2025/10/26 by Jun Xue, Di Wu, Yudong Fan +2
Medicine · #Cardiovascular Function and Risk Factors #Cerebrovascular and Carotid Artery Diseases #Coronary Interventions and Diagnostics
paper · pdf · doi:10.1111/echo.70326
openalex created_date 2025/10/26 · openalex publication_date 2025/10/26 · openalex updated_date 2026/05/27
PURPOSE: This study sought to investigate the predictive effect of combining cardiac color Doppler ultrasound and carotid ultrasound for major adverse cardiac events (MACE) following percutaneous coronary intervention (PCI). METHODS: A retrospective analysis was conducted on 475 coronary heart disease (CHD) patients who underwent PCI between May 2021 and April 2024. Cardiac ultrasound parameters (left atrial diameter [LAD], left ventricular diameter in diastole [LVDd]) and carotid ultrasound metrics (plaque score, intima-media thickness [IMT], total plaque area [TPA], and gray scale median [GSM]) were collected within 48 h post-PCI. Patients were monitored for a 12-month period to record MACE incidence. After 12 months of follow-up, patients were assigned to a Without MACE group (n = 324) and a With MACE group (n = 151). Correlation and multivariate logistic regression analyses were conducted to identify predictors, and receiver operating characteristic (ROC) curves evaluated predictive accuracy. RESULTS: Among 151 patients (31.8%) who experienced MACE, significant predictors included diabetes requiring medication (OR = 1.80, p = 0.039), prior myocardial infarction (OR = 1.93, p = 0.009), elevated discharge heart rate (OR = 1.10, p = 0.013), Charlson Comorbidity Index (OR = 1.60, p = 0.002), maximum left ventricular thickness (OR = 1.181, p = 0.003), higher Tei index (OR = 1.386, p = 0.001), plaque score (OR = 5.032, p = 0.001), carotid IMT (OR = 2.216, p = 0.002), and TPA (OR = 1.039, p = 0.016). Protective factors included beta-blocker use (OR = 0.468, p = 0.027), higher LVEF (OR = 0.957, p = 0.009), and higher GSM (OR = 0.894, p = 0.045). The combined ultrasound model achieved an AUC of 0.833, demonstrating robust predictive accuracy. CONCLUSION: Cardiac color Doppler ultrasound combined with carotid ultrasound effectively predicts post-PCI MACE by integrating cardiac function and atherosclerotic plaque characteristics. These non-invasive imaging tools offer a valuable framework for early risk assessment and personalized treatment strategies in CHD patients following PCI.