Ultrasonic carotid artery plaque structure and the risk of cerebral infarction on computed tomography

Geroulakos, George; Domjan, J.; An, Nicolaides; Stevens, John; Labropoulos, Nicos; Ramaswami, Ganesh; Belcaro, Gianni; Mansfield, Averil O.

doi:10.1016/0741-5214(94)90014-0

Cited by 97 publications

(58 citation statements)

References 18 publications

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“…[16] However, during the last decade an increasing number of reports have indicated that Bmode ultrasound images of the carotid plaque reveal features (echogenicity and structure) related to the presence of brain infarcts on computed tomography images [17] and to the risk of developing new neurological symptoms [2], [6], [20], [22], [25], [32], [38]. In other studies, where carotid endarterectomy was involved, the intensity of the reflected signals has been related directly to the amount of calcification and inversely to the amount of soft materials (lipids and hemorrhage) [8], [13], [31].…”

mentioning

confidence: 99%

Quantitative analysis of ultrasound B-mode images of carotid atherosclerotic plaque: correlation with visual classification and histological examination

Wilhjelm

Grønholdt

Wiebe

et al. 1998

IEEE Trans. Med. Imaging

127

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confidence: 99%

Quantitative analysis of ultrasound B-mode images of carotid atherosclerotic plaque: correlation with visual classification and histological examination

Wilhjelm

Grønholdt

Wiebe

et al. 1998

IEEE Trans. Med. Imaging

127

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“…Confirming these results, Bock et al 17 showed that echolucent plaques were associated with a 5.7% incidence of TIA and stroke, compared with only 2.4% for echogenic plaques (PϽ0.0001). In a cross-sectional study Geroulakos et al 38 found echolucent plaques to be associated with a higher incidence of brain infarcts on CT scans (PϽ0.02). As opposed to positive associations of plaque character to events found by the above-listed studies, Holdsworth et al 20 in a cross-sectional study of 4258 patients only found amaurosis fugax to be associated with echolucent and heterogeneous plaques, whereas the degree of stenosis overall seemed more predictive of events (PϽ0.00001).…”

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confidence: 99%

Ultrasound and Lipoproteins as Predictors of Lipid-Rich, Rupture-Prone Plaques in the Carotid Artery

Grønholdt

1999

ATVB

175

111

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Abstract-The aim of this review is to summarize present knowledge of the ultrasonic detection and determinants of carotid atherosclerosis with lipid-rich cores and to review the evidence that these measures of plaque type may predict cerebral events. With the use of high-resolution ultrasound B-mode imaging, carotid plaques evaluated as only weakly reflecting the ultrasound beam (echolucent) have been associated with a higher risk of neurological events than are plaques reflecting the ultrasound signal strongly (echorich). Histologically, these echolucent plaques have a higher content of lipid and hemorrhage than do echorich plaques, which contain more calcification and fibrous tissue. Findings in the coronary arteries indicate that a lipid-rich plaque with a thin, fibrous cap is more vulnerable, is more prone to rupture, and cause symptoms compared with fibrous plaques. A search for determinants in the blood for these vulnerable plaques suggests that low density lipoprotein (LDL) cholesterol is the best lipid predictor for the extent of atherosclerosis, whereas triglyceride-rich lipoproteins in particular seem to predict an echolucent plaque. Lowering of LDL cholesterol and triglyceride-rich lipoproteins in plasma is associated with reduced progression of coronary atherosclerosis and coronary events. LDL cholesterol reduction is also associated with a reduced stroke rate. These improvements in the prognosis are thought to be the result of a reduction in the lipid content of the plaques, making them more stable and resistant to rupture rather than an actual reduction in plaque volume and degree of stenosis. In conclusion, it appears that ultrasound B-mode imaging as well as lipoproteins presumably may predict dangerous and rupture-prone, lipid-rich plaques in the carotid arteries, thereby being potential diagnostic tools in the prevention of neurological events. (Arterioscler Thromb Vasc Biol. 1999;19:2-13.)

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“…34,35 Large artery atherosclerosis, such as carotid plaque, is an established risk factor for cerebral infarction. 18,19,24 The role of orosomucoid in relation to carotid plaque burden is not known. However, in line with our study, a previous study reported elevated levels of orosomucoid in patients with carotid plaque.…”

Section: Discussionmentioning

confidence: 99%

“…Orosomucoid has also been associated with carotid atherosclerosis, 16,17 which is a major stroke risk factor and a source of thromboembolism leading to stroke. 18,19 The purpose of this study was to examine the association between orosomucoid and carotid plaque in a populationbased cohort of men and women and to study whether elevated levels of orosomucoid modify the relationship between carotid plaque and stroke.…”

mentioning

confidence: 99%

Orosomucoid, Carotid Plaque, and Incidence of Stroke

Berntsson

Östling

Persson

et al. 2016

Stroke

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Between 1991 and 1996, citizens in Malmö, born between 1926 and 1945, were invited to participate in the Malmö Diet and Cancer Study. 20 A total of 28 449 subjects (60% women) participated. Of those, a random sample of 6103 subjects, who entered the Malmö Diet and Cancer Study between 1991 and 1994, were selected to participate in a study of the epidemiology of carotid artery diseases, Background and Purpose-Orosomucoid (α-1-acid glycoprotein) is an acute-phase protein that has been implicated in anti-inflammatory, immunomodulating, and angiogenic pathways. Orosomucoid has also been associated with coronary disease and stroke. The relationship between orosomucoid, carotid plaque, and stroke incidence were explored in this study. Methods-Plasma levels of orosomucoid were assessed in 4285 subjects (39.8% men; mean age 57.5±5.9 years) without cardiovascular disease, who participated in the Malmö Diet and Cancer Study, between 1991 and 1994. The right carotid artery was examined for plaque using B-mode ultrasound examination. Incidence of stroke was followed up during a median follow-up time of 17.7 years. Results-Carotid plaque was present in 43.5% at baseline. Orosomucoid was significantly higher in subjects with carotid plaque (mean±SD: 0.72±0.22 versus 0.69±0.20 g/L; P<0.001). A total of 234 subjects were diagnosed with ischemic stroke during follow-up. Orosomucoid was associated with ischemic stroke after adjustment for risk factors, with hazard ratio 1.48 (95% confidence interval, 1.02-2.16) comparing the third versus first tertile. In subjects with plaque and belonging to the top tertile of orosomucoid, the hazard ratio was 2.07 (95% confidence interval, 1.38-3.11) compared with those without plaque and with orosomucoid in the first and second tertiles, after adjustment for C-reactive protein and other risk factors. Conclusions-Elevated levels of orosomucoid are associated with increased occurrence of carotid plaque and increased incidence of ischemic stroke. The combination of high orosomucoid and carotid plaque substantially increase the risk of stroke.

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Ultrasonic carotid artery plaque structure and the risk of cerebral infarction on computed tomography

Cited by 97 publications

References 18 publications

Quantitative analysis of ultrasound B-mode images of carotid atherosclerotic plaque: correlation with visual classification and histological examination

Quantitative analysis of ultrasound B-mode images of carotid atherosclerotic plaque: correlation with visual classification and histological examination

Ultrasound and Lipoproteins as Predictors of Lipid-Rich, Rupture-Prone Plaques in the Carotid Artery

Orosomucoid, Carotid Plaque, and Incidence of Stroke

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