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@ARTICLE{Kopczak:164038,
author = {Kopczak, Anna and Schindler, Andreas and Sepp, Dominik and
Bayer-Karpinska, Anna and Malik, Rainer and Koch, Mia L and
Zeller, Julia and Strecker, Christoph and Janowitz, Daniel
and Wollenweber, Frank A and Hempel, Johann-Martin and
Boeckh-Behrens, Tobias and Cyran, Clemens C and Helck,
Andreas and Harloff, Andreas and Ziemann, Ulf and Poli, Sven
and Poppert, Holger and Saam, Tobias and Dichgans, Martin},
title = {{C}omplicated {C}arotid {A}rtery {P}laques and {R}isk of
{R}ecurrent {I}schemic {S}troke or {TIA}.},
journal = {Journal of the American College of Cardiology},
volume = {79},
number = {22},
issn = {0735-1097},
address = {New York, NY},
publisher = {American College of Cardiology},
reportid = {DZNE-2022-00701},
pages = {2189-2199},
year = {2022},
note = {(CC BY-NC-ND)},
abstract = {Complicated 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).},
keywords = {Carotid Arteries: pathology / Carotid Stenosis:
complications / Carotid Stenosis: diagnostic imaging /
Carotid Stenosis: epidemiology / Humans / Ischemic Attack,
Transient: epidemiology / Ischemic Attack, Transient:
etiology / Ischemic Stroke / Plaque, Atherosclerotic:
complications / Plaque, Atherosclerotic: diagnostic imaging
/ Plaque, Atherosclerotic: pathology / Risk Factors /
Stroke: diagnosis / Stroke: epidemiology / Stroke: etiology
/ MRI (Other) / carotid artery (Other) / carotid plaque
(Other) / intraplaque hemorrhage (Other) / ischemic stroke
(Other) / stroke recurrence (Other)},
cin = {AG Dichgans},
ddc = {610},
cid = {I:(DE-2719)5000022},
pnm = {353 - Clinical and Health Care Research (POF4-353)},
pid = {G:(DE-HGF)POF4-353},
typ = {PUB:(DE-HGF)16},
pubmed = {pmid:35523659},
doi = {10.1016/j.jacc.2022.03.376},
url = {https://pub.dzne.de/record/164038},
}