Clustering of Risk Factors Increases the Incidence of Echolucent Carotid Plaque in Stroke Patients

Abstract

Background: The purpose of this study was to assess the influence of clusters of risk factors on the incidence of echolucent carotid plaque in stroke patients. Methods: A retrospective analysis of 413 stroke patients who had undergone carotid ultrasonography was performed. High-resolution B-mode ultrasonography was used to evaluate the characteristics of carotid plaque. We investigated the relationships between the incidence of echolucent carotid plaque and clustering of risk factors (hypertension, diabetes mellitus and hyperlipidemia) and stroke subtypes and transient ischemic attack (TIA). Results: Echolucent plaques were present in 10.5% of patients free of risk factors, in 18.8% with a single risk factor (NS), in 27.7% with two risk factors (p <0.01) and in 50.0% with three risk factors (p <0.001), and were significantly more common in patients with multiple risk factors (odds ratio 1.79; 95% CI, 1.05–3.06; p = 0.045). Echolucent plaques were observed in 41.2% of patients with atherothrombotic infarction, in 17.6% with lacunar infarction, in 11.5% with cardioembolic stroke, and in 25.0% with TIA, and were significantly more common in patients with atherothrombotic infarction than in those with lacunar infarction or cardioembolic stroke (p<0.001), or in those with TIA (p <0.05). Conclusions: The clustering of risk factors increased the incidence of echolucent carotid plaque. Patients with multiple risk factors were at increased risk of echolucent plaque, and these had a significant relationship with atherothrombotic infarction compared with other stroke subtypes and TIA.

Common Carotid Artery Intima-Media Thickness and Intracranial Pulsatility Index in Non-ST-Elevation Acute Coronary Syndromes

“…Our data are consistent with other work on the association of the CIMT [16] and the incidence of echolucent carotid plaque [17] with some cardiovascular risk factors. Recently, Granér et al [18] showed that CIMT seems a predictor of coronary arteriosclerosis in mid and distal parts of the coronary tree but not in proximal ones.…”

Echolucency of carotid plaques and cerebrovascular events

“…Echolucent plaques usually consist of a large lipidic or necrotic core with a thin fibrous cap, whereas echogenic plaques consist mostly of fibrous tissue and/or calcification 23–27. Echolucent plaques were found to be more at risk for stroke or cerebrovascular events than echogenic plaques and are thought to be more prone to rupture 2.…”

Definition and Evaluation of Transient Ischemic Attack

“…144 Echolucent plaque detected by high-resolution B-mode ultrasound correlates with clustering of conventional vascular risk factors and large-artery strokes compared with other stroke subtypes and compared with TIA. 145 Echolucency 144 and surface irregularity detected by MRI 146 can be correlated with symptomatic versus asymptomatic status. Recent reports with positron emission tomography and MRI correlate plaque inflammation with plaque stability.…”