SynthesisAnnals of neurology2013
Carotid plaque hemorrhage on magnetic resonance imaging strongly predicts recurrent ischemia and stroke.
Synthesis in Annals of neurology, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03507374 (PCSK9 Inhibition in Patients With Symptomatic Intracranial Atherosclerosis), which is not on this map. Cited by 72 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
PCSK9 Inhibition in Patients With Symptomatic Intracranial Atherosclerosis
Who cites it
72 citing papers in PubMed, 3 syntheses or guidelines pooled it, 183 citations in OpenAlex.
- Pooled it
- Carotid plaque magnetic resonance imaging and recurrent stroke risk: A systematic review and meta-analysis.Medicine · 2020Pooled it
- Carotid Artery Wall Imaging: Perspective and Guidelines from the ASNR Vessel Wall Imaging Study Group and Expert Consensus Recommendations of the American Society of Neuroradiology.AJNR. American journal of neuroradiology · 2018Guideline
- Relation between carotid vulnerable plaques and peripheral leukocyte: a case-control study of comparison utilizing multi-parametric contrast-enhanced ultrasound.BMC medical imaging · 2019Trial
- Cardiovascular risk factors and carotid plaque components in a multi-ethnic cohort using 3 Tesla MRI: the HELIUS study.European radiology · 2026Article
- Article
- Application of the Neuroform Atlas Stent for Intracranial Stenting of Symptomatic Intracranial Atherosclerotic Stenosis: A Multi-Center Retrospective Study.Brain and behavior · 2025Article
- Risk of acute cerebral infarction in patients with hypertension based on high-resolution MRI.Quantitative imaging in medicine and surgery · 2025Article
- The role of non-stenosing carotid artery plaques in embolic stroke of undetermined source, is it a silent offender? A review of literature.Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences · 2024Review
- Biliverdin Reductase B Is a Plasma Biomarker for Intraplaque Hemorrhage and a Predictor of Ischemic Stroke in Patients with Symptomatic Carotid Atherosclerosis.Biomolecules · 2023Article
- An interpretable machine learning model for stroke recurrence in patients with symptomatic intracranial atherosclerotic arterial stenosis.Frontiers in neuroscience · 2023Article
- Stroke risk prediction by color Doppler ultrasound of carotid artery-based deep learning using Inception V3 and VGG-16.Frontiers in neurology · 2023Article
- Extracranial carotid plaque hemorrhage predicts ipsilateral stroke recurrence in patients with carotid atherosclerosis - a study based on high-resolution vessel wall imaging MRI.BMC neurology · 2022Article
- Carotid artery endarterectomy in patients with symptomatic non-stenotic carotid artery disease.Stroke and vascular neurology · 2022Article
- Change of Heart: The Underexplored Role of Plaque Hemorrhage in the Evaluation of Stroke of Undetermined Etiology.Journal of the American Heart Association · 2022Review
- The role of cross-sectional imaging of the extracranial and intracranial vasculature in embolic stroke of undetermined source.Frontiers in neurology · 2022Review
- Radiomics Nomogram for Predicting Stroke Recurrence in Symptomatic Intracranial Atherosclerotic Stenosis.Frontiers in neuroscience · 2022Article
- The potential role of T2*-weighted multi-echo data image combination as an imaging marker for intraplaque hemorrhage in carotid plaque imaging.BMC medical imaging · 2021Observational
- Carotid artery plaque characteristics: current reporting practices on CT angiography.Neuroradiology · 2021Observational
- Cervical Carotid Plaque MRI : Review of Atherosclerosis Imaging Features and their Histologic Underpinnings.Clinical neuroradiology · 2021Review
12 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 2 institutions in 1 country.
Funding
Abstract
objectiveThere is a recognized need to improve selection of patients with carotid artery stenosis for carotid endarterectomy (CEA). We assessed the value of magnetic resonance imaging (MRI)-defined carotid plaque hemorrhage (MRIPH) to predict recurrent ipsilateral cerebral ischemic events, and stroke in symptomatic carotid stenosis.
methodsOne hundred seventy-nine symptomatic patients with ≥ 50% stenosis were prospectively recruited, underwent carotid MRI, and were clinically followed up until CEA, death, or ischemic event. MRIPH was diagnosed if the plaque signal intensity was >150% that of the adjacent muscle. Event-free survival analysis was done using Kaplan-Meier plots and Cox regression models controlling for known vascular risk factors. We also undertook a meta-analysis of reported data on MRIPH and recurrent events.
resultsOne hundred fourteen patients (63.7%) showed MRIPH, suffering 92% (57 of 62) of all recurrent ipsilateral events and all but 1 (25 of 26) future strokes. Patients without MRIPH had an estimated annual absolute stroke risk of only 0.6%. Cox multivariate regression analysis proved MRIPH as a strong predictor of recurrent ischemic events (hazard ratio [HR] = 12.0, 95% confidence interval [CI] = 4.8-30.1, p < 0.001) and stroke alone (HR = 35.0, 95% CI = 4.7-261.6, p = 0.001). Meta-analysis of published data confirmed this association between MRIPH and recurrent cerebral ischemic events in symptomatic carotid artery stenosis (odds ratio = 12.2, 95% CI = 5.5-27.1, p < 0.00001).
interpretationMRIPH independently and strongly predicts recurrent ipsilateral ischemic events, and stroke alone, in symptomatic ≥ 50% carotid artery stenosis. The very low stroke risk in patients without MRIPH puts into question current risk-benefit assessment for CEA in this subgroup.
Indexed as
Identifiers
What Socratic holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.