Echolucency of Carotid Plaque Is Useful for Assessment of Residual Cardiovascular Risk in Patients With Chronic Coronary Artery Disease Who Achieve LDL-C Goals on Statin Therapy
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概要
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Background: Ultrasound assessment of either intima-media thickness (IMT) or plaque echolucency of the carotid artery provides prognostic information on coronary events. This study examined the hypothesis that IMT and plaque echolucency of the carotid artery may remain useful for prediction of coronary events in patients with coronary artery disease (CAD) after achievement of LDL-C goals on statin therapy. Methods and Results: Ultrasound assessment of carotid maximum IMT (maxIMT) and plaque echolucency with integrated backscatter (IBS) analysis was performed in 357 chronic CAD patients with LDL-C <100mg/dl on statin therapy. All patients were prospectively followed up until the occurrence of one of the following coronary events: cardiac death, non-fatal myocardial infarction, or unstable angina pectoris requiring unplanned revascularization. During a mean follow-up of 32±18 months, 33 coronary events occurred. On multivariate Cox proportional hazards analysis, plaque echolucency (lower IBS value) was a significant predictor of coronary events (HR, 0.44; 95% CI: 0.29–0.73; P=0.009), whereas maxIMT was not. The addition of plaque echolucency to traditional risk factors improved net reclassification improvement (NRI) and integrated discrimination improvement (IDI; NRI, 0.59; P=0.0013; and IDI, 0.075; P=0.0009). Conclusions: Measurement of echolucency of the carotid artery was useful for assessment of residual coronary risk in CAD patients after LDL-C goal attainment on statin treatment.
著者
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Kitta Yoshinobu
Department of Internal Medicine II, University of Yamanashi
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Nakamura Takamitsu
Department of Internal Medicine 2, University of Yamanashi, Faculty of Medicine
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Uematsu Manabu
Department Of Cardiology Shizuoka Prefectual General Hospital
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OBATA Jun-ei
Department of Internal Medicine II, Interdisciplinary Graduate School of Medicine and Engineering, U
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Fujioka Daisuke
Department Of Applied Chemistry Graduate School Of Engineering Osaka City University
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Kugiyama Kiyotaka
Department Of Internal Medicine Ii Interdisciplinary Graduate School Of Medicine And Engineering Uni
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Saito Yukio
Department Of Electrical Engineering And Electronics Aoyama Gakuin University
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Watanabe Kazuhiro
Department Of Anesthesiology And Critical Care Medicine University Of Tsukuba
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Watanabe Yosuke
Department Of Internal Medicine Ii University Of Yamanashi Faculty Of Medicine
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Kawabata Ken-ichi
Department Of Internal Medicine Ii University Of Yamanashi Faculty Of Medicine
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Nakamura Takamitsu
Department of Internal Medicine II, Yamanashi University Hospital
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Sugamata Wataru
Department of Internal Medicine II, Yamanashi University Hospital
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Saito Yukio
Department of Internal Medicine II, Yamanashi University Hospital
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Watanabe Yosuke
Department of Internal Medicine II, Yamanashi University Hospital
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Kawabata Ken-ichi
Department of Internal Medicine II, Yamanashi University Hospital
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Kitta Yoshinobu
Department of Internal Medicine II, Yamanashi University Hospital
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Uematsu Manabu
Department of Internal Medicine II, Yamanashi University Hospital
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Obata Jun-ei
Department of Internal Medicine II, Faculty of Medicine, University of Yamanashi
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