. The calibrated IBS value and maximum intima-medial thickness (IMT) of this plaque are –17.6 dB and 2.1 mm, respectively. (Right) High IBS plaque is identified by arrowheads. The calibrated IBS value and maximum IMT of this plaque are –9.1 dB and 2.3 mm, respectively. CCA = common carotid artery; ICA = internal carotid artery.

View larger version (32K): [in a new window]   Figure 2 Comparison of calibrated integrated backscatter (IBS) values between patients with stable coronary artery disease (CAD) and patients with acute coronary syndrome (ACS). The dotted line indicates the cut-off level for echolucent plaque (–13.4 dB, which represents the 75th percentile of the distribution in patients with ACS). Box and whisker plot: lines within boxes represent median values; upper and lower lines of boxes represent 25th and 75th percentiles, respectively; and upper and lower bars outside of boxes represent 90th and 10th percentiles, respectively.

View larger version (19K): [in a new window]   Figure 3 Kaplan-Meier curves comparing the probability of developing a coronary event during a follow-up period of 30 months in 215 patients with stable coronary artery disease, grouped according to the presence or absence of echolucent carotid plaques. The solid line indicates patients with echolucent carotid plaques (n = 112), and the dotted line indicates patients without echolucent carotid plaques (n = 103).