Patients with Unstable Atherosclerosis Have More Echolucent Carotid Plaques Compared with Stable Atherosclerotic...

Area of Science:

• Vascular Ultrasound
• Cardiovascular Imaging
• Atherosclerosis Research

Background:

• Carotid plaque characteristics are crucial for assessing cardiovascular risk.
• Differentiating plaque features between stable and unstable atherosclerotic disease is clinically important.

Purpose of the Study:

• To compare carotid plaque size and echogenicity using 3-D ultrasound in patients with acute myocardial infarction versus chronic peripheral arterial disease.
• To evaluate the potential of 3-D ultrasound in identifying thromboembolic risk based on plaque characteristics.

Main Methods:

• A novel 3-D ultrasound system was employed.
• Seventy patients with acute myocardial infarction (aMI) and 69 patients with chronic peripheral arterial disease (cPAD) were analyzed.
• Carotid plaque volume, thickness, and gray-scale median (GSM) were measured and compared between groups.

Main Results:

• The cPAD group exhibited significantly larger plaque volumes (median: 70.24 mm³ vs. 55.41 mm³), thicker plaques (2.45 mm vs. 1.99 mm), and higher GSMs (mean: 71.75 vs. 60.99) compared to the aMI group.
• These differences in plaque thickness and volume persisted after adjusting for traditional risk factors.
• The difference in GSM remained significant after adjusting for plaque volume.

Conclusions:

• Patients with stable atherosclerotic disease (cPAD) present with larger and brighter carotid plaques compared to those with unstable atherosclerotic disease (aMI).
• 3-D ultrasound imaging can effectively differentiate these plaque characteristics.
• These findings suggest 3-D ultrasound may be a valuable tool for assessing thromboembolic risk in atherosclerotic patients.