P3394Carotid plaque neovascularization correlates to increased intraplaque blood-like tissue in acute coronary syndrome
Bibliographic record
Abstract
Abstract Background The assessment of carotid plaque composition has attracted great interest as a tool to predict plaque vulnerability and subsequent risk of cardiovascular events. These vulnerable plaque lesions are characterized by the presence of intraplaque neovascularization (IPN). Previously, grayscale pixel ranges of ultrasound images have been correlated to various human tissue types. Thus, using these ranges, it is possible to assess the composition of atherosclerotic plaque non-invasively. Purpose This study sought to determine the relationship between carotid plaque composition and the degree of neovascularization in patients presenting with acute coronary syndrome (ACS), when compared to patients with stable angina. Methods A carotid focused vascular ultrasound was performed in 92 participants who had recently undergone coronary angiography due to stable angina or ACS. In 81 participants found to have atherosclerotic plaque in at least one carotid artery, plaque composition was assessed for tissue-like types by pixel distribution analysis: grayscale ranges 0–4 (blood), 8–26 (fat), 41–76 (muscle), 112–196 (fibrous), and 211–255 (calcium) (Figure 1). Participants also received microbubble contrast to assess IPN. IPN was graded based on the presence and location of microbubbles within each plaque (0, not visible; 1, peri-adventitial; 2, plaque core) and averaged to obtain an overall score. An independent t-test was used to compare continuous variables. Pearson pairwise correlations were used to assess associations between IPN and tissue composition. Results In the overall sample population, increased average IPN score correlated with increased plaque % blood tissue type (rho=0.28; p=0.01). Patients presenting with ACS (n=32) had increased neovascularization (IPN score of 1.47 vs 1.09; p=0.4), compared to patients with stable angina. In addition, ACS patients with an IPN score ≥1.25 had higher levels of plaque % blood (1.97% vs 0.75%; p=0.02).In ACS patients only, % blood increased with IPN score (r=0.34; p=0.06) and % fibrous tissue decreased with IPN score (r=−0.42; p=0.02). Figure 1 Conclusion The proportion of blood-like tissue in carotid plaque is associated with neovascularization and is increased in ACS patients. This may indicate hemorrhage within the plaque leading to rupture. Increased fibrous tissue may have a protective role, stabilizing the plaque when present. This data suggests that carotid plaque composition may be used as an imaging biomarker for cardiovascular risk, and its incorporation into routine screening practices may improve patient risk stratification. Acknowledgement/Funding CIHR CGS-Doctoral Award, Heart and Stroke Foundation of Canada, Canada Foundation for Innovation
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".