Size of carotid artery intraplaque hemorrhage and acute ischemic stroke: a cardiovascular magnetic resonance Chinese atherosclerosis risk evaluation study
Size of carotid artery intraplaque hemorrhage and acute ischemic stroke: a cardiovascular magnetic resonance Chinese atherosclerosis risk evaluation study
复制标题
颈动脉斑块内出血大小与急性缺血性脑卒中：心血管磁共振中国动脉粥样硬化风险评估研究
DOI：
10.1186/s12968-019-0548-1
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发表时间：
2019-07-01
影响因子：
6.4
通讯作者：
Zhao, Xihai
中科院分区：
文献类型：
--
作者：
Liu, Yang;Wang, Maoxue;Zhao, Xihai
BackgroundTo determine the useful of the size of carotid arterial intraplaque hemorrhage（IPH）in discriminating the risk of acute ischemic stroke using cardiovascular magnetic resonance（CMR）vessel wall imaging. MethodsSymptoms patients with carotid atherosclerotic plaque who participated in a cross-section，center study of CARE-II（NCT 02017756）were included.所有患者均接受颈动脉和脑CMR成像。测量颈动脉斑块负荷和斑块成分的大小，包括钙化、富脂坏死核心（LRNC）和IPH。确定颈动脉斑块同侧半球是否存在急性脑梗死（ACI）。颈动脉斑块的特点和存在同侧ACI之间的关系，然后analysed.ResultsOf 687例（62.7 ± 10.1岁，69.4%男性）与颈动脉斑块，28.5%有ACI在同侧半球。Logistic回归分析显示，调整临床混杂因素后，颈动脉斑块负荷与ACI的存在显著相关。LRNC体积、%LRNC体积、IPH体积和%IPH体积与ACI显著相关，（LRNC体积：OR = 1.297，p = 0.005; %LRNC体积：OR = 1.119，p = 0.018; IPH体积：OR = 2.514，p = 0.003; %IPH体积：OR = 2.202，p = 0.003）和之后（LRNC体积：OR = 1.312，p = 0.006; %LRNC体积：OR = 1.90，p = 0.034; IPH体积：OR = 2.907，p = 0.007; % IPH体积：OR = 2.374，p = 0.004）调整临床混杂因素。在进一步校正斑块体积后，IPH体积与ACI之间的相关性仍具有统计学意义（OR = 2.813，p = 0.016）或斑块体积和LRNC体积结论在有症状的颈动脉粥样硬化斑块患者中，IPH的大小与同侧ACI独立相关，提示IPH的大小可能是ACI风险的有用指标http://www.clinicaltrials.gov。
BackgroundTo determine the usefulness of the size of carotid artery intraplaque hemorrhage (IPH) in discriminating the risk of acute ischemic stroke using cardiovascular magnetic resonance (CMR) vessel wall imaging.MethodsSymptomatic patients with carotid atherosclerotic plaque who participated in a cross-sectional, multicenter study of CARE-II (NCT02017756) were included. All patients underwent carotid and brain CMR imaging. Carotid plaque burden and the size of plaque compositions including calcification, lipid-rich necrotic core (LRNC), and IPH were measured. Presence of acute cerebral infarct (ACI) in ipsilateral hemisphere of carotid plaque was determined. The relationship between carotid plaque features and presence of ipsilateral ACI was then analyzed.ResultsOf 687 recruited patients (62.7 ± 10.1 years; 69.4% males) with carotid plaque, 28.5% had ACI in ipsilateral hemispheres. Logistic regression revealed that carotid plaque burden was significantly associated with the presence of ACI before and after adjusted for clinical confounding factors. The volume of LRNC, %LRNC volume, volume of IPH, and %IPH volume were significantly associated with ACI before (volume of LRNC: OR = 1.297, p = 0.005; %LRNC volume: OR = 1.119, p = 0.018; volume of IPH: OR = 2.514, p = 0.003; %IPH volume: OR = 2.202, p = 0.003) and after (volume of LRNC: OR = 1.312, p = 0.006; %LRNC volume: OR = 1.90, p = 0.034; volume of IPH: OR = 2.907, p = 0.007; % IPH volume: OR = 2.374, p = 0.004) adjusted for clinical confounding factors. The association between volume of IPH and ACI remained statistically significant after further adjusted for plaque volume (OR = 2.813, p = 0.016) or both plaque volume and volume of LRNC (OR = 4.044, p = 0.024).ConclusionsIn symptomatic patients with carotid atherosclerotic plaques, the size of IPH is independently associated with ipsilateral ACI, suggesting the size of IPH might be a useful indicator for the risk of ACI.Trial registrationClinical Trial Registration-URL: http://www.clinicaltrials.gov. Unique Identifier: NCT02017756.