Prognostic Value of Intraplaque Neovascularization Detected by Carotid Contrast-Enhanced Ultrasound in Patients Undergoing Stress Echocardiography

•Carotid CEUS in patients with SE identified those at increased risk for CVEs.•Carotid findings were associated MRI characteristics of plaque vulnerability. BackgroundStress echocardiography (SE) is used diagnosis and stratification known or suspected coronary artery disease (CAD). Contrast-enhanced ultrasound (CEUS) detects carotid intraplaque neovascularization (IPN). The aim this study was to test the hypothesis that combining CAD might provide incremental prognostic value beyond clinical factors either alone occurrence cardiovascular events.MethodsOne hundred eighty-five (mean age, 69 ± 8 years; 79% men) referred found have on screening recruited imaging. IPN graded by presence location within plaque. Patients followed events (CVEs) including cardiac death, myocardial infarction, unstable angina, transient ischemic attack stroke. A subset (n = 27) underwent magnetic resonance imaging 1 month CEUS; assessed lipid-rich necrotic core, loose matrix, hemorrhage.ResultsSixty-nine had abnormal SE. 112 patients; 52 localized shoulder (IPNS). Plaques IPNS larger cores more likely hemorrhage. During follow-up (median, 31 months), 26 CVEs occurred. Multivariate Cox proportional-hazard analysis showed be predictors (hazard ratios, 3.34 [95% CI, 1.25–8.93; P .02] 4.88 1.77–13.49; .002], respectively). likelihood history (χ2Jeziorska M. Woolley D.E. Local cellular composition vulnerable regions atherosclerotic plaques human arteries.J Pathol. 1999; 188: 189-196Crossref PubMed Scopus (151) Google Scholar 9.0, .02).ConclusionsCarotid detected an independent predictor Stress events. One Sixty-nine .02). Carotid