This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Web of Science (1) Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Brevetti, G. Articles by Chiariello, M. Search for Related Content PubMed PubMed Citation Articles by Brevetti, G. Articles by Chiariello, M. Pubmed/NCBI databases Medline Plus Health Information Coronary Artery Disease Peripheral Arterial Disease Social Bookmarking                         What's this?

Prevalence of hypoechoic carotid plaques in coronary artery disease: relationship with coexistent peripheral arterial disease and leukocyte number

Department of Clinical Medicine and Cardiovascular and Immunological Sciences, University of Naples ‘Federico II’, Naples, Italy brevetti{at}unina.it

Giusy Sirico

Department of Clinical Medicine and Cardiovascular and Immunological Sciences, University of Naples ‘Federico II’, Naples, Italy

Giuseppe Giugliano

Department of Clinical Medicine and Cardiovascular and Immunological Sciences, University of Naples ‘Federico II’, Naples, Italy

Simona Lanero

Department of Clinical Medicine and Cardiovascular and Immunological Sciences, University of Naples ‘Federico II’, Naples, Italy

Julieta Isabel De Maio

Department of Clinical Medicine and Cardiovascular and Immunological Sciences, University of Naples ‘Federico II’, Naples, Italy

Rossella Luciano

Department of Clinical Medicine and Cardiovascular and Immunological Sciences, University of Naples ‘Federico II’, Naples, Italy

Eugenio Laurenzano

Department of Clinical Medicine and Cardiovascular and Immunological Sciences, University of Naples ‘Federico II’, Naples, Italy

Massimo Chiariello

Department of Clinical Medicine and Cardiovascular and Immunological Sciences, University of Naples ‘Federico II’, Naples, Italy

Abstract

In coronary artery disease (CAD), a concomitant peripheral arterial disease (PAD) entails a more severe coronary atherosclerosis. We hypothesized that the severity of carotid artery disease is greater in CAD+PAD than in CAD alone. In 90 CAD and 79 CAD+PAD patients, carotid plaque echolucency was measured by gray-scale median (GSM), and the degree of carotid stenosis by routine Doppler criteria. Plaques were absent in 20 (22.2%) CAD and 8 (10.1%) CAD+PAD patients (p = 0.035), while the prevalence of carotid stenosis 50% was 16.7% and 25.3%, respectively (p = 0.166). The GSM score was 45.1 [21.7–67.7] in CAD+PAD vs 60.1 [44.9–83.1] in CAD alone (p < 0.001). Consistently, hypoechoic plaques (GSM < 25th percentile) were more common in CAD+PAD than in CAD patients (38.0% vs 11.4%, p < 0.001). On multivariate analysis, CAD+PAD was the only variable significantly associated with hypoechoic plaques (OR = 4.16, 95% CI 1.68–10.28). However, when the leukocyte count was added to the model, it showed the strongest association with hypoechoic plaques (OR = 6.70, 95% CI 2.13–21.10). In conclusion, compared with CAD alone patients, those with concomitant PAD showed a greater prevalence of plaques with characteristics of instability. Thus, our data suggest that in CAD+PAD, evaluation of carotid plaque echogenicity could contribute to improve clinical decision-making and differentiate treatments for individual patients.

Key Words: carotid artery disease • coronary artery disease • hypoechoic carotid plaques • inflammation • peripheral arterial disease

Vascular Medicine, Vol. 14, No. 1, 13-19 (2009)
DOI: 10.1177/1358863X08097066


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?