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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![Examples of ultrasound findings and techniques. (A) Images in a 39-year-old male patient with a mass in the left thigh. The mass is heterogeneous on the B-mode US image (compared with the patient in D) and showed increased microvascularity (superb microvascular imaging [SMI]) and shear-wave elastography (SWE) values. Undifferentiated pleomorphic sarcoma was diagnosed at biopsy (with pleomorphic rhabdomyosarcoma in surgical specimen). (B) Images in an 18-year-old male patient with a mass in the left leg. The mass is hypoechoic on the B-mode image, with no other findings suggestive of malignancy. The lesion is in contact with the cortex of the tibia, which is slightly irregular. CT revealed a doubtful anteromedial tibial erosion. The microvascular study demonstrated high vascularization, suggestive of malignancy. Periosteal Ewing sarcoma was diagnosed with both histologic and immunohistochemical confirmation. (C) Images in a 69-year-old female patient with a lump growing on the outside of the left leg. Multiple SWE examinations were performed (please note the high values obtained in the measurements, whereas the color map highlights the stiffness relative to adjacent tissues). SMI showed areas of increased vascularization to target for sampling. Undifferentiated spindle cell sarcoma was diagnosed at biopsy, with residual leiomyosarcoma in the surgical specimen after neoadjuvant therapy. (D) Images in a 56-year-old female patient with a mass in the right thigh. The mass is heterogeneous at both B-mode ultrasound (similar to patient A) and MRI (coronal T2-weighted spectral attenuated inversion recovery [SPAIR]; T1-weighted pre-contrast and postcontrast imaging), which even shows uptake after the administration of paramagnetic contrast material, which is traditionally suggestive of malignancy. Low values at SMI and elastography are suggestive of benignity. Spindle cell lipoma was diagnosed at biopsy, with atypical spindle cell lipomatous tumor in the surgical specimen.](https://img.auntminnieeurope.com/mindful/smg/workspaces/default/uploads/2026/08/images-radiol250278fig2.APCFLSvX6p.jpg?auto=format%2Ccompress&dpr=2&fit=crop&h=167&q=70&w=250)
