Risk Factors of Carotid Intraplaque Neovascularization Detected By Contrast-Enhanced Ultrasound

To evaluate the potential risk factors of intraplaque neovascularization (IPN) detected by contrast-enhanced ultrasound (CEUS).

From June 2018 to June 2022, patients who underwent CEUS in 2 centers were enrolled. Demographics, comorbidities, serum index, blood cell classification, lipids, the classification of IPN and follow-up information were collected and analyzed. The classification of IPN was identified on the basis of microbubbles within the plaque and graded as: grade 1=no appearance of bubbles within the plaque; grade 2=moderate appearance of bubbles within the plaque; and grade 3=extensive appearance of bubbles within the plaque. Univariate and multivariate logistic regression analysis were used to identify potential independent risk factors of IPN.

A total of 91 patients were enrolled and analyzed. The mean age was 66.3±9.45 (ranged: 35 to 92 y). The IPN were detected in 50 (54.9%) patients. Compared with patients without IPN, patients with that were more likely to have diabetes mellitus (DM) ( P <0.001), hyperlipidemia ( P =0.016), and higher serum hs-CRP level ( P <0.001). The level of LDL-C ≥100 mg/dL was detected in more patients with IPN ( P <0.001), and more patients with IPN had a history of alcohol drinking ( P =0.046) and coronary artery disease (CAD) ( P =0.08). Meanwhile, patients with IPN showed significantly higher neutrophil/lymphocyte ratio (NLR) (3.2±1.4 vs. 2.0±1.2, P <0.001), the plaque thickness was higher in patients with IPN compared with patients without that (2.5±1.0 vs. 1.8±1.0 mm, P =0.003). In the multivariate analysis, DM [odds ratio (OR): 0.042; 95% CI: 0.004-0.441; P =0.008], hs-CRP >2 mg/L (OR: 0.124; 95% CI: 0.016-0.978; P =0.048), and LDL-C ≥100 mg/dL (OR: 0.10; 95% CI: 0.001-0.153; P =0.001) were independent risk factors of IPN.

IPN was not rare in patients with carotid plaque, and CEUS was effective in detecting IPN in clinical practice. DM, hs-CRP >2 mg/L, and LDL-C ≥100 mg/dL were independent risk factors of IPN.