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. 2025 Jan;40(1):36-46.
doi: 10.1007/s00380-024-02444-z. Epub 2024 Jul 27.

Association between carotid plaque progression and persistent endothelial dysfunction in an infarct-related coronary artery in STEMI survivors

Takeo Horikoshi  1 , Takamitsu Nakamura  2 , Ryota Yamada  2 , Toru Yoshizaki  2 , Yosuke Watanabe  2 , Manabu Uematsu  2 , Tsuyoshi Kobayashi  2 , Akira Sato  2
Affiliations

Association between carotid plaque progression and persistent endothelial dysfunction in an infarct-related coronary artery in STEMI survivors

Takeo Horikoshi et al. Heart Vessels. 2025 Jan.

Abstract

Persistent coronary endothelial dysfunction predicts future adverse events; however, performing multiple invasive endothelial function tests is difficult in actual clinical practice. This study examined the association between carotid plaque progression and persistent coronary endothelial dysfunction using serial assessments of the coronary vasomotor response to acetylcholine (ACh) in the infarct-related artery (IRA) among patients with ST-elevation acute myocardial infarction (STEMI). This study included 169 consecutive patients with a first STEMI due to the left anterior descending coronary artery (LAD) occlusion who underwent successful percutaneous coronary intervention. The vasomotor response to ACh in the LAD was measured within two weeks after acute myocardial infarction (AMI) (first test) and repeated at six months (second test) after AMI. Ultrasonography of the bilateral common carotid artery and internal carotid artery was performed during the acute phase, and the thickest intima-media thickness (IMT) of either artery was measured as the maximum IMT. After six months, the IMT at the site of maximal IMT was re-measured to determine the carotid plaque progression. Finally, 87 STEMI patients analyzed. At 6 months, 25 patients (28.7%) showed carotid plaque progression. In a multivariable analysis, carotid plaque progression was identified as an independent predictor of persistent coronary endothelial dysfunction, both in terms of coronary diameter response [odd ratio (OR) 3.22, 95% confidence interval (95% CI) 1.13-9.15, p = 0.03] and coronary flow response [OR 2.65, 95% CI 1.01-7.00, p = 0.04]. Independently, carotid plaque progression is linked to persistent endothelial dysfunction in the IRA among STEMI survivors.

Keywords: Carotid plaque; Endothelial function; Myocardial infarction.

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Conflict of interest statement

Declarations. Conflict of interest: All authors certify that they have no affiliations with or involvement in any organization or entity with any financial or non-financial interest in this manuscript.

Figures

Fig. 1
Fig. 1
Timeline of clinical examination and follow-up
Fig. 2
Fig. 2
Representative cases of carotid plaque and coronary vasomotor function test at 1st and 2nd examinations
See this image and copyright information in PMC

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