Comparative analysis of plaque morphology in coronary and carotid arteries with multidetector computed tomography
Mohammed Tayyem1, Ozgur Cakir1, Burak Acar2
1Department of Radiology, Medical Faculty, Kocaeli University, Kocaeli, Turkey.
Insights
Atherosclerosis differs between coronary and carotid arteries. While calcified plaque is systemic, high-risk soft plaque is local, meaning carotid scans may not predict coronary events.
Area of Science:
- Cardiovascular Imaging
- Vascular Biology
- Atherosclerosis Research
Background:
- Atherosclerosis is a systemic disease, yet plaque characteristics vary between coronary and carotid arteries.
- Understanding these differences is crucial for accurate risk assessment.
Purpose of the Study:
- To compare morphological and compositional plaque characteristics in coronary versus carotid arteries.
- To investigate the relationship between plaque burden and composition in both vascular beds within the same patients.
Main Methods:
- Eighty-eight patients underwent both coronary and carotid multidetector computed tomography angiography (MDCTA).
- Quantitative analysis of plaque volume, composition (soft, mixed, calcified), and plaque burden was performed.
Main Results:
- Coronary arteries showed higher plaque burden and soft plaque proportion compared to carotids.
- Carotid arteries had greater total plaque volume and calcified plaque proportion.
- Strong correlation for calcified plaque volume (r=0.651), but no significant correlation for soft plaque volume (r=-0.037) between the two beds.
Conclusions:
- Coronary and carotid atherosclerosis exhibit distinct features.
- Calcified plaque accumulation reflects systemic disease, while soft plaque is influenced by local factors.
- Carotid artery assessment may underestimate the risk of acute coronary events due to soft plaque presence.
Introduction:
Atherosclerosis is a systemic disease, but the relationship between plaque characteristics in the coronary and carotid arteries remains unclear.
Aim:
This study aimed to compare the morphological and compositional characteristics of atherosclerotic plaques in coronary and carotid arteries using multidetector computed tomography angiography (MDCTA) in the same patient group.
Material And Methods:
Eighty-eight patients who underwent both coronary and carotid MDCTA were analyzed. Plaque volume, composition (soft, mixed, calcified), and plaque burden were quantitatively measured in both vascular beds.
Results:
Plaque burden (63.7% vs. 36.9%) and the proportion of soft plaque (23.5% vs. 7.2%) were significantly higher in the coronary arteries compared to the carotid arteries (p < 0.001 for both). Conversely, the total plaque volume and the proportion of calcified plaque were higher in the carotid arteries. While a strong positive correlation was found between the calcified plaque volumes in both vascular beds (r = 0.651, p < 0.001), importantly, no significant relationship was observed between the soft plaque volumes, which are associated with acute events (r = -0.037, p = 0.735).
Conclusions:
Atherosclerosis exhibits different characteristics in the coronary and carotid arteries. While the accumulation of stable, calcified plaque reflects a systemic process, the formation of high-risk soft plaques appears to be more influenced by local factors. Therefore, although non-invasive assessment of the carotid arteries provides valuable information about the overall calcified atherosclerotic burden, it may be insufficient for predicting the presence of soft plaques in the coronary arteries and the associated risk of acute events.
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