A previous study indicated that plaque instability is not merely a local vascular occurrence, 11 but rather exists simultaneously at multiple sites in the systemic vascular bed. It is therefore possible that instability of coronary plaque could be assessed by evaluating plaque neovascularization in the carotid arteries. This study therefore examined whether CEUS of the carotid artery provided information on the severity and instability of coronary artery disease (CAD) and also assessed the efficacy of statin treatment in patients with CAD. ncreased neovascularization in atherosclerotic plaque has been shown to be associated with plaque progression and instability, leading to atherosclerotic occlusive cardiovascular events. 1-3 Contrast-enhanced ultrasound (CEUS) is an emerging valuable tool for visualizing plaque neovascularization in the carotid artery, with the properties of contrast agent microbubbles, making them act as pure intravascular tracers. 3-5 CEUS has the advantages of being a simple and minimally invasive in vivo technique. 3-5 The usefulness and reliability of CEUS have been validated by previous studies in animals and humans that showed the degree of plaque neovascularization assessed by CEUS correlated strongly with histological density of neovessels. 6-8 CEUS also showed a greater extent of plaque neovascularization of the carotid artery in symptomatic patients with previous cerebro- Background: Contrast-enhanced ultrasound (CEUS) in the carotid artery has potential as a technique for imaging plaque neovascularization. This study examined whether CEUS could provide information on the severity and instability of coronary artery disease (CAD).

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BackgroundGlycemic variability (GV) induces coronary microcirculatory disturbance and myocardial damage in diabetic patients with acute myocardial infarction. However, in nondiabetic acute myocardial infarction patients, the relationship between GV and myocardial damage remains unclear. Patients and methodsWe investigated GV with a continuous glucose monitoring system in nondiabetic ST-segment elevation myocardial infarction patients treated with emergent percutaneous coronary intervention. GV was expressed as the mean amplitude of glycemic excursions (MAGE). Myocardial damage was estimated by myocardial blush grade and ST-segment resolution (STRes). STRes was defined as complete (>70%), partial (30–70%), or none (<30%). ResultsConsecutive patients (n=73) were enrolled and classified into a lower or higher MAGE group on the basis of the median MAGE. The higher MAGE group showed lower levels of myocardial blush grade (2.41±0.76 vs. 1.72±0.85, P=0.001) and STRes (complete: 56.8 vs. 33.3%, P=0.044; partial: 32.4 vs. 36.1%, P=0.741; none: 10.8 vs. 30.6%, P=0.037). ConclusionGV was associated with myocardial damage after percutaneous coronary intervention in nondiabetic ST-segment elevation myocardial infarction patients.

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