title: Contrast-enhanced ultrasound imaging of carotid plaque neovascularization is useful for identifying high-risk patients with coronary artery disease.
abstract: BACKGROUND
  Contrast-enhanced ultrasound (CEUS) in the carotid artery has potential as a technique for imaging plaque neovascularization. This study examined whether CEUS could provide information on the severity and instability of coronary artery disease (CAD).
  
  
  RESULTS
  A total of 304 patients with CAD and carotid plaque underwent CEUS examination of the carotid artery. Intraplaque neovascularization was identified on the basis of microbubbles within the plaque and graded as: G0, not visible; G1, moderate; or G2, extensive microbubbles. The complexity and extent of the coronary lesions were assessed angiographically. A higher grade of CEUS-assessed plaque neovascularization of the carotid artery was associated significantly with greater complexity (ρ=0.48 by Spearman's rank correlation test) and extent (ρ=0.51) of coronary lesions. G2 plaque neovascularization was a risk for acute coronary syndrome, independent of traditional risk factors (odds ratio 1.91, 95% confidence interval 1.04-3.53, P<0.01). Subgroup analysis showed that carotid CEUS-assessed neovascularization regressed in 12 (46%) of 26 plaques in patients during 6 months of statin treatment, whereas regression occurred in 2 (14%) of 14 plaques in patients not taking a statin (P=0.04, Chi-square test).
  
  
  CONCLUSIONS
  CEUS examination of the carotid artery may provide valuable information on the severity and instability of CAD and also the efficacy of antiatherosclerotic treatment.
authors.affiliation: Department of Internal Medicine II, Faculty of Medicine, University of Yamanashi, Shimokato, Chuo 409-3898, Japan.
authors.forename: Juntaro
authors.initials: J
authors.lastname: Deyama
authors.forename: Takamitsu
authors.initials: T
authors.lastname: Nakamura
authors.forename: Isao
authors.initials: I
authors.lastname: Takishima
authors.forename: Daisuke
authors.initials: D
authors.lastname: Fujioka
authors.forename: Ken-ichi
authors.initials: K
authors.lastname: Kawabata
authors.forename: Jun-ei
authors.initials: JE
authors.lastname: Obata
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Watanabe
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Watanabe
authors.forename: Yukio
authors.initials: Y
authors.lastname: Saito
authors.forename: Hideto
authors.initials: H
authors.lastname: Mishina
authors.forename: Kiyotaka
authors.initials: K
authors.lastname: Kugiyama
mesh_terms: D054058:Acute Coronary Syndrome / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology; D000368:Aged; D000369:Aged, 80 and over; D002339:Carotid Arteries / Q000648:ultrastructure*; D003324:Coronary Artery Disease / Q000150:complications / Q000000981:diagnostic imaging* / Q000188:drug therapy; D004452:Echocardiography; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D009389:Neovascularization, Pathologic / Q000150:complications / Q000000981:diagnostic imaging* / Q000188:drug therapy; D058226:Plaque, Atherosclerotic / Q000150:complications / Q000000981:diagnostic imaging* / Q000188:drug therapy; D012307:Risk Factors
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors