Echolucent carotid plaques predict in-stent restenosis after bare metal stenting in native coronary arteries

Echolucent carotid plaque is considered to predict coronary events. This study examined whether echolucent carotid plaque may predict in-stent restenosis (ISR) in coronary arteries. This study included 202 patients who had elective and successful percutaneous coronary intervention (PCI) with bare metal stents in de novo lesions of native coronary arteries for symptomatic coronary artery disease (CAD). Carotid plaque echolucency was assessed by ultrasound with integrated backscatter (IBS) analysis (intima-media IBS value minus adventitia IBS) 1 day before PCI. All patients underwent planned coronary angiography (CAG) at 6 months after PCI, or CAG before 6 months due to acute coronary syndromes. ISR (defined as >50% diameter stenosis) was found in 65 (32%) patients. The calibrated IBS values of carotid plaques were inversely correlated with late luminal loss of the stented lesions. Using multivariate logistic regression analysis, the presence of echolucent carotid plaques (≤−13.7dB, arbitrarily determined by an ROC curve) served as an independent predictor of ISR (odds ratio 3.8, 95% CI 1.9–7.3, p = 0.01) and target lesion revascularization (n = 48) (odds ratio 2.8, 95% CI 1.4–5.7, p = 0.01). In conclusion, echolucent carotid plaques with low IBS values were independently and closely associated with ISR in native coronary arteries.