Treatment with betablockers is associated with higher grey-scale median in carotid plaques
Giuseppe Asciutto1, Nuno V Dias, Ana Persson
1Vascular Center Malmö-Lund, Skåne University Hospital, Ruth Lundskogs gata 10, 1st floor, Malmö 205 02, Sweden. giuseppe.asciutto@med.lu.se.
Insights
Beta-blocker treatment is associated with higher carotid plaque echogenicity, indicated by increased grey-scale median (GSM). This suggests a potential link between beta-blockers and plaque stability, warranting further investigation in larger studies.
Area of Science:
- Cardiovascular Medicine
- Vascular Ultrasound
- Pharmacology
Background:
- Echolucent carotid plaques (low ultrasound grey-scale median - GSM) correlate with increased stroke and myocardial infarction risk.
- Beta-blockers may possess anti-atherosclerotic properties.
- This study investigates the association between carotid plaque GSM and beta-blocker use.
Purpose of the Study:
- To determine if carotid plaque grey-scale median (GSM) is associated with beta-blocker treatment.
- To explore the relationship between plaque echogenicity and medication use in patients undergoing carotid endarterectomy.
Main Methods:
- Carotid plaque GSM was measured in 350 patients undergoing carotid endarterectomy (CEA).
- Patients were stratified into two groups: those on long-term oral beta-blockers and those not.
- Demographic and clinical data, including comorbidities and lifestyle factors, were collected.
Main Results:
- Patients on beta-blockers exhibited significantly higher plaque GSM (37.79 ± 25 vs 32.61 ± 23.50, P = .036).
- Echogenic plaques (GSM > 30) were more prevalent in the beta-blocker group, even after adjusting for multiple confounding factors (P = .024).
- While groups were similar in neurological symptoms, beta-blocker users had higher rates of hypertension and diabetes.
Conclusions:
- Beta-blocker treatment is associated with increased carotid plaque echogenicity (higher GSM).
- Standardized ultrasound techniques are valuable for assessing anti-atherosclerotic medication effects.
- Further prospective studies with larger cohorts are needed to confirm these findings.
Background:
The presence of echolucent carotid plaques as defined by low ultrasound grey-scale median (GSM) is associated with a higher risk of stroke and myocardial infarction. Betablockers have shown possible anti-atherosclerotic effects. The aim of the present study was to determine if there is an association between carotid plaque GSM and treatment with betablockers.
Methods:
The GSM of the carotid plaques of 350 patients who underwent carotid endarterectomy (CEA) for asymptomatic (n = 113) or symptomatic (n = 237) carotid disease was measured. Patients were divided in two groups based on the absence/presence of an on-going long-term (i.e. at least 6 months) oral treatment with betablockers at the time of CEA.
Results:
The prevalence and type of preoperative neurological symptoms were similar in the two groups. Patients with betablockers had more frequently arterial hypertension (P < .0001), diabetes (P = .035) and a higher BMI (P = .0004), while patients without betablockers were most frequently smokers (P = .017). Patients with betablockers revealed to have higher GSM (37.79 ± 25 vs 32.61 ± 23.50 P = .036). Echogenic plaques (i.e. with GSM > 30) showed to be more frequent in patients with betablockers also after correction for age, gender, the occurrence of preoperative symptoms, diabetes, hypertension, smoking and statins use (P = .024).
Conclusions:
These results suggest the use of standardized ultrasound techniques as an important tool in evaluating the effect of anti-atherosclerotic medications and underline the need of.further prospective randomized studies on larger patient cohorts in order to confirm these results.
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