Application of parameters of carotid plaques in prediction of progression of non-culprit coronary lesions in patients with coronary heart disease after PCI

SU Xinhui; CHE Xu; YAO Deshan; JIAO Yungen

doi:10.3969/j.issn.1002-266X.2023.33.005

Abstract：Objective To investigate the predictive value of the parameters of carotid plaques for the progression of non-culprit coronary lesions(NCCLs)in the patients with coronary heart disease after percutaneous coronary intervention(PCI).Methods Totally 167 patients with coronary heart disease who underwent PCI for the first time and reviewed cor-onary angiography(CAG)over 6 months were selected.According to the results of two CAGs,the subjects were divided in-to the progressive group and the non-progressive group of NCCLs.Baseline information,relevant medical history,and lab-oratory test results of fasting peripheral venous blood samples taken within 24 h of admission were collected,including blood routine,hepatorenal function,fasting blood glucose,glycosylated hemoglobin,blood lipid levels,and meanwhile the ratio of neutrophil to high density lipoprotein(NHR),ratio of monocyte to high density lipoprotein(MHR)were calcu-lated.All patients underwent carotid ultrasound,and the parameters of carotid plaques that included maximum plaque height,maximum plaque length,graded scores of carotid atherosclerosis,plaque vulnerable scores were assessed by the ultrasonic reports.Multivariate Logistic regression model was used to analyze the independent risk factors for the progress of NCCLs,and receiver operating characteristic(ROC)curve was plotted to evaluate the predictive value of these factors for the progress of NCCLs.Results The level of NHR in the progressive group was higher than that in the non-progressive group(P<0.05),while there were no statistical differences in baseline clinical data or biochemical laboratory results between the progressive group and the non-progressive group(all P>0.05).The maximum plaque height,maximum plaque length and plaque vulnerable scores were all higher in the progressive group than those in the non-progressive group(all P<0.05).The plaque vulnerable score was an independent risk factor for the progress of NCCLs in patients with coro-nary heart disease after PCI[OR(95%CI)=1.190(1.062-1.335),P=0.003].The area under the curve(AUC)of the plaque vulnerable score in predicting the progress of NCCLs in patients with coronary heart disease after PCI was 0.693(95%CI:0.610-0.776,P<0.001).The optimal cutoff value of plaque vulnerable score was 4.5,with a sensitivity of 72.0%and specificity of 68.7%,respectively.Conclusion High carotid plaque vulnerable score is an independent risk factor for the progress of NCCLs in patients with coronary heart disease after PCI,and has good predictive value.