Culprit Plaque in Acute Cerebral Infarction: A Histological and MRI Assessment

描述（由申请人提供）：每40秒，美国就有一个人中风。中风是总体死亡的第四大原因（在女性中排名第三），它占美国每18例死亡中的一例，它是中国第三大死因。Sino-MONICA-Beijing项目的数据表明，1984年至2004年，25-74岁人群中缺血性卒中的发病率翻了一番，从100.5/100，000增加到213.2/100，000。中风也是导致严重、长期残疾的主要原因。在65岁及以上的缺血性卒中幸存者中，50%有一定程度的轻偏瘫，30%在没有辅助的情况下无法行走，19%有失语症，26%在缺血性事件发生后6个月被安置在疗养院。2008年，美国卒中的直接和间接成本为343亿美元2，预计2050年的成本将超过2.2万亿美元，这导致人们呼吁在美国和中国更加关注卒中的二级预防。这项研究的目的是提供成像技术，这将有助于临床医生选择最合适的治疗策略，为个别病人。我们的目标是通过开发用于检测和定位导致中风的动脉粥样硬化病变（称为罪魁祸首斑块）的改进方法来实现这一目标。此外，我们试图提供新的标志物和高危斑块发展的风险因素的见解。这项研究的结果将为前瞻性研究奠定基础，这些研究将评估MRI检测到的罪犯斑块的存在是否会增加复发性卒中的风险，以及特定的循环标志物是否可以预测进展为高风险斑块。

DESCRIPTION (provided by applicant): Every 40 seconds, one person in the U.S. has a stroke. Stroke is the fourth leading cause of death overall (third leading among women), it accounts for one of every 18 deaths in the U.S., and it is the third leading cause of death in China. Data from the Sino-MONICA-Beijing Project indicate that the incidence of ischemic stroke in 25-74 year old individuals has doubled between 1984 and 2004, from 100.5 to 213.2 per 100,000. Stroke is also the leading cause of serious, long-term disability. Amongst ischemic stroke survivors 65 years of age and older, 50% have some hemiparesis, 30% are unable to walk without assistance, 19% have aphasia, and 26% are institutionalized in a nursing home six months following their ischemic event. In 2008, the direct and indirect cost of stroke in the U.S. was $34.3 billion2 and projected costs in 2050 exceed $2.2 trillion, leading to calls for greater focus on secondary stroke prevention in the U.S. and in China. The goal of this research is to provide imaging techniques that will help clinicians select the most appropriate treatment strategy for the individual patient. We aim to accomplish this goal through development of improved methods for the detection and localization of the atherosclerotic lesion responsible for stroke, referred to as the culprit plaque. Furthermore, we seek to provide insight into novel markers and risk factors for development of the high-risk plaque. Findings from this study will lay the foundation for prospective studies that will assess whether presence of an MRI-detected culprit plaque poses a higher risk for recurrent stroke, and whether specific circulating markers predict progression to a high-risk plaque.