This retrospective study aimed to investigate the association between carotid artery plaque characteristics evaluated by virtual histology intravascular ultrasound (VH-IVUS) and high-risk coronary plaques determined by coronary computed tomography angiography (CCTA) among patients (n = 72) who underwent carotid artery stenting (CAS). VH-IVUS examination was performed during CAS and CCTA examination before CAS. Logistic regression models were used to explore the association between carotid plaque characteristics and high-risk coronary plaque. Of 72 patients, 46 (63.9%) were diagnosed as having high-risk coronary plaques. The necrotic core (NC) area, NC percentage, dense calcium (DC) area, and symptomatic carotid artery stenosis were significantly associated with high-risk coronary plaques (all P< .05). Isolated upper-NC area, and upper-NC area combined with upper-DC area were associated with high-risk coronary plaques. Compared with the lower-NC area and lower-DC area groups, participants with upper-NC area and upper-NC area had 12.53 times higher odds ratio of having high-risk coronary plaques. This study showed that the NC area, NC percentage, DC area and symptomatic carotid artery stenosis were associated with high-risk coronary plaques. Participants with both upper-NC area and upper-DC area might have a higher risk of high-risk coronary plaques.
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