Statistical segmentation of carotid plaque neovascularization

Background: Severity of stenosis remains the main factor for assessing risk of stroke in patients with internal carotid artery (ICA) disease. This study was conducted to investigate the association of plaque echostructure and other established and emerging cardiovascular risk factors with symptomatic ICA disease. Design: Cross-sectional study of consecutive patients with significant (> 50 %) ICA stenosis. Patients and methods: Carotid plaque echostructure, smoking, hypertension, diabetes mellitus, serum lipoprotein (a), homocysteine, vitamin B12, folate, cholesterol to high-density lipoprotein ratio, triglycerides, C-reactive protein, and the Framingham risk score were assessed in 124 consecutive patients (70 asymptomatic; 54 symptomatic) with significant (> 50 %) ICA stenosis. Results: The asymptomatic and symptomatic groups did not differ in terms of gender distribution (p = 0.76) and severity of stenosis (p = 0.62). Echolucent plaques (type 1 and 2) were more predominant in patients with symptomatic disease (p = 0.004, OR = 2.13, 95 % CI = 1.26-3.6). Patients with plaques type 1 were relatively younger than those with type 4 (p = 0.02). None of the other factors assessed had any significant association with symptomatic disease and any type of carotid plaque. Conclusions: Besides the severity of carotid stenosis, the presence of an echolucent plaque appears as an important factor associated with symptomatic ICA disease. Also, young patients are more likely to have an echolucent plaque suggesting an age-related association with plaque maturation.

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Comparison of High-dose Rosuvastatin Versus Low-dose Rosuvastatin Plus Ezetimibe on Carotid Plaque Inflammation in Patients With Acute Coronary Syndrome

Case Medical Research ◽

10.31525/ct1-nct04056169 ◽

2019 ◽

Author(s):

Keyword(s):

Acute Coronary Syndrome ◽

Carotid Plaque ◽

Low Dose ◽

High Dose ◽

Coronary Syndrome ◽

Plaque Inflammation

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Using serum biomarkers for identifying unstable carotid plaque: update of current evidence

Current Pharmaceutical Design ◽

10.2174/1381612826666201112094734 ◽

2020 ◽

Vol 26 ◽

Author(s):

Areti Sofogianni ◽

Konstantinos Tziomalos ◽

Triantafyllia Koletsa ◽

Apostolos G. Pitoulias ◽

Lemonia Skoura ◽

...

Keyword(s):

High Risk ◽

Great Proportion ◽

Current Literature ◽

Early Identification ◽

Carotid Plaque ◽

Potential Role ◽

Carotid Atherosclerosis ◽

Serum Biomarkers ◽

Current Evidence

: Carotid atherosclerosis is responsible for a great proportion of ischemic strokes. Early identification of unstable or vulnerable carotid plaques and therefore of patients at high risk for stroke is of significant medical and socioeconomical value. We reviewed the current literature and discuss the potential role of the most important serum biomarkers in identifying patients with carotid atherosclerosis who are at high risk for atheroembolic stroke.

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The analysis of the connection between plaque morphology of the asymptomatic carotid stenosis and ischemic brain lesions

Vojnosanitetski pregled ◽

10.2298/vsp110519020m ◽

2013 ◽

Vol 70 (11) ◽

pp. 993-998 ◽

Cited By ~ 3

Author(s):

Djordje Milosevic ◽

Janko Pasternak ◽

Vladan Popovic ◽

Dragan Nikolic ◽

Pavle Milosevic ◽

...

Keyword(s):

Risk Factors ◽

Carotid Stenosis ◽

Carotid Plaque ◽

Brain Infarction ◽

Statistical Significance ◽

Brain Parenchyma ◽

Plaque Morphology ◽

Asymptomatic Carotid Stenosis ◽

Asymptomatic Carotid ◽

Silent Brain Infarction

Background/Aim. A certain percentage of patients with asymptomatic carotid stenosis have an unstable carotid plaque. For these patients it is possible to register by modern imaging methods the existence of lesions of the brain parenchyma - the silent brain infarction. These patients have a greater risk of ischemic stroke. The aim of this study was to analyze the connection between the morphology of atherosclerotic carotid plaque in patients with asymptomatic carotid stenosis and the manifestation of silent brain infarction, and to analyze the influence of risk factors for cardiovascular diseases on the occurrence of silent brain infarction and the morphology of carotid plaque. Methods. This retrospective study included patients who had been operated for high grade (> 70%) extracranial atherosclerotic carotid stenosis at the Clinic for Vascular and Transplantation Surgery of the Clinical Center of Vojvodina over a period of 5 years. The patients analyzed had no clinical manifestation of cerebrovascular insufficiency of the carotid artery territory up to the time of operation. The classification of carotid plaque morphology was carried out according to the Gray-Weale classification, after which all the types were subcategorized into two groups: stable and unstable. Brain lesions were verified using preoperative imaging of the brain parenchyma by magnetic resonance. We analyzed ipsilateral lesions of the size > or = 3 mm. Results. Out of a 201 patients 78% had stable plaque and 22% unstable one. Unstable plaque was prevalent in the male patients (male/female ratio = 24.8% : 17.8%), but without a statistically significant difference (p > 0.05). The risk factors (hypertension, nicotinism, hyperlipoproteinemia, and diabetes mellitus) showed no statistically significant impact on carotid plaque morphology and the occurrence of silent brain infarction. Silent brain infarction was detected in 30.8% of the patients. Unstable carotid plaque was found in a larger percentage of patients with silent brain infarction (36.4% : 29.3%) but without a significant statistical difference (p > 0.05). Conclusions. Even though silent brain infarction is more frequent in patients with unstable plaque of carotid bifurication, the difference is of no statistical significance. The effects of the number and type of risk factors bear no statistical significance on the incidence of morphological asymptomatic carotid plaque.

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Preliminaryin vivoatherosclerotic carotid plaque characterization using the accumulated axial strain and relative lateral shift strain indices

Physics in Medicine and Biology ◽

10.1088/0031-9155/53/22/008 ◽

2008 ◽

Vol 53 (22) ◽

pp. 6377-6394 ◽

Cited By ~ 74

Author(s):

Hairong Shi ◽

Carol C Mitchell ◽

Matthew McCormick ◽

Mark A Kliewer ◽

Robert J Dempsey ◽

...

Keyword(s):

Carotid Plaque ◽

Axial Strain ◽

Lateral Shift ◽

Plaque Characterization

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Carotid Plaque, Arterial Stiffness Gradient, and Remodeling in Hypertension

Hypertension ◽

10.1161/hypertensionaha.108.115972 ◽

2008 ◽

Vol 52 (4) ◽

pp. 729-736 ◽

Cited By ~ 41

Author(s):

Hélène Beaussier ◽

Ingrid Masson ◽

Cédric Collin ◽

Erwan Bozec ◽

Brigitte Laloux ◽

...

Keyword(s):

Arterial Stiffness ◽

Carotid Plaque

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Patients with SLE have higher risk of cardiovascular events and mortality in comparison with controls with the same levels of traditional risk factors and intima-media measures, which is related to accumulated disease damage and antiphospholipid syndrome: a case–control study over 10 years

Lupus Science & Medicine ◽

10.1136/lupus-2020-000454 ◽

2021 ◽

Vol 8 (1) ◽

pp. e000454

Author(s):

Sofia Ajeganova ◽

Ingiäld Hafström ◽

Johan Frostegård

Keyword(s):

Risk Factors ◽

Antiphospholipid Syndrome ◽

Carotid Plaque ◽

Adverse Outcome ◽

Density Lipoprotein ◽

Index Score ◽

Baseline Body Mass Index ◽

Systemic Lupus ◽

Increased Risk ◽

History Of

ObjectiveSLE is a strong risk factor for premature cardiovascular (CV) disease and mortality. We investigated which factors could explain poor prognosis in SLE compared with controls.MethodsPatients with SLE and population controls without history of clinical CV events who performed carotid ultrasound examination were recruited for this study. The outcome was incident CV event and death. Event-free survival rates were compared using Kaplan-Meier curves. Relative HR (95% CI) was used to estimate risk of outcome.ResultsPatients (n=99, 87% female), aged 47 (13) years and with a disease duration of 12 (9) years, had mild disease at inclusion, Systemic Lupus Erythematosus Diseases Activity Index score of 3 (1–6) and Systemic Lupus International Collaborating Clinics (SLICC) Damage Index score of 0 (0–1). The controls (n=109, 91% female) were 49 (12) years old. Baseline carotid intima-media thickness (cIMT) did not differ between the groups, but plaques were more prevalent in patients (p=0.068). During 10.1 (9.8-10.2) years, 12 patients and 4 controls reached the outcome (p=0.022). Compared with the controls, the risk of the adverse outcome in patients increased threefold to fourfold taking into account age, gender, history of smoking and diabetes, family history of CV, baseline body mass index, waist circumference, C reactive protein, total cholesterol, high-density lipoprotein, low-density lipoprotein, dyslipidaemia, cIMT and presence of carotid plaque. In patients, higher SLICC score and SLE-antiphospholipid syndrome (SLE-APS) were associated with increased risk of the adverse outcome, with respective HRs of 1.66 (95% CI 1.20 to 2.28) and 9.08 (95% CI 2.71 to 30.5), as was cIMT with an HR of 1.006 (95% CI 1.002 to 1.01). The combination of SLICC and SLE-APS with cIMT significantly improved prediction of the adverse outcome (p<0.001).ConclusionIn patients with mild SLE of more than 10 years duration, there is a threefold to fourfold increased risk of CV events and death compared with persons who do not have SLE with similar pattern of traditional CV risk factors, cIMT and presence of carotid plaque. SLICC, SLE-APS and subclinical atherosclerosis may indicate a group at risk of worse outcome in SLE.

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