Associations between Carotid Artery Plaque Score, Carotid Hemodynamics and Coronary Heart Disease

Area of Science:

• Cardiovascular Imaging
• Vascular Ultrasound
• Predictive Biomarkers

Background:

• Carotid artery plaque score (PS) is a known predictor of Coronary Heart Disease (CHD).
• Carotid hemodynamics, such as blood flow and velocity, may offer additional predictive information.
• Integrating plaque burden and flow dynamics could refine CHD risk assessment.

Purpose of the Study:

• To evaluate the combined predictive value of carotid artery plaque score (PS) and carotid hemodynamics for Coronary Heart Disease (CHD).
• To determine if combining PS with specific hemodynamic parameters improves CHD prediction compared to PS alone.
• To assess the incremental predictive value of patient demographics, like age, when combined with PS and hemodynamics.

Main Methods:

• Retrospective analysis of 476 patients undergoing carotid ultrasonography and coronary angiography.
• Measurement of carotid intima-media thickness, carotid plaque score (PS), and carotid blood flow parameters including peak systolic velocity (PSA).
• Receiver operating characteristic (ROC) curve analysis to compare predictive models for CHD presence.

Main Results:

• Significant associations found between age, sex, carotid intima-media thickness, PS, and PSA of the right internal carotid artery (RICA) with CHD presence.
• A combined model incorporating PS, carotid hemodynamics (PSA of RICA), and age demonstrated superior predictive performance (higher area under the curve) compared to models using fewer factors.
• Age, PS, and PSA of RICA were identified as significant independent predictors of CHD.

Conclusions:

• The combined model of carotid artery plaque score (PS) and peak systolic velocity (PSA) of the right internal carotid artery (RICA) offers enhanced predictive value for Coronary Heart Disease (CHD) compared to PS alone.
• Incorporating patient age into the PS and PSA of RICA model further improves its predictive accuracy for CHD.
• This integrated approach highlights the potential of combining imaging markers and hemodynamic data for more precise CHD risk stratification.