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Hot carotid plaques exhibit temperature decrease after two years of statin therapy in patients with CAD

Session Poster Session 1

Speaker Konstantinos Toutouzas

Event : ESC Congress 2018

  • Topic : diseases of the aorta, peripheral vascular disease, stroke
  • Sub-topic : Peripheral Vascular and Cerebrovascular Disease: Treatment, Other
  • Session type : Poster Session

Authors : G Benetos (Athens,GR), K Toutouzas (Athens,GR), G Oikonomou (Athens,GR), I Koutagiar (Athens,GR), S Galanakos (Athens,GR), M Karmpalioti (Athens,GR), N Barampoutis (Patras,GR), P Davlouros (Patras,GR), V Gata (Athens,GR), F Antoniadou (Athens,GR), E Siores (Bolton,GB), D Tousoulis (Athens,GR)

G. Benetos1 , K. Toutouzas1 , G. Oikonomou1 , I. Koutagiar1 , S. Galanakos1 , M. Karmpalioti1 , N. Barampoutis2 , P. Davlouros2 , V. Gata1 , F. Antoniadou1 , E. Siores3 , D. Tousoulis1 , 1Athens School of Medicine, 1st Department of Cardiology, Hippocration General Hospital of Athens - Athens - Greece , 2University Hospital of Patras, Department of Cardiology - Patras - Greece , 3University of Bolton, Center of Material Research and Innovations - Bolton - United Kingdom ,

European Heart Journal ( 2018 ) 39 ( Supplement ), 117

Introduction: Noninvasive techniques for the detection and long-term monitoring of vascular inflammation is a subject of rigorous research. Microwave radiometry (MWR) can assess the inflammatory status in carotid vessel wall by measuring noninvasively the internal temperature of tissues.

Purpose: To evaluate the changes in structural and functional characteristics of carotid arteries in patients with coronary artery disease (CAD).

Methods: Consecutive patients with significant CAD as determined by coronary angiography (≥50% stenosis in at least one major epicardial vessel) were included. In all patients statin therapy was introduced. All patients underwent carotid artery ultrasound and MWR at baseline and at three years. During ultrasound study, plaque texture, surface, echogenicity and maximum plaque thickness were analyzed. Thermal heterogeneity (ΔT) by MR was assigned as maximal temperature along the carotid artery minus the minimum. ΔT ≥0.90°C was assigned as high ΔT.

Results: In total 156 patients were included in the study and 312 carotids were analyzed.The mean age was 62.18±10.87 years and 88.5% were men. The median follow-up was 730 days (25% QR 730, 75% QR 1096). At baseline 199 carotid arteries had plaques and 77 had high ΔT values. Fatty plaques (n=140) showed higher temperatures compared to mixed (n=42) or calcified (n=17): 0.77±0.44 vs 0.70±0.37 vs 0.41±0.13 °C, p=0.003. Similarly, plaques with irregular (n=30) surface showed higher temperatures compared to plaques with regular (n=169) surface (1.07±0.44 vs 0.66±0.38°C, p<0.001) and heterogeneous plaques had higher temperatures compared to homogeneous (1.05±0.48 vs 0.61±0.32, p<0.001). At follow up the change in temperatures was significantly different between carotids with high ΔT at baseline and carotids with non-high ΔT at baseline (-0.42±0.51 vs 0.17±0.37 °C, p<0.001). In contrast the change in structural characteristics (maximum plaque thickness) was not significantly different between the two groups (0.14±1.04 vs 0.08±0.9 mm, p=0.65).

Conclusion: MWR can safely and effectively monitor carotid artery temperatures over time. “Hot” carotid arteries show decrease in their temperatures over time in patients with CAD after initiation of statin therapy.

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