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. 2023 Jul 12;9(4):253-260.
eCollection 2023 Aug 31.

Association between carotid and coronary atherosclerotic plaque morphology: a virtual histology intravascular ultrasound study

Dace Sondore  1 , Kārlis Trušinskis  1   2 , Matīss Linde  2 , Ieva Briede  1   3 , Inga Narbute  1   3 , Sanda Jēgere  1   3 , Kārlis Griķis  1   3 , Kārlis Štrenge  1   3 , Andrejs Ērglis  1   3
Affiliations

Association between carotid and coronary atherosclerotic plaque morphology: a virtual histology intravascular ultrasound study

Dace Sondore et al. J Clin Transl Res. .

Abstract

Background and aim: Atherosclerosis is considered to be a systemic disease; however, evidence exists on the heterogeneous nature of atherosclerotic disease. To date, continuous research seeks to determine the morphological differences between carotid and coronary artery disease. This study aimed to evaluate the relationship of morphological characteristics assessed by virtual histology intravascular ultrasound (VH-IVUS) between carotid and coronary plaque composition among patients with and without a history of cerebrovascular events.

Methods: This study was a single-center prospective study (n = 100; age 69.6 ± 8.4). All patients were scheduled for carotid or coronary artery stenting and underwent VH-IVUS examination of the carotid and coronary arteries before intervention.

Results: There was a modest, but statistically significant correlation between the carotid and coronary necrotic core ([NC] r = 0.46, P < 0.01), fibrofatty ([FF] r = 0.38, P < 0.01), dense calcium (r = 0.56, P < 0.01), and fibrous (r = 0.42, P < 0.01) plaque composition. The high amount of NC was detected in both arteries of the carotid artery stenting (CAS) group with higher proportion in the coronary artery (20.2% ± 9.4 % vs. 22.7% ± 6.8%, P = 0.02). More fibrolipid content was observed in carotid plaque compared to coronary (19.6% ± 9.9% vs. 12.2% ± 8.1%, P < 0.01). Patients with a history of cerebrovascular events had a numerically greater proportion of necrotic tissue in the carotid artery compared to asymptomatic and symptomatic CAS group patients (23.5% ± 10.7% vs. 18.9% ± 8.2% and 18.7% ± 9.5%, P = 0.11).

Conclusion: The percentage of all analyzed plaque components was moderately correlated between coronary and carotid artery plaques. Nevertheless, the proportion of NC plaque tissue was greater in the coronary arteries, while the carotid arteries showed more %FF atherosclerotic lesions. CAS group patients with a history of cerebrovascular events had a tendency of greater proportion of necrotic tissue in analyzed carotid plaques compared to others in the CAS group.

Relevance for patients: In this study, we found that patients with a history of cerebrovascular event had a tendency of increased NC content in culprit lesion of carotid artery. Complementary use of non-invasive and invasive imaging modalities allows to detect high-risk atherosclerotic plaques and adjust treatment strategy.

Keywords: Atherosclerosis; Carotid artery stenting; Percutaneous coronary intervention; Virtual histology.

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Conflict of interest statement

None.

Figures

Figure 1
Figure 1. Correlation between carotid and coronary plaque composition in study patients. Correlation of: A) necrotic cores, B) calcified tissue, C) fibrolipidic tissue, and D) fibrotic tissue among carotid and coronary arteries.
Figure 2
Figure 2. Representative case example of VH-IVUS analysis in the CAS patient.
See this image and copyright information in PMC

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