Carotid plaque surface irregularity predicts ischemic stroke: the northern Manhattan study

Area of Science:

• Neurology
• Vascular Medicine
• Medical Imaging

Background:

• Limited population-based data exists on extracranial carotid plaque surface irregularity and ischemic stroke risk.
• Carotid plaque is a significant risk factor for cerebrovascular events.

Purpose of the Study:

• To evaluate the association between carotid plaque surface irregularity and ischemic stroke risk.
• To assess the predictive value of plaque surface characteristics in a multiethnic cohort.

Main Methods:

• Prospective cohort study of 1939 stroke-free subjects.
• High-resolution B-mode ultrasound to assess carotid plaque morphology.
• Cox proportional hazard models to analyze stroke risk associated with plaque characteristics.

Main Results:

• Carotid plaque was present in 56.3% of subjects; irregular plaque in 5.5%.
• Irregular plaque was independently associated with an increased risk of ischemic stroke (Hazard Ratio, 3.1).
• Unadjusted 5-year stroke risk was 8.5% for irregular plaque versus 3.0% for regular plaque.

Conclusions:

• Irregular carotid plaque independently predicts ischemic stroke in a multiethnic population.
• B-mode ultrasonography assessment of plaque surface irregularities can identify individuals at intermediate-to-high risk.
• This imaging marker may enhance stroke risk stratification beyond traditional vascular risk factors.