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November 29, 2024MedicineOpen Access

Comparison of stable carotid plaques in patients with mild-to-moderate carotid stenosis with vulnerable plaques in patients with significant carotid stenosis

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Key result

Vulnerable carotid plaques are linked to ~36% lower downstream wall shear stress than stable plaques.

  • AUC 0.96
  • 95% CI 0.79-1.14
  • P=.003
  • n=64

Why the study?

The study was conducted to compare characteristics of stable and vulnerable carotid plaques and evaluate the diagnostic performance of wall shear stress based on magnetic resonance plaque imaging.

Do wall shear stress parameters differ between stable carotid plaques with mild-to-moderate stenosis and vulnerable plaques with significant stenosis?

Population

64 atherosclerotic plaques

Comparison

Vulnerable plaques with significant stenosis vs stable plaques with mild-to-moderate stenosis

Design

Retrospective observational study

Authors

YLYumeng LiuBWBokai WuSWSongxiong Wu

Discussion

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Overview

WSS metrics may help identify vulnerable carotid plaques on MR imaging; hypothesis-generating in retrospective data and requires prospective validation.

Study Design

Type

Observational (n=64)

Structured PICO

Do wall shear stress parameters differ between stable carotid plaques with mild-to-moderate stenosis and vulnerable plaques with significant stenosis?

P
Population
64 atherosclerotic plaques were retrospectively analyzed to compare wall shear stress between stable plaques with mild-to-moderate stenosis and vulnerable plaques with significant stenosis.
E
Exposure
Vulnerable carotid plaques with significant stenosis
C
Comparator
Stable carotid plaques with mild-to-moderate stenosis
O
Outcome
Wall shear stress (WSS) parameters (upstream, downstream, and core) and their diagnostic performancesurrogate

Main Result

Effect estimate: AUC 0.96 (95% CI 0.79-1.14)

Absolute Event Rate: 2.88% vs 4.47%

p-value: p=.003

Vulnerable carotid plaques with significant stenosis exhibit significantly lower wall shear stress compared to stable plaques, with downstream WSS offering high diagnostic accuracy.

Cite This Study

Liu et al. (2024) conducted an observational in Carotid stenosis (n=64). Vulnerable carotid plaques with significant stenosis vs. Stable carotid plaques with mild-to-moderate stenosis was evaluated on Downstream wall shear stress (WSSdown) (AUC 0.96, 95% CI 0.79-1.14, p=.003). Vulnerable carotid plaques with significant stenosis had significantly lower downstream wall shear stress than stable plaques (2.88 vs 4.47 Pa, P=0.003), with an AUC of 0.96 for discrimination.

synapsesocial.com/papers/6a4d965ec013a1313da07ee6https://doi.org/10.1097/md.0000000000040613
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Contemporary carotid imaging: from degree of stenosis to plaque vulnerability2015 · 400 citations
  2. 2Low WSS Induces Intimal Thickening, while Large WSS Variation and Inflammation Induce Medial Thinning, in an Animal Model of Atherosclerosis2015 · 39 citations
  3. 3A parametric study of the effect of 3D plaque shape on local hemodynamics and implications for plaque instability2024 · 17 citations
  4. 4Endothelial shear stress in the evolution of coronary atherosclerotic plaque and vascular remodelling: current understanding and remaining questions2012 · 354 citations
  5. 5The Role of Magnetic Resonance Imaging and the Expression of MMP-9 Protein in the Analysis of Carotid Atherosclerotic Plaques in Patients Undergoing Carotid Endarterectomy: A Prospective Pilot Study2021 · 1 citations