Carotid Plaque Characteristics Combined With Serum Inflammatory Biomarkers Predict Recurrent Ischemic Stroke

To investigate the potential value of serum inflammatory markers combined with carotid plaque characteristics for predicting subsequent recurrent ischemic events.

Patients with cerebral infarction localized to the internal carotid artery territory were recruited. Carotid MRI examinations were performed, and the plaque characteristics were evaluated at baseline. Serum samples were obtained, and clinical characteristics were documented at baseline. All participants received clinical follow-up 1 year after discharge. Recurrent ipsilateral ischemic stroke was considered the clinical endpoint. Logistic regression analyses were employed to assess the correlations between serum inflammatory biomarkers, plaque characteristics, and the endpoint. The diagnostic performances were evaluated using receiver operating characteristic curves. DeLong's test was used to compare the areas under the curve (AUCs) of the models.

In total, 89 patients (84.3% men; mean age, 56.57 ± 9.05 years) with recent anterior circulation (carotid territory) cerebral hemisphere ischemia were included. Sixteen patients presented with an endpoint within the 1-year follow-up. Multivariate logistic regression demonstrated that the normalized wall index, intraplaque hemorrhage, lipid-rich necrotic core, and high-sensitivity C-reactive protein (Hs-CRP) were associated with the endpoint. The model combining plaque characteristics and Hs-CRP had the highest diagnostic performance with an AUC of 0.855.

Serum Hs-CRP level and plaque characteristics may provide complementary information for predicting recurrent stroke. The combination of these two indicators may be a better potential predictor of the population at high risk of stroke recurrence.