Correlation of Coronary Plaque Phenotype and Carotid Atherosclerotic Plaque Composition

Introduction: Studies have shown that atherosclerosis in coronary arteries is closely related to that in carotid arteries, but there are few investigations on the correlation between unstable plaques in these 2 vascular beds. The authors aim to investigate the correlation between coronary plaque phenotype and carotid plaque composition.

Methods: Patients (n = 123) with suspected coronary artery disease underwent computed tomography angiography of coronary arteries. Magnetic resonance imaging of bilateral carotid arteries was performed within 2 weeks after computed tomography angiography. The plaque type in each coronary segment was analyzed. Coronary plaques were classified into 3 types: noncalcified, calcified and mixed. The total number of each plaque type was scored. Carotid plaque with calcification, lipid-rich necrotic core (LRNC) or intraplaque hemorrhage (IPH) in either carotid artery was defined as positive. Logistic regression analysis was used to determine the correlation between coronary plaque phenotype and carotid plaque composition. The area under the receiver-operating characteristic curve (AUC) was calculated.

Results: There was a significant correlation between the mixed coronary plaque score and carotid IPH (odds ratio = 1.50, P < 0.05). The scores for all 3 types of the coronary plaque were significantly correlated with carotid LRNC and calcification. The mixed coronary plaque score had the highest value in predicting carotid IPH (AUC = 0.74). The calcified coronary plaque score showed the highest value in predicting carotid LRNC (AUC = 0.75) and calcification (AUC = 0.75).

Conclusion: There was significant correlation between coronary plaque phenotype and carotid plaque composition. A mixed coronary plaque may be suggestive of a high-risk carotid plaque.