Coronary plaque vulnerability in metabolic syndrome: assessment of carotid artery morphology in acute coronary syndrome.

BACKGROUND: The aim of the present study was to investigate the clinical implication of metabolic syndrome and carotid artery morphologies on coronary plaque vulnerability in Japanese men with acute coronary syndrome (ACS). METHODS AND RESULTS: Consecutive ACS Japanese men (n=225) underwent emergent coronary angiography and B-mode ultrasonography within 1 week of the acute coronary event. With a 11.3-MHz linear array transducer, the morphologies of common carotid artery were examined. Common carotid arteries with an intima-media thickness>1.1 mm and interadventitial diameter>8.0 mm were considered to be undergoing carotid artery remodeling. Patients were divided into 2 groups based on the number of complex plaques identified by coronary angiography. Abdominal obesity, low level of high-density lipoprotein and carotid artery remodeling were more often observed in patients with multiple, complex coronary plaques than in patients with a single, complex plaque (p<0.03, p<0.03 and p=0.0001, respectively). Metabolic syndrome and carotid artery remodeling were independent predictors of multiple, complex coronary plaques (odds ratio 1.86, p<0.05; odds ratio 5.96, p<0.0001). CONCLUSION: Metabolic syndrome and carotid artery remodeling might be useful indicators to assess the efficacy of aggressive treatments for secondary prevention of cardiovascular events in ACS Japanese men.