Plaque Morphology in Carotid Stenosis is a Risk Factor for Ischemic Cerebrovascular Events.

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Bibliographic Details
Title:	Plaque Morphology in Carotid Stenosis is a Risk Factor for Ischemic Cerebrovascular Events.
Authors:	Mathiesen*†, Ellisiv B., Bønaa, Kaare H., Joakimsen†, Oddmund
Source:	Acta Neurologica Scandinavica. May2001, Vol. 103 Issue 5, p327. 7p.
Subjects:	Carotid artery diseases, Arterial stenosis, Coronary disease
Abstract:	Purpose: To assess in a prospective, population-based design whether plaque morphology is associated with increased risk of ischemic stroke and other cerebrovascular events in subjects with carotid stenosis. Methods: A total of 223 subjects with carotid stenosis and 215 controls matched by age and sex who participated in a population health survey were followed up for 3 years. At baseline, plaque morphology and degree of stenosis were assessed by ultrasound, and information on risk factors was obtained. Plaque echogenicity was scored as echolucent, predominantly echolucent, predominantly echogenic, or echogenic. Results: Forty-four subjects experienced one or more ischemic cerebrovascular events in the follow-up period. Plaque echogenicity, degree of stenosis, and white blood cell count were independent predictors of cerebrovascular events. The unadjusted relative risk for cerebrovascular events was 12.98 in subjects with echolucent plaques (95% confidence interval [CI] 4.50-37.43), and in subjects with echogenic plaques 3.67 (95% CI 0.74-18.21) when subjects without stenosis were used as the reference. When adjustments were made for age, sex, degree of stenosis and cardiovascular risk factors, the relative risk for cerebrovascular events in subjects with echolucent plaques was 4.21 (95% CI 1.01-17.63), and there was a significant linear trend (p=0.02) for higher risk with increasing plaque echolucency. Conclusions: Subjects with echolucent atherosclerotic plaques have increased risk of ischemic cerebrovascular events independent of degree of stenosis and cardiovascular risk factors. Subjects with high risk of ischemic vascular events may be identified by ultrasound assessment of plaque morphology. [ABSTRACT FROM AUTHOR]
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Database:	Psychology and Behavioral Sciences Collection

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Abstract:	Purpose: To assess in a prospective, population-based design whether plaque morphology is associated with increased risk of ischemic stroke and other cerebrovascular events in subjects with carotid stenosis. Methods: A total of 223 subjects with carotid stenosis and 215 controls matched by age and sex who participated in a population health survey were followed up for 3 years. At baseline, plaque morphology and degree of stenosis were assessed by ultrasound, and information on risk factors was obtained. Plaque echogenicity was scored as echolucent, predominantly echolucent, predominantly echogenic, or echogenic. Results: Forty-four subjects experienced one or more ischemic cerebrovascular events in the follow-up period. Plaque echogenicity, degree of stenosis, and white blood cell count were independent predictors of cerebrovascular events. The unadjusted relative risk for cerebrovascular events was 12.98 in subjects with echolucent plaques (95% confidence interval [CI] 4.50-37.43), and in subjects with echogenic plaques 3.67 (95% CI 0.74-18.21) when subjects without stenosis were used as the reference. When adjustments were made for age, sex, degree of stenosis and cardiovascular risk factors, the relative risk for cerebrovascular events in subjects with echolucent plaques was 4.21 (95% CI 1.01-17.63), and there was a significant linear trend (p=0.02) for higher risk with increasing plaque echolucency. Conclusions: Subjects with echolucent atherosclerotic plaques have increased risk of ischemic cerebrovascular events independent of degree of stenosis and cardiovascular risk factors. Subjects with high risk of ischemic vascular events may be identified by ultrasound assessment of plaque morphology. [ABSTRACT FROM AUTHOR]
ISSN:	00016314