title: Comparison of carotid atherosclerotic plaque characteristics between patients with first-time and recurrent acute ischaemic stroke using B-mode ultrasound.
abstract: OBJECTIVE
  The differences between initial and recurrent stroke plaques are not defined. Hence, a nested case-control study was conducted to evaluate the association of stroke recurrence with the echogenic characteristics of carotid plaques in patients with ischaemic stroke.
  
  
  METHODS
  One hundred and four patients with 1-year recurrent acute ischaemic stroke were enrolled and compared with 104 control patients (first-time ischaemic stroke) matched for age, gender, stroke severity and treatment allocation. Based on the Mannheim Carotid Intima-Media Thickness Consensus (2004-2006), the number of carotid plaques and echogenicity between the two groups of patients were compared.
  
  
  RESULTS
  As compared to patients with first-time stroke, those with recurrent stroke showed significantly higher prevalence of heart disease (13.46 vs 28.85%, P = 0.0066) and presence of intracranial stenosis (55.77 vs 89.90%, P < 0.0001). During the 1-year follow-up, patients with recurrent stroke had a significantly higher rate of unstable plaques (80.41%) than patients with first-time stroke (64.21%, P = 0.036). Also, patients with recurrent stroke had a significantly larger number of plaques than patients with first-time stroke (P = 0.0152). Multivariate conditional logistic regression analysis (after adjustment for heart disease and intracranial stenosis) identified an association between 1-year stroke recurrence and the presence of unstable plaques (hazard ratio 3.077; 95% CI: 1.133-8.355).
  
  
  CONCLUSIONS
  Stroke recurrence is related to advanced atherosclerosis defined by carotid plaque and its characteristics.
authors.affiliation: Department of Neurology, Harrison International Peace Hospital, Hengshui, Hebei, China.
authors.forename: Jin
authors.initials: J
authors.lastname: Li
authors.forename: Donghua
authors.initials: D
authors.lastname: Mi
authors.forename: Yuehua
authors.initials: Y
authors.lastname: Pu
authors.forename: Xinying
authors.initials: X
authors.lastname: Zou
authors.forename: Yuesong
authors.initials: Y
authors.lastname: Pan
authors.forename: Yannie
authors.initials: Y
authors.lastname: Soo
authors.forename: Thomas
authors.initials: T
authors.lastname: Leung
authors.forename: Yilong
authors.initials: Y
authors.lastname: Wang
authors.forename: Ka Sing
authors.initials: KS
authors.lastname: Wong
authors.forename: Liping
authors.initials: L
authors.lastname: Liu
keywords: Carotid ultrasonography; Cerebrovascular diseases; Echogenic plaque; Ischaemic stroke