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European Radiology
Published in: European Radiology 9/2022

02-04-2022 | Cerebral Small Vessel Disease | Head and Neck

Carotid vulnerable plaque coexisting with cerebral small vessel disease and acute ischemic stroke: a Chinese Atherosclerosis Risk Evaluation study

Authors: Jin Li, Hengqu Wu, Hailun Hang, Beibei Sun, Huilin Zhao, Zengai Chen, Yan Zhou, Jianrong Xu, Jinmei Chen, Dan Zhou, Xihai Zhao, Chun Yuan

Published in: European Radiology | Issue 9/2022

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Abstract

Objectives

We aimed to investigate the associations between carotid vulnerable plaque features coexisting with cerebral small vessel diseases (CSVDs) and acute ischemic stroke (AIS) and, furthermore, to determine whether coexisting diseases had a stronger association with AIS than a single disease.

Methods

Patients with cerebrovascular symptoms and carotid plaque were recruited from the cross-sectional, multicenter CARE-II study. The population was divided into two groups (AIS and transient ischemic stroke (TIA)). MRI features of carotid plaques (including luminal stenosis and plaque vulnerabilities) and CSVDs (such as white matter hyperintensities (WMHs) and lacunes) were evaluated. Coexisting diseases were defined as the presence of at least one carotid plaque features and one or more CSVDs feature. Multivariate logistic regression was performed to examine the associations between coexisting diseases and AIS.

Results

Of the recruited 634 patients (mean age: 59.1 ± 11.3 years; 429 males), 312 (49.2%) patients had AIS. These subjects had a higher prevalence of carotid vulnerable plaques, lacunes, and moderate-to-severe WMHs (a total Fazekas score of 3–6) than those with TIA (42.6% vs. 29.5%, 59.6% vs. 26.4%, 69.9% vs. 60.6%, respectively, all p < 0.05). Multivariate analysis revealed that carotid plaque features coexisting with lacunes or moderate-to-severe WMHs had a stronger association with AIS compared to carotid lesions alone (all p < 0.05) (i.e., vulnerable plaque coexisting with lacunes vs. vulnerable plaque alone, adjusted odds ratio: 3.67 vs. 1.62).

Conclusions

Carotid vulnerable plaque features coexisting with CSVDs, particularly lacunes, had a stronger association with AIS compared to carotid lesions alone in a large, symptomatic, cohort.

Trial registration

Clinical trial registration URL: http://​www.​clinicaltrials.​gov, unique identifier: NCT02017756

Key Points

• Carotid vulnerable plaque features coexisting with cerebral small vessel diseases, such as lacunes, had a stronger association with acute ischemic stroke compared to single diseases in symptomatic patients.
• A comprehensive assessment of coexisting cerebrovascular diseases may help stratify the risk of acute ischemic stroke.
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Metadata
Title
Carotid vulnerable plaque coexisting with cerebral small vessel disease and acute ischemic stroke: a Chinese Atherosclerosis Risk Evaluation study
Authors
Jin Li
Hengqu Wu
Hailun Hang
Beibei Sun
Huilin Zhao
Zengai Chen
Yan Zhou
Jianrong Xu
Jinmei Chen
Dan Zhou
Xihai Zhao
Chun Yuan
Publication date
02-04-2022
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 9/2022
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-022-08757-9

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