Noninvasive carotid ultrasound for predicting vulnerable plaques of the coronary artery based on optical coherence tomography images

Background: The risk factors for coronary and carotid plaque development are consistent. Coronary plaque rupture is a major cause of adverse cardiovascular events. Ultrasound can evaluate vulnerable carotid plaques and provide information for predicting vulnerable coronary plaques identified by optical coherence tomography (OCT). This study aimed to investigate the predictive role of non-invasive carotid ultrasound in OCT diagnosis of atherosclerotic vulnerable plaque.Methods: A total of 70 participants, including 35 patients with and 35 without vulnerable coronary plaque, were enrolled in this case-control study at Beijing Anzhen Hospital from 2016 to 2021. The data of 70 patients with suspected coronary heart disease who had undergone OCT examination during percutaneous coronary intervention (PCI) surgery and completed carotid ultrasound examination within 3 days before PCI were analyzed retrospectively. According to the OCT diagnostic criteria for vulnerable plaques, the patients were divided into the vulnerable-plaque group and the stable-plaque group. Univariate and binary logistic regression analyses assessed risk factors for vulnerable coronary plaque. Receiver operating characteristic (ROC) curve analysis was used to determine the predictive power of carotid plaque features.Results: The univariate analysis demonstrated that the differences in high-sensitivity C-reactive protein levels and carotid plaque characteristics (irregular fibrous cap, heterogeneous plaque, hypoechoic plaque, plaque calcification, and a plaque thickness of greater than 3 mm) between the two groups were statistically significant. The logistic multivariate regression analysis revealed that an irregular fibrous cap of a carotid plaque [odds ratio (OR) =4.819; 95% confidence interval (CI): 1.106-22.867; P=0.048] and a hypoechoic plaque (OR =9.632; 95% CI: 2.138-43.384; P<0.05) were independent risk factors for predicting vulnerable plaques of the coronary artery.Conclusions: Noninvasive carotid ultrasound is feasible and clinically valuable for predicting vulnerable and asymptomatic coronary plaques defined by OCT. With this method, adverse events can be diagnosed and treated in advance.