title: Echolucent femoral plaques entail higher risk of echolucent carotid plaques and a more severe inflammatory profile in peripheral arterial disease.
abstract: OBJECTIVE
  Plaque instability is recognized as a multivessel phenomenon related to inflammation. This study examined if the morphology of femoral plaques was related to that of carotid plaques.
  
  
  METHODS
  The echogenicity of femoral and carotid plaques of 102 patients with peripheral artery disease (PAD) was studied and classified as echolucent or echorich according to the gray-scale median (GSM) value, which was 53.6 for femoral plaques and 55.2 for carotid plaques. Serum C-reactive protein (CRP) levels and neutrophil count were also measured.
  
  
  RESULTS
  Echolucent carotid plaques were more frequent in patients with echolucent than in those with echorich femoral plaques (55.8% vs 32.0%; P < .01). At multivariate analysis, femoral GSM lower than the median was the only significant predictor of echolucent carotid plaques (odds ratio [OR], 3.87; 95% confidence interval [CI], 1.53-9.83). Patients with echolucent femoral plaques had higher serum CRP levels (P < .01) and a higher neutrophil count (P = .029) than patients with echorich femoral plaques. However, univariate analysis showed that neutrophil count (OR, 3.48; 95% CI, 1.23-9.85) but not hs-CRP was associated with echolucent carotid plaques. At multivariate analysis, neutrophil count exceeding the median remained associated with echolucent carotid plaques (OR, 5.71; 95% CI, 1.37-23.85), whereas the association between femoral and carotid echolucency was attenuated (OR, 3.75; 95% CI, 0.98-4.43).
  
  
  CONCLUSIONS
  In PAD, the presence of echolucent femoral plaques is associated with a greater prevalence of echolucent carotid plaques, probably as a consequence of a more pronounced inflammatory profile. This confirms and extends the finding that plaque echolucency is a multivessel phenomenon. Prospective studies are needed to assess whether carotid screening in PAD patients might contribute to improving clinical decision-making.
authors.affiliation: Department of Clinical Medicine and Cardiovascular and Immunological Sciences, University of Naples Federico II, Naples, Italy.
authors.forename: Giusy
authors.initials: G
authors.lastname: Sirico
authors.forename: Gregorio
authors.initials: G
authors.lastname: Brevetti
authors.forename: Simona
authors.initials: S
authors.lastname: Lanero
authors.forename: Eugenio
authors.initials: E
authors.lastname: Laurenzano
authors.forename: Rossella
authors.initials: R
authors.lastname: Luciano
authors.forename: Massimo
authors.initials: M
authors.lastname: Chiariello
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D050197:Atherosclerosis / Q000000981:diagnostic imaging* / Q000276:immunology; D002097:C-Reactive Protein / Q000032:analysis; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging* / Q000276:immunology; D003430:Cross-Sectional Studies; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging*; D006801:Humans; D007249:Inflammation / Q000000981:diagnostic imaging* / Q000276:immunology; D018836:Inflammation Mediators / Q000097:blood; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D009504:Neutrophils; D016017:Odds Ratio; D058729:Peripheral Arterial Disease / Q000000981:diagnostic imaging* / Q000276:immunology; D018570:Risk Assessment; D012720:Severity of Illness Index; D018616:Ultrasonography, Doppler, Duplex
chemical_list: D018836:Inflammation Mediators; D002097:C-Reactive Protein