Key result
Progression of carotid artery stenosis was associated with an increased risk of stroke or transient ischemic attack.
Why the study?
Carotid artery stenosis is a leading cause of ischemic stroke, but knowledge regarding changes in the plaque itself is lacking.
Do hypoechoic plaque and high-risk hs-CRP predict carotid stenosis progression and subsequent cerebrovascular events in patients with carotid stenosis?
Cohort (n=736)
Do hypoechoic plaque and high-risk hs-CRP predict carotid stenosis progression and subsequent cerebrovascular events in patients with carotid stenosis?
High-risk hs-CRP and hypoechoic plaque on ultrasound identify patients with carotid stenosis at higher risk for progression and subsequent cerebrovascular events.
Answers are grounded in this paper and cite their sources.
Hypoechoic plaques and high-risk hs-CRP were associated with CAS progression and events; leaves open whether they should guide intensified surveillance or trials.
BACKGROUND: Carotid artery stenosis (CAS) is one of the leading causes of ischemic stroke. However, knowledge of the changes in the plaque itself is lacking. Information about the ultrasound and clinical features of CAS will help elucidate the changes in prognostic and risk factors. METHODS: We evaluated 736 patients with carotid stenosis for an average 18-month follow-up. According to their degree of CAS stenosis, patients were allocated to one of three groups: regression (n=125), stable (n=443), or progression (n=168). An ordinal regression analysis was used to determine the risk factors for atherosclerosis progression. A logistic regression was subsequently applied to investigate the effects of CAS stenosis on cerebrovascular events after adjusting for various factors. RESULTS: The progression group had more male patients (P=0.02), hypoechoic plaque (P<0.01), high-risk high sensitivity C-reactive protein (hs-CRP) (P=0.02), ulcerative plaque (P=0.05), and hyperlipidemia (P=0.05) than the other two groups. There were no significant differences in residual ultrasound and clinical features among the three groups, including age, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), intima-media thickness (IMT), body mass index (BMI), diabetes mellitus (DM), hypertension (HTN), coronary heart disease (CHD), statin use, ulcerative plaque. The ordinal regression analysis identified hypoechoic plaque (OR, 1.53; 95% CI: 1.14-2.05; P<0.01) and high-risk hs-CRP (OR, 1.75; 95% CI: 1.17-2.61; P<0.01) as independent risk factors for CAS progression. Logistic regression analysis revealed that the stroke/transient ischemic attack adjusted odds ratio was 1.80 (95% CI: 1.03-3.13) in the progression group. CONCLUSIONS: High-risk hs-CRP and hypoechoic plaque are independently associated with CAS progression. The progression of carotid stenosis is associated with a high risk of cerebrovascular events.
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Liu et al. (2021) conducted a cohort in Carotid artery stenosis (n=736). Carotid artery stenosis progression vs. Stable or regression of carotid artery stenosis was evaluated on Stroke or transient ischemic attack (OR 1.80, 95% CI 1.03-3.13). Progression of carotid artery stenosis was associated with an increased risk of stroke or transient ischemic attack.
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