Extracranial carotid plaque hemorrhage predicts ipsilateral stroke recurrence in patients with carotid atherosclerosis – a study based on high-resolution vessel wall imaging MRI
Abstract Background Intraplaque hemorrhage (IPH) is a hallmark of carotid plaque vulnerability. We aim to investigate the association between IPH and recurrent ipsilateral ischemic stroke. Methods Patients with a recent stroke or transient ischemic attack (TIA) were prospectively recruited and under...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-06-01
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| Series: | BMC Neurology |
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| Online Access: | https://doi.org/10.1186/s12883-022-02758-3 |
| _version_ | 1818533912183308288 |
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| author | Fengli Che Donghua Mi Anxin Wang Yi Ju Binbin Sui Xiaokun Geng Xihai Zhao Xingquan Zhao |
| author_facet | Fengli Che Donghua Mi Anxin Wang Yi Ju Binbin Sui Xiaokun Geng Xihai Zhao Xingquan Zhao |
| author_sort | Fengli Che |
| collection | DOAJ |
| description | Abstract Background Intraplaque hemorrhage (IPH) is a hallmark of carotid plaque vulnerability. We aim to investigate the association between IPH and recurrent ipsilateral ischemic stroke. Methods Patients with a recent stroke or transient ischemic attack (TIA) were prospectively recruited and underwent an ultrasonographic examination and carotid HR VWMRI on the side consistent with symptoms. Carotid plaque was defined as carotid intima-media-thickness (IMT) by ultrasound≥1.5 mm. IPH was determined that the ratio of the plaque signal intensity relative to that of adjacent muscle was > 1.5. All enrolled patients were clinically followed until an ipsilateral ischemic stroke, TIA, carotid endarterectomy (CEA)/carotid artery stenting (CAS), or death within 12 months. Univariate analysis was used to analyze the correlation between clinical characteristics and IPH. Kaplan-Meier survival analysis and a log-rank test were used to compare recurrence-free survival time between the IPH and non-IPH groups. Cox regression models evaluated IPH as the predictor of ipsilateral stroke recurrence. Results A total of 171 patients (mean age, 60.13 ± 10.04 years; 118 males) were included in the final analysis. Thirty-two patients (18.7%) showed carotid IPH. During the follow-up, patients with carotid IPH suffered 60.9% (14 of 23) of recurrent ipsilateral strokes and 60.0% (3 of 5) TIA. Multivariate Cox regression analysis proved IPH as a strong predictor of ipsilateral stroke; the adjusted hazard ratio (HR) was 6.64 (95% confidence interval [CI], 2.84–15.54, P < 0.001). Meanwhile, Cox regression analysis also proved that IPH could predict recurrent ischemic events; the adjusted HR was 8.08 (95% CI, 3.65–17.91, P < 0.001). Conclusions Carotid intraplaque hemorrhage is strongly associated with recurrent ischemic events and could predict recurrent ipsilateral stroke. |
| first_indexed | 2024-12-11T18:04:58Z |
| format | Article |
| id | doaj.art-a0f21dbc4b0f4bb58c83226682f07403 |
| institution | Directory Open Access Journal |
| issn | 1471-2377 |
| language | English |
| last_indexed | 2024-12-11T18:04:58Z |
| publishDate | 2022-06-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Neurology |
| spelling | doaj.art-a0f21dbc4b0f4bb58c83226682f074032022-12-22T00:55:45ZengBMCBMC Neurology1471-23772022-06-0122111110.1186/s12883-022-02758-3Extracranial carotid plaque hemorrhage predicts ipsilateral stroke recurrence in patients with carotid atherosclerosis – a study based on high-resolution vessel wall imaging MRIFengli Che0Donghua Mi1Anxin Wang2Yi Ju3Binbin Sui4Xiaokun Geng5Xihai Zhao6Xingquan Zhao7Department of Neurology, Beijing Tiantan Hospital, Capital Medical UniversityDepartment of Neurology, Beijing Tiantan Hospital, Capital Medical UniversityTiantan Neuroimaging Center for Excellence, Beijing Tiantan Hospital, Capital Medical UniversityDepartment of Neurology, Beijing Tiantan Hospital, Capital Medical UniversityTiantan Neuroimaging Center for Excellence, Beijing Tiantan Hospital, Capital Medical UniversityDepartment of Neurology, Beijing Luhe Hospital, Capital Medical UniversityDepartment of Biomedical Engineering, Center for Biomedical Imaging Research, Tsinghua UniversityDepartment of Neurology, Beijing Tiantan Hospital, Capital Medical UniversityAbstract Background Intraplaque hemorrhage (IPH) is a hallmark of carotid plaque vulnerability. We aim to investigate the association between IPH and recurrent ipsilateral ischemic stroke. Methods Patients with a recent stroke or transient ischemic attack (TIA) were prospectively recruited and underwent an ultrasonographic examination and carotid HR VWMRI on the side consistent with symptoms. Carotid plaque was defined as carotid intima-media-thickness (IMT) by ultrasound≥1.5 mm. IPH was determined that the ratio of the plaque signal intensity relative to that of adjacent muscle was > 1.5. All enrolled patients were clinically followed until an ipsilateral ischemic stroke, TIA, carotid endarterectomy (CEA)/carotid artery stenting (CAS), or death within 12 months. Univariate analysis was used to analyze the correlation between clinical characteristics and IPH. Kaplan-Meier survival analysis and a log-rank test were used to compare recurrence-free survival time between the IPH and non-IPH groups. Cox regression models evaluated IPH as the predictor of ipsilateral stroke recurrence. Results A total of 171 patients (mean age, 60.13 ± 10.04 years; 118 males) were included in the final analysis. Thirty-two patients (18.7%) showed carotid IPH. During the follow-up, patients with carotid IPH suffered 60.9% (14 of 23) of recurrent ipsilateral strokes and 60.0% (3 of 5) TIA. Multivariate Cox regression analysis proved IPH as a strong predictor of ipsilateral stroke; the adjusted hazard ratio (HR) was 6.64 (95% confidence interval [CI], 2.84–15.54, P < 0.001). Meanwhile, Cox regression analysis also proved that IPH could predict recurrent ischemic events; the adjusted HR was 8.08 (95% CI, 3.65–17.91, P < 0.001). Conclusions Carotid intraplaque hemorrhage is strongly associated with recurrent ischemic events and could predict recurrent ipsilateral stroke.https://doi.org/10.1186/s12883-022-02758-3High-resolution vessel wall MRICarotid atherosclerotic plaqueIntraplaque hemorrhageRecurrence of stroke |
| spellingShingle | Fengli Che Donghua Mi Anxin Wang Yi Ju Binbin Sui Xiaokun Geng Xihai Zhao Xingquan Zhao Extracranial carotid plaque hemorrhage predicts ipsilateral stroke recurrence in patients with carotid atherosclerosis – a study based on high-resolution vessel wall imaging MRI BMC Neurology High-resolution vessel wall MRI Carotid atherosclerotic plaque Intraplaque hemorrhage Recurrence of stroke |
| title | Extracranial carotid plaque hemorrhage predicts ipsilateral stroke recurrence in patients with carotid atherosclerosis – a study based on high-resolution vessel wall imaging MRI |
| title_full | Extracranial carotid plaque hemorrhage predicts ipsilateral stroke recurrence in patients with carotid atherosclerosis – a study based on high-resolution vessel wall imaging MRI |
| title_fullStr | Extracranial carotid plaque hemorrhage predicts ipsilateral stroke recurrence in patients with carotid atherosclerosis – a study based on high-resolution vessel wall imaging MRI |
| title_full_unstemmed | Extracranial carotid plaque hemorrhage predicts ipsilateral stroke recurrence in patients with carotid atherosclerosis – a study based on high-resolution vessel wall imaging MRI |
| title_short | Extracranial carotid plaque hemorrhage predicts ipsilateral stroke recurrence in patients with carotid atherosclerosis – a study based on high-resolution vessel wall imaging MRI |
| title_sort | extracranial carotid plaque hemorrhage predicts ipsilateral stroke recurrence in patients with carotid atherosclerosis a study based on high resolution vessel wall imaging mri |
| topic | High-resolution vessel wall MRI Carotid atherosclerotic plaque Intraplaque hemorrhage Recurrence of stroke |
| url | https://doi.org/10.1186/s12883-022-02758-3 |
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