Suleyman Hilmi Aksoy1, Oğuzhan Birdal2, Işıl Yurdaışık3

1Department of Radiology, Hisar Hospital Intercontinental, Istanbul, Turkey
2Department of Cardiology, Faculty of Medicine, University of Atatürk, Erzurum, Turkey
3Department of Radiology, University of Istinye, Gaziosmanpasa Medical Park Hospital, Istanbul, Turkey

Keywords: Carotid plaque morphology; coronary artery by-pass surgery; coronary artery disease; SYNTAX score; ultrasound


Introduction: Although there are many studies assessing the relationship between carotid artery ultrasound findings and coronary artery disease, the relationship between carotid plaque types and the complexity of coronary lesions is not assessed. We aimed to examine the relationship between the SYNTAX score and carotid plaque morphology.
Patients and Methods: We retrospectively screened patients who underwent carotid Ultrasound before the coronary artery bypass graft operation between 2015 and 2020. Syntax score was calculated by two independent interventional cardiologists with online SYNTAX score calculator ( The lesions of carotid arteries by ultrasound were classified as fibrous, calcific and mixed plaques.
Results: A total of 407 patients were enrolled. Median age was 65 (58-71) years and 81.6% of patients were male. We used multinomial logistic regression to test the association between plaque types and syntax score. The syntax score was associated with calcified plaque both in right (odds ratio 1.04, 95% CI 1.01-1.07, p= 0.006) and left internal carotid artery (odds ratio 1.04, 95% CI 1.02-1.06, p= 0.004). However, the syntax score was not associated with fibrous (odds ratio 0.97, 95% CI 0.94-1.01, p= 0.155 for right and odds ratio 0.99, 95% CI 0.96-1.02, p= 0.759 for left carotid artery) and mixed plaque types (odds ratio 1.02, 95% CI 0.98-1.06, p= 0.168 for right and odds ratio 1.00, 95% CI 0.96-1.04, p= 0.791 for left carotid artery).
Conclusion: SYNTAX score may provide an idea for carotid plaque morphology prediction. Especially higher SYNTAX score may be a predictor of calcific carotid plaque.

Ethics Committee Approval

This study was approved by the Istinye University Ethics Committee (Decision number: 2017-KAEK120/2/2021.G-20).

Peer Review

Externally peer-reviewed.

Author Contributions

Concept/Design - SA, OB, IY; Analysis/ Interpretation - SA, OB, IY; Data Collection - SA, OB; Writing - SA,IY; Critical Revision - SA; Statistical Analysis - OB, SA, IY; Overall Responsibility - SA; Final Approval - All of Authors.

Conflict of Interest

The authors have no conflicts of interest to declare.

Financial Disclosure

The authors declared that this study has received no financial support.