A Comparative Study Between Carotid Plaque Characteristics in Symptomatic (Tia and Stroke) and Asymptomatic Patients

BACKGROUNDFew cohort studies have examined the association of carotid plaque characteristics in symptomatic and apparently healthy persons.The aim of our comparative study is to evaluate the relationship of carotid plaques, surface and morphology in symptomatic and asymptomatic patients in a clinical setting. MATERIALS AND METHODSCarotid plaques were evaluated bilaterally with ultrasonography in 75 patients, with and without a previous stroke or coronary heart disease.In this comparative study, the subsequent incidence of stroke was investigated with respect to plaque morphology. RESULTSAll the cases of TIA and Stroke had occurred within 2 weeks before examination.Cases of TIA and Stroke combined, represented the symptomatic group.Out of the 38 cases of TIA, 11 (29%) cases had previous history of TIA and one patient had history of amaurosis fugax.Among 37 cases of stroke, 8 (21.6%) cases had previous history of TIA.The age range of the cases was from 18 to 68 years with the mean age being 57.1 years.Mean age in symptomatic (TIA & Stroke) and asymptomatic group was 56.5 years and 56.8 years respectively.50% cases were in the age group of 60 to 69 years.Among the symptomatic cases 50.6% and among the asymptomatic cases 48.6% were in the age range of 60 to 69 years.Among the 58 plaques seen in cases of TIA and Stroke ipsilateral to hemisphere involved, 44 (75.86%) were heterogeneous, whereas among the 9 plaques seen in asymptomatic cases only 1 (11.11%) was heterogeneous.The association of heterogeneous plaque with the presence of symptoms was highly significant.(Z = 5.44, p <0.01).There was more difference in the prevalence of homogenous (Fig. 2) and heterogenous plaque between cases of TIA and Stroke.The prevalence of irregular surface of plaques (32) (Fig. 3) was significantly (p value < 0.01) more in symptomatic cases (55.17%) as compared to asymptomatic cases (11.11%).Whereas the prevalence of irregular surface of plaque was almost the same in cases of TIA and stroke.No plaque of the S3 type (pocketed) was found in this study. CONCLUSIONPrevalence of heterogeneous and irregular surface of plaque ipsilateral to the brain hemisphere involved was statistically more significant in symptomatic cases.A direct relationship was seen between the prevalence of heterogeneous plaque and irregular surface of plaque with the severity of stenosis.