Atherosclerotic carotid plaque in patients with acute coronary syndrome (ACS)

Objectives: Stroke is the third cause of death in western countries. Patients (pts) with acute coronary syndrome (ACS) have a high incidence of cerebrovascular ischemia risk. The purpose of this study was to evaluate the correlation between instability of atherosclerotic carotid plaque and its morpho-functional pattern showed by ecocolordoppler, in patients with ASC. Methods: The study included 105 patients, 68 men and 37 women, average of 6520 years. All patients selected, at the admission presented ACS, all underwent to ecocolordoppler of epiaortic vessels. The population was followed for 6 months to evaluate cerebrovascular events. The patients were divided into two groups: Group A, 48 pts with diabetes type 2; Group B, 57 pts without diabetes. Results: (see figure 1 and figure 2) During admission 4 pts of Group A and only 1 pts of Group B went encounter to a cerebrovascular accident and all these patients showed a soft plaque at the ecocolordoppler. During the follow up, exactly, in the 4th month of observation, only 1 patient of Group A had a transitory ischemia attack. This patient showed a fibrocalcific plaque associated with an carotid artery stenosis of 70%. Conclusion: In agreement with literature, our study shows that diabetic patients have an atherosclerotic disease more aggressive than non diabetic patients, therefore these patients have a high risk to develop cerebrovascular events. The study advises that to stratify cerebrovascular disease risk, the morphology of atherosclerotic plaque correlates with its instability better than its functional pattern.