To investigate the possible correlation between ultrasound features of carotid plaques positive for neovascularization according to contrast-enhanced ultrasound (CEUS) and eight serum biomarkers.

Patients who had one or more carotid plaques were included primarily and then examined by CEUS. Finally, 210 patients whose carotid plaques were all positive for neovascularization were included. Two carotid plaque features including carotid plaque number and maximum plaque height (MPH) were recorded. All subjects were divided into four groups (I-IV) according to the number of carotid plaques. Eight serum biomarkers including total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), fasting blood glucose (FBG), high-sensitivity C-reactive protein (hsCRP), homocysteine (Hcy), lipoprotein-associated phospholipase A2 (Lp-PLA2), and small and dense LDL-C (sdLDL-C) were measured with an automatic biochemistry analyzer.

The participants had a mean (standard deviation [SD]) age of 60.73 (8.59) years, with 83% being male. HDL-C levels and FBG levels were statistically different among the four groups (F=2.810 and 5.447, respectively; P<0.05). HDL-C level in group I were statistically different from those in groups III and IV (t=2.525 and 2.035, respectively; P<0.05). FBG levels in groups I, II, and III were statistically different from that of group IV, (t=-2.645, -3.140, and -2.652, respectively; P<0.05). Correlation analysis showed that carotid plaque number was correlated with HDL-C levels and FBG levels, separately (r=-0.202 and 0.224, respectively; P<0.05). In male patients, carotid plaque number was also correlated with hsCRP levels (r=0.184, P<0.05). There was a good correlation between MPH and age (r=0.253, P<0.001), especially in male patients (r=0.287, P<0.001).

For carotid plaques with neovascularization, serum HDL-C, FBG, and male hsCRP levels can possibly predict the number of carotid plaques. The MPH of carotid plaques is associated with age.