Department of Radiology, The Military General Hospital of Beijing of PLA, China.
Am J Med Sci. 2011 Dec;342(6):480-5. doi: 10.1097/MAJ.0b013e31821caa88.
Studies have shown that atherosclerosis in coronary arteries is closely related to that in carotid arteries, but there are few investigations on the correlation between unstable plaques in these 2 vascular beds. The authors aim to investigate the correlation between coronary plaque phenotype and carotid plaque composition.
Patients (n = 123) with suspected coronary artery disease underwent computed tomography angiography of coronary arteries. Magnetic resonance imaging of bilateral carotid arteries was performed within 2 weeks after computed tomography angiography. The plaque type in each coronary segment was analyzed. Coronary plaques were classified into 3 types: noncalcified, calcified and mixed. The total number of each plaque type was scored. Carotid plaque with calcification, lipid-rich necrotic core (LRNC) or intraplaque hemorrhage (IPH) in either carotid artery was defined as positive. Logistic regression analysis was used to determine the correlation between coronary plaque phenotype and carotid plaque composition. The area under the receiver-operating characteristic curve (AUC) was calculated.
There was a significant correlation between the mixed coronary plaque score and carotid IPH (odds ratio = 1.50, P < 0.05). The scores for all 3 types of the coronary plaque were significantly correlated with carotid LRNC and calcification. The mixed coronary plaque score had the highest value in predicting carotid IPH (AUC = 0.74). The calcified coronary plaque score showed the highest value in predicting carotid LRNC (AUC = 0.75) and calcification (AUC = 0.75).
There was significant correlation between coronary plaque phenotype and carotid plaque composition. A mixed coronary plaque may be suggestive of a high-risk carotid plaque.
研究表明，冠状动脉中的动脉粥样硬化与颈动脉中的动脉粥样硬化密切相关，但关于这两个血管床中不稳定斑块之间的相关性研究较少。作者旨在探讨冠状动脉斑块表型与颈动脉斑块成分之间的相关性。
疑似冠心病患者 123 例，行冠状动脉计算机断层血管造影术。冠状动脉计算机断层血管造影术后 2 周内行双侧颈动脉磁共振成像。分析每个冠状动脉节段的斑块类型。冠状动脉斑块分为 3 种类型：非钙化、钙化和混合。每种斑块类型的总数进行评分。双侧颈动脉中任何一侧有钙化、富含脂质的坏死核心（LRNC）或斑块内出血（IPH）的颈动脉斑块为阳性。采用 Logistic 回归分析确定冠状动脉斑块表型与颈动脉斑块成分之间的相关性。计算受试者工作特征曲线下的面积（AUC）。
混合冠状动脉斑块评分与颈动脉 IPH 显著相关（比值比=1.50，P<0.05）。冠状动脉的所有 3 种斑块类型的评分与颈动脉的 LRNC 和钙化均显著相关。混合冠状动脉斑块评分对预测颈动脉 IPH 的价值最高（AUC=0.74）。钙化冠状动脉斑块评分对预测颈动脉的 LRNC（AUC=0.75）和钙化（AUC=0.75）的价值最高。
冠状动脉斑块表型与颈动脉斑块成分之间存在显著相关性。混合性冠状动脉斑块可能提示颈动脉斑块高危。
