The Comparison of Carotid Artery Intima-media Thickness and Plaque Characteristics between Patients with ST-elevation Myocardial Infarction and Coronary Artery Chronic Total Occlusion

Abstract

ST-segment elevation myocardial infarction (STEMI) and chronic total occlusion (CTO) of coronary artery are wellknown atherosclerotic vascular diseases. However, the difference of intima-media thickness and plaque characteristics of carotid arteries between STEMI and CTO patients were not directly compared in previous studies. Medical records of a total of 158 (101 STEMI, 57 CTO) patients, who underwent carotid artery ultrasonography, were selected for the analysis. The baseline characteristics, ultrasonography findings, and clinical outcomes of the two groups were compared. The prevalence of hypertension, diabetes mellitus, and dyslipidemia was significantly higher in CTO patients. Carotid intima-media thickness (0.97 ± 0.13 vs. 0.78 ± 0.17 cm, P < 0.0001) and number of plaques (2.2 ± 1.0 vs. 1.7 ± 1.2, P < 0.0001) were greater in CTO than STEMI patients. Multiple (≥ 3) or echogenic plaques were more frequently observed in CTO patients. During the median follow-up duration of 27 months, major adverse cardiovascular events occurred in 31% of CTO and 14% of STEMI patients (P = 0.008). We found that, compared with STEMI, CTO patients have higher burden of carotid artery atherosclerosis associated with more comorbid diseases and poor clinical outcomes.