AIMS  Data regarding the relationship between carotid plaque length (CPL) and coronary artery disease (CAD) are lacking. This study aimed to assess the predictive value of CPL for the severity of CAD. METHODS AND RESULTS We prospectively enrolled 2149 consecutive patients who underwent both first coronary angiography and carotid ultrasonography with measurements of intima-media thickness (IMT), plaque score (PS), and CPL. In total, 1408 (65.5%) patients had CAD (defined as stenosis ≥50%), and 741 (34.5%) patients had no CAD. Patients with CAD had longer maximal CPL than those without CAD (P < 0.001). The severity of CAD, measured by the Gensini score (GS), was closely correlated with max-CPL (rs = 0.560), followed by PS (rs = 0.486) and mean-IMT (rs = 0.292). Multivariate analysis revealed that max-CPL remained independently associated with CAD and high-GS after adjustment for traditional risk factors (TRF). Max-CPL, compared with PS or mean-IMT, had significantly higher discrimination value for predicting high-GS [area under the curve (AUC) 0.819 vs. 0.769 vs. 0.634, P < 0.001]. At a cut-off value for the max-CPL of 6.3 mm, the sensitivity and negative predictive value for high-GS were 84.6% and 89.1%, respectively. Furthermore, the addition of max-CPL significantly improved the discrimination (AUC 0.832 vs. 0.720, P < 0.001) and reclassification (net reclassification improvement = 0.431, P < 0.001) over TRF for high-GS. CONCLUSION  Ultrasound max-CPL provides independent and incremental predictive value for the clinical severity of CAD over TRF and seems a simple useful marker in CAD risk stratification.

中文翻译：

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超声颈动脉斑块长度的独立和增量值可预测冠状动脉疾病的存在和严重程度：从颈动脉斑块长度的前瞻性分析中进行分析。

AIMS缺乏有关颈动脉斑块长度（CPL）与冠状动脉疾病（CAD）之间关系的数据。这项研究旨在评估CPL对CAD严重程度的预测价值。方法和结果我们前瞻性纳入了2149例连续接受首次冠状动脉造影和颈动脉超声检查的患者，并测量了内膜中层厚度（IMT），斑块评分（PS）和CPL。总共有1408名患者（65.5％）患有CAD（定义为狭窄≥50％），而741名患者（34.5％）没有CAD。有CAD的患者的最大CPL比没有CAD的患者更长（P <0.001）。通过Gensini评分（GS）衡量的CAD严重程度与max-CPL（rs = 0.560），PS（rs = 0.486）和平均IMT（rs = 0.292）密切相关。多变量分析显示，在调整传统危险因素（TRF）后，max-CPL仍然独立于CAD和高GS。与PS或均值IMT相比，Max-CPL在预测高GS时具有明显更高的辨别力[曲线下面积（AUC）0.819 vs. 0.769 vs. 0.634，P <0.001]。在最大CPL的临界值为6.3 mm时，高GS的灵敏度和阴性预测值分别为84.6％和89.1％。此外，对于高GS，与TRF相比，添加max-CPL显着改善了分辨力（AUC 0.832对0.720，P <0.001）和重分类（净重分类改进= 0.431，P <0.001）。