Carotid plaque rather than intima-media thickness as a predictor of recurrent vascular events in patients with acute ischemic stroke

Yoon, Hyun Ju; Kim, Kye Hun; Park, Hyukjin; Cho, Jae Yeong; Hong, Young Joon; Kim, Ju Han; Ahn, Youngkeun; Cho, Jeong Gwan; Park, Jong Chun

doi:10.1186/s12947-017-0110-y

Cited by 17 publications

(28 citation statements)

References 38 publications

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“…10,11,13 Additionally, carotid imaging further identifies advanced stages of atherosclerosis, such as plaques and stenosis, either in the absence of or concurrent with diffuse carotid thickening. 14,17 Moreover, PWV measurement is the most appropriate method to assess arterial stiffness, 18,19 and the identification of increased PWV improves risk discrimination of the first cardiovascular event. 14 Increased CIMT is an independent, strong predictor of future vascular events, 11,15,16 while carotid plaques independently predict cardiac events and CVD recurrence in patients who have had an ischemic stroke.…”

Section: Introductionmentioning

confidence: 99%

“…14 Increased CIMT is an independent, strong predictor of future vascular events, 11,15,16 while carotid plaques independently predict cardiac events and CVD recurrence in patients who have had an ischemic stroke. 14,17 Moreover, PWV measurement is the most appropriate method to assess arterial stiffness, 18,19 and the identification of increased PWV improves risk discrimination of the first cardiovascular event. 6,18 However, the relationship between migraine and arterial stiffening [20][21][22][23][24] or carotid artery disease 20,[23][24][25][26][27][28][29][30][31][32][33][34][35] is controversial.…”

Section: Introductionmentioning

confidence: 99%

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Migraine and Markers of Carotid Atherosclerosis in Middle‐Aged Women: A Cross‐Sectional Study

et al. 2018

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Objective This study evaluated the association between migraine and the markers of carotid artery disease. Background Migraine increases the risk of cardiovascular events, but its relationship with vascular dysfunction is unclear. Methods In this cross‐sectional study, middle‐aged women with no known cardiovascular diseases underwent clinical, neurological, and laboratory evaluations; pulse wave velocity (PWV) assessment; and carotid artery ultrasonography. We divided the participants based on the presence of migraine and, further, based on the type of migraine. Associations between migraine and carotid thickening (intima‐media thickness >0.9 mm), carotid plaques, or arterial stiffening (PWV >10 m/s) were evaluated using a multiple regression analysis. Results The study comprised 112/277 (40%) women with migraine, of whom 46/277 (17%) reported having an aura. Compared to the non‐migraineurs, the migraine with aura group had an increased risk of diffuse carotid thickening (3/46 [6.8%] vs 2/165 [1.3%], adjusted OR = 7.12, 95% CI 1.05–48.49). Migraine without aura was associated with a low risk of carotid plaques (3/66 [4.7%] vs 26/165 [16.7%], adjusted OR = 0.28, 95% CI 0.08–0.99) and arterial stiffening (21/66 [34.4%] vs 82/165 [51.2%], adjusted OR = 0.39, 95% CI 0.19–0.79). There were no correlations between migraine characteristics and arterial stiffness or carotid thickness measurements. Conclusion Migraine with aura is associated with an increased risk of carotid thickening, and migraine without aura is associated with a low risk of carotid plaques and arterial stiffening.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Migraine and Markers of Carotid Atherosclerosis in Middle‐Aged Women: A Cross‐Sectional Study

et al. 2018

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“…Therefore, plaque assessment in addition to CIMT should be considered in CV risk prediction. Several articles have shown that the assessment of carotid plaque (e.g., presence/absence of plaque, plaque thickness, plaque area or plaque score) is more useful than CIMT for predicting future CVD. Furthermore, considering not only the largest identified plaque, but also the total plaque burden in both carotid arteries might further improve risk estimation.…”

Section: What Kind Of Carotid Ultrasound Parameters Should Be Measured?mentioning

confidence: 99%

Clinical utility of carotid ultrasonography: Application for the management of patients with diabetes

Katakami

Matsuoka

Shimomura

2019

J of Diabetes Invest

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Carotid ultrasonography is a non‐invasive, simple and inexpensive modality to assess the severity of atherosclerosis. This article reviews related articles, summarizes the rationale for the application of carotid ultrasonography in clinical practice, and addresses the features and the limitations of carotid ultrasonography in cardiovascular risk prediction. Numerous large studies have confirmed that various carotid ultrasound measures, such as carotid intima‐media thickness, the presence or absence of carotid plaque, plaque number and plaque area, can be independent predictors of cardiovascular diseases in individuals with and without diabetes mellitus. Furthermore, many studies showed that the use of carotid intima‐media thickness (especially maximum intima‐media thickness, including plaque thickness) and/or carotid plaque in addition to traditional risk factors significantly improved the prediction of the occurrence of cardiovascular diseases , while controversy remains. Several studies showed that the progression of carotid intima‐media thickness also can be a surrogate end‐point of cardiovascular events. However, the accumulated evidence has not been sufficient. Further study with sufficient power should be carried out. As plaque disruption, which plays a crucial role in the pathogenesis of cardiovascular events, is dependent on the content of lipid in the atheroma and the thickness of the fibrous cap, tissue characterization of a plaque might be useful for determining its fragility. Interestingly, recent studies have shown that ultrasonic tissue characterization of carotid lesions could improve the prediction ability of future cardiovascular diseases . Thus, carotid ultrasonography is a useful modality for better clinical practice of atherosclerosis in patients with diabetes.

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“…[9][10][11][12][13] The association between CCA-IMT and risk or prediction of stroke has been questioned. [13][14][15][16] The present meta-analysis was aimed to clarify the association of CCA-IMT with risk of stroke and its subtypes by estimating pooled analysis of published literature.…”

Section: Introductionmentioning

confidence: 99%

CIMT as a risk factor for stroke subtype: A systematic review

Kumar

Sharma

Misra

et al. 2020

Eur J Clin Investigation

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Introduction: An increase in the common carotid artery intima-media thickness (CCA-IMT) is generally considered an early marker of atherosclerosis and is a well-established predictor of cardiovascular disease (CVD). An association between changes in CCA-IMT and risk of stroke has been reported but has conflicting findings. Objective: The present meta-analysis was aimed to clarify the association between CCA-IMT with the risk of stroke and its subtype by estimating pooled analysis of published literature. Methods: Comprehensive search for all published articles was performed in electronic databases including PubMed, Embase, Cochrane Library, Trip Databases, Worldwide Science, CINAHL and Google Scholar from 01 January 1950 to 30 April 2020. Results: In our meta-analysis, a total of 19 studies, of which sixteen studies involving 3475 ischaemic stroke (IS) cases and 11 826 controls; six studies with 902 large vessel disease (LVD) and 548 small vessel disease (SVD) of IS subtypes; five studies with 228 intracerebral haemorrhage (ICH) and 1032 IS cases, were included. Our findings suggest a strong association between increased CCA-IMT with risk of IS as compared to control subjects [SMD = 1.46, 95% CI = 0.90-2.02]. However, there is an increased risk of LVD as compared to the SVD subtype of IS [SMD = 0.36, 95% CI = 0.19-0.52] and more chance of occurrence of IS rather than ICH [SMD = 0.71, 95% CI = 0.28-1.41]. Conclusions: Carotid intima thickness measurements are found to be associated with the risk of stroke along with its subtypes and may be used as a diagnostic marker for predicting the risk of stroke events.

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Carotid plaque rather than intima-media thickness as a predictor of recurrent vascular events in patients with acute ischemic stroke

Cited by 17 publications

References 38 publications

Migraine and Markers of Carotid Atherosclerosis in Middle‐Aged Women: A Cross‐Sectional Study

Migraine and Markers of Carotid Atherosclerosis in Middle‐Aged Women: A Cross‐Sectional Study

Clinical utility of carotid ultrasonography: Application for the management of patients with diabetes

CIMT as a risk factor for stroke subtype: A systematic review

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