Intraplaque Hemorrhage and the Plaque Surface in Carotid Atherosclerosis: The Plaque At RISK Study (PARISK

A.C. van Dijk, M. T. Truijman, B. Hussain, T. Zadi, G. Saiedie, A.A. de Rotte, M.I. Liem, A.F. van der Steen, M.J. Daemen, P.J. Koudstaal, P.J. Nederkoorn, J. Hendrikse, E.M. Kooi, A. van der Lugt

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Abstract

BACKGROUND AND PURPOSE: An important characteristic of vulnerable plaque, intraplaque hemorrhage, may predict plaque rupture. Plaque rupture can be visible on noninvasive imaging as a disruption of the plaque surface. We investigated the association between intraplaque hemorrhage and disruption of the plaque surface. MATERIALS AND METHODS: We selected the first 100 patients of the Plaque At RISK study, an ongoing prospective noninvasive plaque imaging study in patients with mild-to-moderate atherosclerotic lesions in the carotid artery. In carotid artery plaques, disruption of the plaque surface (defined as ulcerated plaques and/or fissured fibrous cap) and intraplaque hemorrhage were assessed by using MDCTA and 3T MR imaging, respectively. We used a chi2 test and multivariable logistic regression to assess the association between intraplaque hemorrhage and disrupted plaque surface. RESULTS: One hundred forty-nine carotid arteries in 78 patients could be used for the current analyses. Intraplaque hemorrhage and plaque ulcerations were more prevalent in symptomatic compared with contralateral vessels (hemorrhage, 38% versus 11%; P < .001; and ulcerations, 27% versus 7%; P = .001). Fissured fibrous cap was more prevalent in symptomatic compared with contralateral vessels (13% versus 4%; P = .06). After adjustment for age, sex, diabetes mellitus, and degree of stenosis, intraplaque hemorrhage was associated with disrupted plaque surface (OR, 3.13; 95% CI, 1.25-7.84) in all vessels. CONCLUSIONS: Intraplaque hemorrhage is associated with disruption of the plaque surface in patients with a carotid artery stenosis of <70%. Serial studies are needed to investigate whether intraplaque hemorrhage indeed increases the risk of plaque rupture and subsequent ischemic stroke during follow-up.
Original languageEnglish
Pages (from-to)2127-2133
Number of pages7
JournalAmerican Journal of Neuroradiology
Volume36
Issue number11
DOIs
Publication statusPublished - Nov 2015

Keywords

  • ROW CT ANGIOGRAPHY
  • CEREBROVASCULAR EVENTS
  • ASSESSMENT STRATEGIES
  • SYMPTOMATIC PATIENTS
  • VULNERABLE PATIENT
  • STENOSIS
  • ENDARTERECTOMY
  • MORPHOLOGY
  • IDENTIFICATION
  • DEFINITIONS

Cite this

van Dijk, A. C., Truijman, M. T., Hussain, B., Zadi, T., Saiedie, G., de Rotte, A. A., Liem, M. I., van der Steen, A. F., Daemen, M. J., Koudstaal, P. J., Nederkoorn, P. J., Hendrikse, J., Kooi, E. M., & van der Lugt, A. (2015). Intraplaque Hemorrhage and the Plaque Surface in Carotid Atherosclerosis: The Plaque At RISK Study (PARISK. American Journal of Neuroradiology, 36(11), 2127-2133. https://doi.org/10.3174/ajnr.A4414