Echolucent carotid plaques as a feature in patients with acute coronary syndrome.

Carotid arterial ultrasound examination may be helpful for screening populations at high risk for acute coronary syndrome (ACS), so the present study was designed to identify the carotid arterial characteristics of patients with ACS. Carotid ultrasound examinations were performed in 172 patients with ACS, 166 patients with stable coronary artery disease (CAD), and 96 control subjects. Common carotid arterial structures were assessed by the intima - media thickness (IMT), interadventitial diameter (IAD), lumen diameter (LD), the IMT to LD ratio (IMT/LD), and the plaque burden based on the plaque score. Plaque morphology was assessed by the echogenecity based on the gray-scale median (GSM). IMT, IAD, IMT/LD, and plaque score did not differ between the ACS and stable CAD groups. The GSM in the ACS group was lower (47.5+/-25.3, p<0.001) than in the control (70.1+/-22.5) and stable CAD (73.7+/-23.4) groups. Multiple logistic regression analysis showed that the presence of carotid echolucent plaques (GSM <or=60) was an independent predictor of ACS. Echolucent carotid plaques were strongly associated with ACS and may be a surrogate marker of high-risk patients.