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Meta-Analysis
. 2020 Jan;51(1):311-314.
doi: 10.1161/STROKEAHA.119.027272. Epub 2019 Nov 22.

Carotid Plaque With High-Risk Features in Embolic Stroke of Undetermined Source: Systematic Review and Meta-Analysis

Joseph Kamtchum-Tatuene  1 , Alan Wilman  2 , Maher Saqqur  3 , Ashfaq Shuaib  3 , Glen C Jickling  3
Affiliations
Meta-Analysis

Carotid Plaque With High-Risk Features in Embolic Stroke of Undetermined Source: Systematic Review and Meta-Analysis

Joseph Kamtchum-Tatuene et al. Stroke. 2020 Jan.

Abstract

Background and Purpose- An ipsilateral mild carotid stenosis, defined as plaque with <50% luminal narrowing, is identified in nearly 40% of patients with embolic stroke of undetermined source and could represent an unrecognized source of atheroembolism. We aimed to summarize data about the frequency of mild carotid stenosis with high-risk features in embolic stroke of undetermined source. Methods- We searched Pubmed and Ovid-Embase for studies reporting carotid plaque imaging features in embolic stroke of undetermined source. The prevalence of ipsilateral and contralateral mild carotid stenosis with high-risk features was pooled using random-effect meta-analysis. Results- Eight studies enrolling 323 participants were included. The prevalence of mild carotid stenosis with high-risk features in the ipsilateral carotid was 32.5% (95% CI, 25.3-40.2) compared with 4.6% (95% CI, 0.1-13.1) in the contralateral carotid. The odds ratio of finding a plaque with high-risk features in the ipsilateral versus the contralateral carotid was 5.5 (95% CI, 2.5-12.0). Conclusions- Plaques with high-risk features are 5 times more prevalent in the ipsilateral compared with the contralateral carotid in embolic stroke of undetermined source, suggesting a relationship to stroke risk.

Keywords: carotid stenosis; odds ratio; prevalence; risk; stroke.

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Figures

Figure 1:
Figure 1:. Prevalence of ipsilateral carotid plaque with high-risk features in ESUS
3D-TOF = 3-dimensional time of flight, CI = Confidence interval, CT = Computed tomography, ES = Effect size, ipsi_hr_plaque = ipsilateral carotid plaque with high-risk features, MRI = Magnetic resonance imaging, sample_size = number of participants in the study, year_pub = year of publication
Figure 2:
Figure 2:. Odds-ratio of finding plaque with high-risk features in the ipsilateral versus the contralateral carotid in ESUS
3D-TOF = 3-dimensional time of flight, CI = Confidence interval, CT = Computed tomography, cont_hr_plaque = contralateral carotid plaque with high-risk features, ipsi_hr_plaque = ipsilateral carotid plaque with high-risk features, MRI = Magnetic resonance imaging, OR = Odds ratio, sample_size = number of participants in the study, year_pub = year of publication
See this image and copyright information in PMC

References

    1. Hart RG, Catanese L, Perera KS, Ntaios G, Connolly SJ. Embolic Stroke of Undetermined Source: A Systematic Review and Clinical Update. Stroke. 2017;48:867–872. - PubMed
    1. Ntaios G, Perlepe K, Sirimarco G, Strambo D, Eskandari A, Karagkiozi E, et al. Carotid plaques and detection of atrial fibrillation in embolic stroke of undetermined source. Neurology. 2019;92:e2644–e2652. - PubMed
    1. Ntaios G, Swaminathan B, Berkowitz SD, Gagliardi RJ, Lang W, Siegler JE, et al. Efficacy and Safety of Rivaroxaban Versus Aspirin in Embolic Stroke of Undetermined Source and Carotid Atherosclerosis. Stroke. 2019;50:2477–2485. - PubMed
    1. Saba L, Saam T, Jager HR, Yuan C, Hatsukami TS, Saloner D, et al. Imaging biomarkers of vulnerable carotid plaques for stroke risk prediction and their potential clinical implications. Lancet Neurol. 2019;18:559–572. - PubMed
    1. Bayer-Karpinska A, Schwarz F, Wollenweber FA, Poppert H, Boeckh-Behrens T, Becker A, et al. The carotid plaque imaging in acute stroke (CAPIAS) study: protocol and initial baseline data. BMC Neurol. 2013;13:201. - PMC - PubMed

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