title: Carotid plaque morphology improves stroke risk prediction: usefulness of a new ultrasonographic score.
abstract: Carotid thickening and plaque detected by B-mode imaging ultrasound are useful to improve the ischemic risk evaluation in asymptomatic subjects over and beyond the traditional cardiovascular risk factors. Some plaque's echographic parameters help describing the vascular risk. We hypothesized that the stenosis degree, plaque surface irregularity, echolucency and texture, compounded in a Total Plaque Risk Score (TPRS), are predictors of the ischemic events in the San Daniele study, a general population-based study of 1,348 subjects followed for 12 years in average. In the 171 subjects with at least one plaque at baseline, high TPRS was the most powerful independent predictor of cerebrovascular events, which occurred in 115 subjects. Addition of plaque characteristics significantly increased the area under the ROC curve (0.90 vs. 0.88, p = 0.04) versus the Framingham risk score alone. The TPRS is a potential new tool to improve the stroke risk prediction.
authors.affiliation: Neurology Department, Gervasutta Hospital, Via Gervasutta 48, Udine, Italy. patrizio.prati@tin.it
authors.forename: P
authors.initials: P
authors.lastname: Prati
authors.forename: A
authors.initials: A
authors.lastname: Tosetto
authors.forename: M
authors.initials: M
authors.lastname: Casaroli
authors.forename: A
authors.initials: A
authors.lastname: Bignamini
authors.forename: L
authors.initials: L
authors.lastname: Canciani
authors.forename: N
authors.initials: N
authors.lastname: Bornstein
authors.forename: G
authors.initials: G
authors.lastname: Prati
authors.forename: P J
authors.initials: PJ
authors.lastname: Touboul
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016893:Carotid Stenosis / Q000150:complications / Q000000981:diagnostic imaging* / Q000401:mortality; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D007558:Italy; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D020521:Stroke / Q000209:etiology* / Q000401:mortality; D013997:Time Factors; D014463:Ultrasonography; D055815:Young Adult