title: Treatment with betablockers is associated with higher grey-scale median in carotid plaques.
abstract: BACKGROUND
  The presence of echolucent carotid plaques as defined by low ultrasound grey-scale median (GSM) is associated with a higher risk of stroke and myocardial infarction. Betablockers have shown possible anti-atherosclerotic effects. The aim of the present study was to determine if there is an association between carotid plaque GSM and treatment with betablockers.
  
  
  METHODS
  The GSM of the carotid plaques of 350 patients who underwent carotid endarterectomy (CEA) for asymptomatic (n = 113) or symptomatic (n = 237) carotid disease was measured. Patients were divided in two groups based on the absence/presence of an on-going long-term (i.e. at least 6 months) oral treatment with betablockers at the time of CEA.
  
  
  RESULTS
  The prevalence and type of preoperative neurological symptoms were similar in the two groups. Patients with betablockers had more frequently arterial hypertension (P < .0001), diabetes (P = .035) and a higher BMI (P = .0004), while patients without betablockers were most frequently smokers (P = .017). Patients with betablockers revealed to have higher GSM (37.79 ± 25 vs 32.61 ± 23.50 P = .036). Echogenic plaques (i.e. with GSM > 30) showed to be more frequent in patients with betablockers also after correction for age, gender, the occurrence of preoperative symptoms, diabetes, hypertension, smoking and statins use (P = .024).
  
  
  CONCLUSIONS
  These results suggest the use of standardized ultrasound techniques as an important tool in evaluating the effect of anti-atherosclerotic medications and underline the need of.further prospective randomized studies on larger patient cohorts in order to confirm these results.
authors.affiliation: Vascular Center Malmö-Lund, Skåne University Hospital, Ruth Lundskogs gata 10, 1st floor, Malmö 205 02, Sweden. giuseppe.asciutto@med.lu.se.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Asciutto
authors.forename: Nuno V
authors.initials: NV
authors.lastname: Dias
authors.forename: Ana
authors.initials: A
authors.lastname: Persson
authors.forename: Jan
authors.initials: J
authors.lastname: Nilsson
authors.forename: Isabel
authors.initials: I
authors.lastname: Gonçalves
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D000368:Aged; D002339:Carotid Arteries / Q000000981:diagnostic imaging* / Q000187:drug effects* / Q000601:surgery; D002340:Carotid Artery Diseases / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery; D016894:Endarterectomy, Carotid; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D058226:Plaque, Atherosclerotic; D013997:Time Factors; D014463:Ultrasonography
chemical_list: D000319:Adrenergic beta-Antagonists