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000164038 037__ $$aDZNE-2022-00701
000164038 041__ $$aEnglish
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000164038 1001_ $$aKopczak, Anna$$b0
000164038 245__ $$aComplicated Carotid Artery Plaques and Risk of Recurrent Ischemic Stroke or TIA.
000164038 260__ $$aNew York, NY$$bAmerican College of Cardiology$$c2022
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000164038 520__ $$aComplicated nonstenosing carotid artery plaques (CAPs) are an under-recognized cause of stroke.The purpose of this study was to determine whether complicated CAP ipsilateral to acute ischemic anterior circulation stroke (icCAP) are associated with recurrent ischemic stroke or transient ischemic attack (TIA).The CAPIAS (Carotid Plaque Imaging in Acute Stroke) multicenter study prospectively recruited patients with ischemic stroke restricted to the territory of a single carotid artery. Complicated (AHA-lesion type VI) CAP were defined by multisequence, contrast-enhanced carotid magnetic resonance imaging obtained within 10 days from stroke onset. Recurrent events were assessed after 3, 12, 24, and 36 months. The primary outcome was recurrent ischemic stroke or TIA.Among 196 patients enrolled, 104 patients had cryptogenic stroke and nonstenosing CAP. During a mean follow-up of 30 months, recurrent ischemic stroke or TIA occurred in 21 patients. Recurrent events were significantly more frequent in patients with icCAP than in patients without icCAP, both in the overall cohort (incidence rate [3-year interval]: 9.50 vs 3.61 per 100 patient-years; P = 0.025, log-rank test) and in patients with cryptogenic stroke (10.92 vs 1.82 per 100 patient-years; P = 0.003). The results were driven by ipsilateral events. A ruptured fibrous cap (HR: 4.91; 95% CI: 1.31-18.45; P = 0.018) and intraplaque hemorrhage (HR: 4.37; 95% CI: 1.20-15.97; P = 0.026) were associated with a significantly increased risk of recurrent events in patients with cryptogenic stroke.Complicated CAP ipsilateral to acute ischemic anterior circulation stroke are associated with an increased risk of recurrent ischemic stroke or TIA. Carotid plaque imaging identifies high-risk patients who might be suited for inclusion into future secondary prevention trials. (Carotid Plaque Imaging in Acute Stroke [CAPIAS]; NCT01284933).
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000164038 650_7 $$2Other$$aMRI
000164038 650_7 $$2Other$$acarotid artery
000164038 650_7 $$2Other$$acarotid plaque
000164038 650_7 $$2Other$$aintraplaque hemorrhage
000164038 650_7 $$2Other$$aischemic stroke
000164038 650_7 $$2Other$$astroke recurrence
000164038 650_2 $$2MeSH$$aCarotid Arteries: pathology
000164038 650_2 $$2MeSH$$aCarotid Stenosis: complications
000164038 650_2 $$2MeSH$$aCarotid Stenosis: diagnostic imaging
000164038 650_2 $$2MeSH$$aCarotid Stenosis: epidemiology
000164038 650_2 $$2MeSH$$aHumans
000164038 650_2 $$2MeSH$$aIschemic Attack, Transient: epidemiology
000164038 650_2 $$2MeSH$$aIschemic Attack, Transient: etiology
000164038 650_2 $$2MeSH$$aIschemic Stroke
000164038 650_2 $$2MeSH$$aPlaque, Atherosclerotic: complications
000164038 650_2 $$2MeSH$$aPlaque, Atherosclerotic: diagnostic imaging
000164038 650_2 $$2MeSH$$aPlaque, Atherosclerotic: pathology
000164038 650_2 $$2MeSH$$aRisk Factors
000164038 650_2 $$2MeSH$$aStroke: diagnosis
000164038 650_2 $$2MeSH$$aStroke: epidemiology
000164038 650_2 $$2MeSH$$aStroke: etiology
000164038 7001_ $$aSchindler, Andreas$$b1
000164038 7001_ $$aSepp, Dominik$$b2
000164038 7001_ $$aBayer-Karpinska, Anna$$b3
000164038 7001_ $$aMalik, Rainer$$b4
000164038 7001_ $$aKoch, Mia L$$b5
000164038 7001_ $$aZeller, Julia$$b6
000164038 7001_ $$aStrecker, Christoph$$b7
000164038 7001_ $$aJanowitz, Daniel$$b8
000164038 7001_ $$aWollenweber, Frank A$$b9
000164038 7001_ $$aHempel, Johann-Martin$$b10
000164038 7001_ $$aBoeckh-Behrens, Tobias$$b11
000164038 7001_ $$aCyran, Clemens C$$b12
000164038 7001_ $$aHelck, Andreas$$b13
000164038 7001_ $$aHarloff, Andreas$$b14
000164038 7001_ $$aZiemann, Ulf$$b15
000164038 7001_ $$aPoli, Sven$$b16
000164038 7001_ $$aPoppert, Holger$$b17
000164038 7001_ $$aSaam, Tobias$$b18
000164038 7001_ $$0P:(DE-2719)2000030$$aDichgans, Martin$$b19$$eLast author$$udzne
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