Abstract 12151: Contrast-Enhanced Carotid Plaque for Detection of Myocardial Damage Risks After PCI in ST-segment Elevation Myocardial Infarction

Abstract

Background: The presence of coronary vulnerable plaque has been shown to increase the risk of myocardial damage after percutaneous coronary intervention (PCI) in ST-segment elevation myocardial infarction (STEMI) patients. It is possible that coronary plaque vulnerability may be assessed by evaluating plaque characteristics in other vessels such as the carotid arteries. Contrast-enhanced ultrasound (CEUS) of carotid plaque has been shown to detect the plaque neovascularization of carotid plaques, which is a feature of vulnerable plaque. Thus, in this study we examined whether CEUS of the carotid artery may provide information for myocardial damage risks after PCI in STEMI patients. Methods and Results: CEUS of the carotid plaques using perfluorobutane microbubbles as an ultrasound contrast agent were performed in consecutive 95 STEMI patients treated with emergent PCI. Intraplaque neovascularization was identified on the basis of microbubbles within the carotid plaque and graded as: G0, not visible; G1, moderate; or G2, extensive microbubbles. Obtained coronary flow and myocardial damage after PCI were estimated by corrected TIMI frame count (cTFC), Myocardial Blush Grade (MBG), peak CK-MB and Troponin T. The presence of G2 in the carotid arteries was associated with higher levels of cTFC (G0, 34±19 frames; G1, 41±21 frames; 43±24 frames,ρ=0.005) , lower levels of MBG (G0, 2.3±0.7; G1, 1.7±0.9; G2, 1.5±0.9,ρ=0.013), and higher levels of carotid IMT, fast blood glucose, hemoglobin A1c, hsCRP, and troponin T (ρ=0.049, 0.042, 0.046, 0.048, 0.01, and 0.02). Conclusion: The presence of carotid plaque neovascularization was related with myocardial damage after PCI in STEMI patients. Measurement of CEUS of Carotid Plaque is useful for risk stratification of STEMI patients underwent emergent PCI.