Key result
Higher lipid-rich necrotic core proportion predicts ~230% greater odds of intraplaque hemorrhage and cap rupture.
Why the study?
Does the Carotid Atherosclerosis Score (CAS) based on MR imaging improve the classification of high-risk carotid plaque features (IPH or FCR) compared to MRA stenosis in individuals with carotid stenosis?
Population
344 individuals from 4 imaging centers with 16%-99% carotid stenosis by duplex sonography
Comparison
Carotid Atherosclerosis Score based on carotid… vs MRA stenosis
Design
Cross-sectional
Authors
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Supports MRI plaque characterization by LRNC; leaves open whether CAS improves risk classification over stenosis alone.
Cross-Sectional (n=334)
Single-blind
Yes
Does the Carotid Atherosclerosis Score (CAS) based on MR imaging improve the classification of high-risk carotid plaque features (IPH or FCR) compared to MRA stenosis in individuals with carotid stenosis?
Odds Ratio: 3.3 (95% CI 2.3–4.7)
p-value: p=<0.001
The Carotid Atherosclerosis Score, based on lipid-rich necrotic core quantification by MRI, accurately classifies high-risk carotid plaque features (IPH and FCR) better than stenosis severity alone.
Underhill et al. (2010) conducted a cross-sectional in Carotid atherosclerotic disease (n=334). Maximum percentage lipid-rich necrotic core (LRNC) vs. Lower percentage LRNC was evaluated on Presence of intraplaque hemorrhage (IPH) (OR 3.3, 95% CI 2.3-4.7, p=<0.001). A 10% increase in the maximum proportion of the arterial wall occupied by the lipid-rich necrotic core strongly predicted the presence of intraplaque hemorrhage (OR 3.3) and fibrous cap rupture.
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