MRI-depicted thin and/or ruptured fibrous cap was strongly associated with recurrent ipsilateral TIA or stroke at 1 year (HR 5.756; 95% CI 1.913-17.324; P=0.002).
Cohort (n=126)
Effect estimate: HR 5.756 (95% CI 1.913-17.324)
p-value: p=0.002
PURPOSE: To evaluate the potential of carotid plaque MRI to predict transient ischemic attack (TIA) and stroke recurrence in previously symptomatic patients. MATERIALS AND METHODS: One hundred twenty-six TIA/stroke patients with ipsilateral 30-69% carotid stenosis underwent multisequence carotid plaque MRI. The presence of a lipid-rich necrotic core (LRNC), fibrous cap (FC) status, and intraplaque hemorrhage (IPH) were assessed. Patients were followed to determine the recurrence of ipsilateral TIA and/or stroke within 1 year after inclusion. RESULTS: Thirteen patients suffered from recurrent ipsilateral clinical ischemic events (10 TIAs and 3 strokes). Carotid stenosis grade was not associated with recurrent events (hazard ratio HR for 50-69% versus 30-49% stenosis = 1.198; 95% confidence interval CI, 0.383 to 3.749; P = 0.756). The presence of an LRNC (HR = 3.2001; 95% CI, 1.078 to 9.504; P = 0.036), a thin and/or ruptured FC (HR = 5.756; 95% CI, 1.913 to 17.324; P = 0.002), and IPH (HR = 3.542; 95% CI, 1.058 to 11.856; P = 0.040) were associated with recurrence. CONCLUSION: The presence of MRI-depicted LRNC, a thin and/or ruptured FC, and IPH are associated with the recurrence of clinical cerebrovascular ischemic events in TIA and stroke patients with carotid atherosclerosis.
Kwee et al. (Fri,) conducted a cohort in Transient ischemic attack (TIA) and stroke (n=126). Carotid plaque MRI (assessing LRNC, FC status, and IPH) was evaluated on Recurrence of ipsilateral TIA and/or stroke (HR 5.756, 95% CI 1.913-17.324, p=0.002). MRI-depicted thin and/or ruptured fibrous cap was strongly associated with recurrent ipsilateral TIA or stroke at 1 year (HR 5.756; 95% CI 1.913-17.324; P=0.002).