What question did this study set out to answer?

To determine whether specific carotid plaque composition features, particularly intraplaque hemorrhage, are independently associated with prior coronary events beyond traditional risk factors and plaque burden.

July 23, 2015Neurovascular ImagingOpen Access

Incremental value of carotid intraplaque hemorrhage for discriminating prior coronary events

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Why the study?

Does the presence of carotid intraplaque hemorrhage on MRI associate with prior coronary events in asymptomatic patients with carotid stenosis?

Population

159 asymptomatic subjects with 50-79% carotid stenosis by ultrasound, mean age 69.7 ± 9.0 years, 84% males…

Design

Cross-sectional, Image analysis was performed by reviewers blinded to clinical…

Authors

JSJie SunNantong University DHDaniel S. HippeCape Town HVTN Immunology Laboratory / Hutchinson Centre Research Institute of South Africa HUHunter R. UnderhillCardiac Imaging

Discussion

Member takes

Overview

May mark systemic atherosclerotic vulnerability in carotid stenosis; hypothesis-generating for risk stratification, pending prospective validation.

Key Points

To determine whether specific carotid plaque composition features, particularly intraplaque hemorrhage, are independently associated with prior coronary events beyond traditional risk factors and plaque burden.
Assessed 159 asymptomatic participants (mean age 69.7 ± 9.0 years, 84% male) with 50–79% carotid stenosis via 1.5 T multi-contrast carotid MRI.
Quantified plaque components, including fibrous tissue, calcification, lipid-rich necrotic core, and intraplaque hemorrhage, alongside plaque burden metrics.
Performed multivariate logistic regression adjusting for traditional cardiovascular risk factors and carotid percent wall volume to evaluate associations with prior coronary events.
Prior coronary events occurred in 42% (66/159) of subjects and were accompanied by higher rates of carotid intraplaque hemorrhage (32% vs. 15%, p = 0.019).
Percent wall volume independently discriminated prior coronary events after adjusting for traditional risk factors (odds ratio per 1-SD increase: 1.7, 95% CI [1.2, 2.6]).
Carotid intraplaque hemorrhage remained an independent discriminator of prior coronary events after adjusting for traditional risk factors and percent wall volume (odds ratio: 2.9, 95% CI [1.1, 7.6]), while other plaque components did not.

Structured PICO

Does the presence of carotid intraplaque hemorrhage on MRI associate with prior coronary events in asymptomatic patients with carotid stenosis?

Population

159 asymptomatic subjects with 50-79% carotid stenosis by ultrasound, mean age 69.7 ± 9.0 years, 84% males. Key inclusion: no cerebrovascular symptoms in the 6 months prior to enrollment, no prior carotid endarterectomy, neck radiation or contraindications for MRI.

Intervention

Multi-contrast carotid MRI protocol at 1.5 T to assess plaque composition (fibrous tissue, calcification, lipid-rich necrotic core, and intraplaque hemorrhage)

Outcome

Prior coronary events (hospitalization for myocardial infarction or coronary revascularization including angioplasty, stenting and CABG)hard clinical

Carotid intraplaque hemorrhage detected by MRI is independently associated with prior coronary events, suggesting it may serve as a marker of systemic atherosclerotic vulnerability.

Limitations

Selective population (only neurologically asymptomatic subjects with 50-79% carotid stenosis)
Retrospective design precluding inclusion of patients with severe coronary events such as coronary death
Circulating biomarkers (e.g., C-reactive protein) were not examined

Cite This Study

Sun et al. (2015) studied this question.

synapsesocial.com/papers/6a824bd4477bdf2e97a20c56 https://doi.org/10.1186/s40809-015-0005-y

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July 23, 2015Neurovascular ImagingOpen Access

Incremental value of carotid intraplaque hemorrhage for discriminating prior coronary events

View Full Paper

Ask AI

Bookmark

Why the study?

Does the presence of carotid intraplaque hemorrhage on MRI associate with prior coronary events in asymptomatic patients with carotid stenosis?

Population

159 asymptomatic subjects with 50-79% carotid stenosis by ultrasound, mean age 69.7 ± 9.0 years, 84% males…

Design

Cross-sectional, Image analysis was performed by reviewers blinded to clinical…

Authors

JSJie SunNantong University DHDaniel S. HippeCape Town HVTN Immunology Laboratory / Hutchinson Centre Research Institute of South Africa HUHunter R. UnderhillCardiac Imaging

Discussion

Member takes

Overview

May mark systemic atherosclerotic vulnerability in carotid stenosis; hypothesis-generating for risk stratification, pending prospective validation.

Key Points

To determine whether specific carotid plaque composition features, particularly intraplaque hemorrhage, are independently associated with prior coronary events beyond traditional risk factors and plaque burden.
Assessed 159 asymptomatic participants (mean age 69.7 ± 9.0 years, 84% male) with 50–79% carotid stenosis via 1.5 T multi-contrast carotid MRI.
Quantified plaque components, including fibrous tissue, calcification, lipid-rich necrotic core, and intraplaque hemorrhage, alongside plaque burden metrics.
Performed multivariate logistic regression adjusting for traditional cardiovascular risk factors and carotid percent wall volume to evaluate associations with prior coronary events.
Prior coronary events occurred in 42% (66/159) of subjects and were accompanied by higher rates of carotid intraplaque hemorrhage (32% vs. 15%, p = 0.019).
Percent wall volume independently discriminated prior coronary events after adjusting for traditional risk factors (odds ratio per 1-SD increase: 1.7, 95% CI [1.2, 2.6]).
Carotid intraplaque hemorrhage remained an independent discriminator of prior coronary events after adjusting for traditional risk factors and percent wall volume (odds ratio: 2.9, 95% CI [1.1, 7.6]), while other plaque components did not.

Structured PICO

Does the presence of carotid intraplaque hemorrhage on MRI associate with prior coronary events in asymptomatic patients with carotid stenosis?

Population

Intervention

Multi-contrast carotid MRI protocol at 1.5 T to assess plaque composition (fibrous tissue, calcification, lipid-rich necrotic core, and intraplaque hemorrhage)

Outcome

Prior coronary events (hospitalization for myocardial infarction or coronary revascularization including angioplasty, stenting and CABG)hard clinical

Carotid intraplaque hemorrhage detected by MRI is independently associated with prior coronary events, suggesting it may serve as a marker of systemic atherosclerotic vulnerability.

Limitations

Selective population (only neurologically asymptomatic subjects with 50-79% carotid stenosis)
Retrospective design precluding inclusion of patients with severe coronary events such as coronary death
Circulating biomarkers (e.g., C-reactive protein) were not examined

Cite This Study

Sun et al. (2015) studied this question.

synapsesocial.com/papers/6a824bd4477bdf2e97a20c56 https://doi.org/10.1186/s40809-015-0005-y

Also Consider

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