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Carotid plaque inflammation as a marker for the presence of severe coronary artery disease in patients evaluated for chest pain

Session Poster Session 3

Speaker Konstantinos Toutouzas

Event : ESC Congress 2013

  • Topic : basic science
  • Sub-topic : Atherosclerosis, Cerebrovascular Diseases, Aneurysm, Restenosis
  • Session type : Poster Session

Authors : M Drakopoulou (Athens,GR), K Toutouzas (Athens,GR), G Benetos (Athens,GR), A Synetos (Athens,GR), G Latsios (Athens,GR), E Tsiamis (Athens,GR), H Grassos (Athens,GR), E Siores (Bolton,GB), D Tousoulis (Athens,GR), CH Stefanadis (Athens,GR)

M. Drakopoulou1 , K. Toutouzas1 , G. Benetos1 , A. Synetos1 , G. Latsios1 , E. Tsiamis1 , H. Grassos1 , E. Siores2 , D. Tousoulis1 , C.H. Stefanadis1 , 1Hippokration Hospital, University of Athens, 1st Department of Cardiology - Athens - Greece , 2University of Bolton, Centre for Material Research and Innovation - Bolton - United Kingdom ,

European Heart Journal ( 2013 ) 34 ( Abstract Supplement ), 445-446

Purpose: Intima-media thickness (IMT) measurement in carotid arteries has been widely used as a surrogate marker for coronary artery disease. However, IMT does not provide any functional characteristics, especially regarding the inflammatory status. Microwave radiometry (MR) allows non-invasive in vivo measuring of internal temperature of tissues, reflecting inflammation. The purpose of this study was to evaluate the predictive value of thermal heterogeneity measured by MR for the diagnosis of significant coronary artery disease (CAD).

Methods: Consecutive patients (n=246) hospitalized for chest pain and scheduled for coronary angiography were evaluated by 1) ultra-sound echo-color Doppler (US-ECD) study of both carotid arteries, and 2) temperature measurements with MR. During ultrasound IMT measurements were performed. Thermal heterogeneity (ΔT), measured by MR, was assigned as the maximal temperature along the carotid artery minus the minimum temperature.

Results: Significant CAD was found in 200 patients (81%) documented by coronary angiography. Mean IMT was significantly higher in carotid arteries of the CAD group (1.18±1.09 vs 0.78±0.76mm, p<0.001). Carotid arteries of the CAD group had higher ΔT (0.80±0.49 vs 0.40±0.38°C, p<0.001). Patients with one-vessel disease (n=88, 35.8%) had lower ΔT compared to patients with two-vessel disease (n=76, 30.9%) and three-vessel disease (n=36, 14.6%) (0.70±0.19°C vs 0.87±0.27°C vs 0.91±0.28°C, p<0.01 for all comparisons). By ROC curve analysis the optimal cutoff point of ΔT for predicting the presence of CAD was ≥0.50°C with a sensitivity of 76.00% and a specificity of 78.26% (95% CI 0.71 to 0.861, p<0.001). In 76% (152 out of 200) of patients with CAD increased ΔT (≥0.5°C) was found in at least one carotid artery compared to only 21.7% (10 out of 46) of patients with no CAD (p<0.001).

Conclusions: Local inflammatory activation as detected by microwave radiometry in carotid plaques correlates well with the extent of coronary artery disease. The results of this study justify the conduction of a large multicenter study to validate the predictive value of this new method for the presence of CAD.

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