Noninvasive assessment of stenotic severity and plaque characteristics by coronary CT angiography in patients scheduled for carotid artery revascularization

Meiko Hoshino, Hideki Kawai, Masayoshi Sarai, Akiyo Sadato, Motoharu Hayakawa, Sadako Motoyama, Yasuomi Nagahara, Keiichi Miyajima, Hiroshi Takahashi, Junichi Ishii, Ichiro Nakahara, Yuichi Hirose, Yukio Ozaki

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Aims: Coronary artery atherosclerosis in patients needing carotid revascularization has not been fully clarified. The aim of this study was to evaluate the stenotic severity and plaque characteristics of coronary arteries by coronary computed tomography angiography (CTA) in patients scheduled for carotid-artery stenting (CAS) or carotid endarterectomy (CEA). Methods: We performed coronary CTA after carotid ultrasound (US) in 164 patients (81.7% male, aged 68.1± 12.2 years) from 2014 to 2016. Of all, 70 were scheduled for CAS or CEA (CAS/CEA group) and 94 were not (non-CAS/CEA group). Carotid US and coronary CTA were compared for the evaluation of stenotic severity and plaque characteristics of each vessel between CAS/CEA and non-CAS/CEA groups. Results: Between the two groups, there were significant differences in the presence of significant stenosis (SS: ≥ 70% stenosis of coronary artery) (55.7% vs. 39.4%, P =0.038), triple-vessel disease (TVD)/left main trunk (LMT) (SS in each of three epicardial vessels and/or LMT) (24.3% vs. 7.5%, P = 0.0025), and high-risk plaque (HRP: positive remodeling and/or low attenuation) (55.7% vs. 24.5%, P <0.0001). CAS/CEA was independently associated with TVD/LMT (OR = 2.30, 95%CI: 1.14 – 8.59, P = 0.026) and HRP (OR = 3.17, 95%CI: 1.57 – 6.54, P = 0.0012) in multivariable logistic regression analysis. Similarly, vulnerable plaque (78.6% vs. 2.1%, P <0.0001) as well as severe stenosis of carotid artery (98.6% vs. 0%, P <0.0001) was seen more often in CAS/CEA than in non-CAS/CEA group. Conclusions: The prevalence of TVD/LMT and HRP determined by coronary CTA is higher in patients needing CAS/CEA than in those without. Management of systemic atherosclerosis is required in the perioperative period of CAS/CEA.

Original languageEnglish
Pages (from-to)1022-1031
Number of pages10
JournalJournal of atherosclerosis and thrombosis
Volume25
Issue number10
DOIs
Publication statusPublished - 01-01-2018

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Angiography
Carotid Endarterectomy
Coronary Angiography
Carotid Arteries
Tomography
Ultrasonics
Regression analysis
Logistics
Arteries
Coronary Vessels
Computed Tomography Angiography
Perioperative Period
Coronary Stenosis
Carotid Stenosis
Coronary Artery Disease
Atherosclerosis
Pathologic Constriction
Logistic Models
Regression Analysis

All Science Journal Classification (ASJC) codes

  • Internal Medicine
  • Cardiology and Cardiovascular Medicine
  • Biochemistry, medical

Cite this

Hoshino, Meiko ; Kawai, Hideki ; Sarai, Masayoshi ; Sadato, Akiyo ; Hayakawa, Motoharu ; Motoyama, Sadako ; Nagahara, Yasuomi ; Miyajima, Keiichi ; Takahashi, Hiroshi ; Ishii, Junichi ; Nakahara, Ichiro ; Hirose, Yuichi ; Ozaki, Yukio. / Noninvasive assessment of stenotic severity and plaque characteristics by coronary CT angiography in patients scheduled for carotid artery revascularization. In: Journal of atherosclerosis and thrombosis. 2018 ; Vol. 25, No. 10. pp. 1022-1031.
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title = "Noninvasive assessment of stenotic severity and plaque characteristics by coronary CT angiography in patients scheduled for carotid artery revascularization",
abstract = "Aims: Coronary artery atherosclerosis in patients needing carotid revascularization has not been fully clarified. The aim of this study was to evaluate the stenotic severity and plaque characteristics of coronary arteries by coronary computed tomography angiography (CTA) in patients scheduled for carotid-artery stenting (CAS) or carotid endarterectomy (CEA). Methods: We performed coronary CTA after carotid ultrasound (US) in 164 patients (81.7{\%} male, aged 68.1± 12.2 years) from 2014 to 2016. Of all, 70 were scheduled for CAS or CEA (CAS/CEA group) and 94 were not (non-CAS/CEA group). Carotid US and coronary CTA were compared for the evaluation of stenotic severity and plaque characteristics of each vessel between CAS/CEA and non-CAS/CEA groups. Results: Between the two groups, there were significant differences in the presence of significant stenosis (SS: ≥ 70{\%} stenosis of coronary artery) (55.7{\%} vs. 39.4{\%}, P =0.038), triple-vessel disease (TVD)/left main trunk (LMT) (SS in each of three epicardial vessels and/or LMT) (24.3{\%} vs. 7.5{\%}, P = 0.0025), and high-risk plaque (HRP: positive remodeling and/or low attenuation) (55.7{\%} vs. 24.5{\%}, P <0.0001). CAS/CEA was independently associated with TVD/LMT (OR = 2.30, 95{\%}CI: 1.14 – 8.59, P = 0.026) and HRP (OR = 3.17, 95{\%}CI: 1.57 – 6.54, P = 0.0012) in multivariable logistic regression analysis. Similarly, vulnerable plaque (78.6{\%} vs. 2.1{\%}, P <0.0001) as well as severe stenosis of carotid artery (98.6{\%} vs. 0{\%}, P <0.0001) was seen more often in CAS/CEA than in non-CAS/CEA group. Conclusions: The prevalence of TVD/LMT and HRP determined by coronary CTA is higher in patients needing CAS/CEA than in those without. Management of systemic atherosclerosis is required in the perioperative period of CAS/CEA.",
author = "Meiko Hoshino and Hideki Kawai and Masayoshi Sarai and Akiyo Sadato and Motoharu Hayakawa and Sadako Motoyama and Yasuomi Nagahara and Keiichi Miyajima and Hiroshi Takahashi and Junichi Ishii and Ichiro Nakahara and Yuichi Hirose and Yukio Ozaki",
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Noninvasive assessment of stenotic severity and plaque characteristics by coronary CT angiography in patients scheduled for carotid artery revascularization. / Hoshino, Meiko; Kawai, Hideki; Sarai, Masayoshi; Sadato, Akiyo; Hayakawa, Motoharu; Motoyama, Sadako; Nagahara, Yasuomi; Miyajima, Keiichi; Takahashi, Hiroshi; Ishii, Junichi; Nakahara, Ichiro; Hirose, Yuichi; Ozaki, Yukio.

In: Journal of atherosclerosis and thrombosis, Vol. 25, No. 10, 01.01.2018, p. 1022-1031.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Noninvasive assessment of stenotic severity and plaque characteristics by coronary CT angiography in patients scheduled for carotid artery revascularization

AU - Hoshino, Meiko

AU - Kawai, Hideki

AU - Sarai, Masayoshi

AU - Sadato, Akiyo

AU - Hayakawa, Motoharu

AU - Motoyama, Sadako

AU - Nagahara, Yasuomi

AU - Miyajima, Keiichi

AU - Takahashi, Hiroshi

AU - Ishii, Junichi

AU - Nakahara, Ichiro

AU - Hirose, Yuichi

AU - Ozaki, Yukio

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Aims: Coronary artery atherosclerosis in patients needing carotid revascularization has not been fully clarified. The aim of this study was to evaluate the stenotic severity and plaque characteristics of coronary arteries by coronary computed tomography angiography (CTA) in patients scheduled for carotid-artery stenting (CAS) or carotid endarterectomy (CEA). Methods: We performed coronary CTA after carotid ultrasound (US) in 164 patients (81.7% male, aged 68.1± 12.2 years) from 2014 to 2016. Of all, 70 were scheduled for CAS or CEA (CAS/CEA group) and 94 were not (non-CAS/CEA group). Carotid US and coronary CTA were compared for the evaluation of stenotic severity and plaque characteristics of each vessel between CAS/CEA and non-CAS/CEA groups. Results: Between the two groups, there were significant differences in the presence of significant stenosis (SS: ≥ 70% stenosis of coronary artery) (55.7% vs. 39.4%, P =0.038), triple-vessel disease (TVD)/left main trunk (LMT) (SS in each of three epicardial vessels and/or LMT) (24.3% vs. 7.5%, P = 0.0025), and high-risk plaque (HRP: positive remodeling and/or low attenuation) (55.7% vs. 24.5%, P <0.0001). CAS/CEA was independently associated with TVD/LMT (OR = 2.30, 95%CI: 1.14 – 8.59, P = 0.026) and HRP (OR = 3.17, 95%CI: 1.57 – 6.54, P = 0.0012) in multivariable logistic regression analysis. Similarly, vulnerable plaque (78.6% vs. 2.1%, P <0.0001) as well as severe stenosis of carotid artery (98.6% vs. 0%, P <0.0001) was seen more often in CAS/CEA than in non-CAS/CEA group. Conclusions: The prevalence of TVD/LMT and HRP determined by coronary CTA is higher in patients needing CAS/CEA than in those without. Management of systemic atherosclerosis is required in the perioperative period of CAS/CEA.

AB - Aims: Coronary artery atherosclerosis in patients needing carotid revascularization has not been fully clarified. The aim of this study was to evaluate the stenotic severity and plaque characteristics of coronary arteries by coronary computed tomography angiography (CTA) in patients scheduled for carotid-artery stenting (CAS) or carotid endarterectomy (CEA). Methods: We performed coronary CTA after carotid ultrasound (US) in 164 patients (81.7% male, aged 68.1± 12.2 years) from 2014 to 2016. Of all, 70 were scheduled for CAS or CEA (CAS/CEA group) and 94 were not (non-CAS/CEA group). Carotid US and coronary CTA were compared for the evaluation of stenotic severity and plaque characteristics of each vessel between CAS/CEA and non-CAS/CEA groups. Results: Between the two groups, there were significant differences in the presence of significant stenosis (SS: ≥ 70% stenosis of coronary artery) (55.7% vs. 39.4%, P =0.038), triple-vessel disease (TVD)/left main trunk (LMT) (SS in each of three epicardial vessels and/or LMT) (24.3% vs. 7.5%, P = 0.0025), and high-risk plaque (HRP: positive remodeling and/or low attenuation) (55.7% vs. 24.5%, P <0.0001). CAS/CEA was independently associated with TVD/LMT (OR = 2.30, 95%CI: 1.14 – 8.59, P = 0.026) and HRP (OR = 3.17, 95%CI: 1.57 – 6.54, P = 0.0012) in multivariable logistic regression analysis. Similarly, vulnerable plaque (78.6% vs. 2.1%, P <0.0001) as well as severe stenosis of carotid artery (98.6% vs. 0%, P <0.0001) was seen more often in CAS/CEA than in non-CAS/CEA group. Conclusions: The prevalence of TVD/LMT and HRP determined by coronary CTA is higher in patients needing CAS/CEA than in those without. Management of systemic atherosclerosis is required in the perioperative period of CAS/CEA.

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