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Carotid intraplaque neovascularization predicts atherosclerotic renal artery stenosis in patients with carotid artery stenosis.
- Source :
-
Nutrition, metabolism, and cardiovascular diseases : NMCD [Nutr Metab Cardiovasc Dis] 2020 Aug 28; Vol. 30 (9), pp. 1492-1499. Date of Electronic Publication: 2020 May 19. - Publication Year :
- 2020
-
Abstract
- Background and Aims: This study aimed to examine whether intraplaque neovascularization (IPN) of carotid plaques, as characterized by contrast-enhanced ultrasound (CEUS), is associated with atherosclerotic renal artery stenosis (ARAS) in patients with normal kidney function.<br />Methods and Results: We investigated carotid IPN using CEUS in 198 consecutive patients with normal kidney function with and without ARAS. IPN was graded on the basis of the presence and location of microbubbles within each plaque (0, no visible microbubbles in the plaque; 1, moderate microbubbles confined to the shoulder and/or adventitial side of the plaque; and 2, extensive microbubbles throughout the plaque). The grades of each plaque were averaged to obtain an overall score per patient. ARAS was determined angiographically. We found that a higher CEUS-assessed carotid IPN score was associated with ARAS (Odd Ratio, OR: 7.281; 95% Confidence Interval, 95% CI: 3.246-16.336; P < 0.001). Furthermore, an IPN score >1.75 predicted severe stenosis with a sensitivity of 81% and specificity of 58%. Compared with using the IPN score alone, the addition of the homocysteine (HCY) cutoff value (>22.5 mmol/L) resulted in a stronger predictive value (Area Under Curve, AUC: 0.893 vs 0.834; P < 0.001) for severe ARAS.<br />Conclusion: Carotid plaque neovascularization combined with HCY levels is predictive of severe ARAS in patients with normal kidney function. CEUS-assessed carotid IPN is clinically useful for stratification of ARAS in patients with normal kidney function.<br />Competing Interests: Declaration of Competing Interest The authors declare that they have no conflicts of interest.<br /> (Copyright © 2020 The Italian Diabetes Society, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.)
- Subjects :
- Aged
Biomarkers blood
Carotid Stenosis blood
Carotid Stenosis epidemiology
Carotid Stenosis therapy
China epidemiology
Contrast Media administration & dosage
Female
Homocysteine blood
Humans
Male
Microbubbles
Middle Aged
Patient Admission
Predictive Value of Tests
Prevalence
Renal Artery Obstruction blood
Renal Artery Obstruction epidemiology
Risk Assessment
Risk Factors
Severity of Illness Index
Carotid Arteries diagnostic imaging
Carotid Stenosis diagnostic imaging
Neovascularization, Pathologic
Plaque, Atherosclerotic
Renal Artery diagnostic imaging
Renal Artery Obstruction diagnostic imaging
Ultrasonography
Subjects
Details
- Language :
- English
- ISSN :
- 1590-3729
- Volume :
- 30
- Issue :
- 9
- Database :
- MEDLINE
- Journal :
- Nutrition, metabolism, and cardiovascular diseases : NMCD
- Publication Type :
- Academic Journal
- Accession number :
- 32620336
- Full Text :
- https://doi.org/10.1016/j.numecd.2020.04.031