NEW YORK (Reuters Health), Sep 15 - Patients with acute myocardial infarction (AMI) have more unstable carotid atherosclerotic plaques than individual without coronary disease, Italian researchers report.
In a study published in the August issue of the International Journal of Cardiology, 69 consecutive patients with AMI and 95 patients without coronary events underwent carotid artery duplex ultrasound.
Dr. Andrea Rossi at the Ospedale Maggiore in Verona, Italy, and colleagues evaluated the number of unstable carotid plaques, intimal media thickening and degree of maximal stenosis. The investigators divided plaques into stable if they were fibrocalcific, or unstable if they were soft and/or not homogenous.
Mean age was similar in both groups and both groups were primarily male. Mean number of plaques was essentially the same (2.8 and 2.5) in both groups, as was the degree of stenoses (59% and 36%, respectively) and the degree of intimal medial thickening (1.04 mm and 1.06 mm, respectively).
However, 43% of patients with AMI had unstable plaques, compared with only 15% of those without coronary disease.
The investigators note that unstable plaques are not only the result of local events but also systemic effects, as unstable plaques are typically located in a number of arterial beds. Inflammatory factors in particular are involved, as they disrupt the fibrous cap.
The high number of unstable plaques in patients with AMI may explain why they are at high risk of cerebral thrombi.
Last Updated: 2006-09-14 16:17:14 -0400 (Reuters Health)
Intl J Cardiol 2006;111:263-266.
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