Carotid plaques and neurological impairment in patients with acute cerebral infarction

English version

Autoři: Tongtian Ni ^aff001; Yi Fu ^aff002; Wei Zhou ^aff003; Min Chen ^aff001; Jianwei Shao ^aff001; Weijun Zhou ^aff001; Enqiang Mao ^aff001; Erzhen Chen ^aff001
Působiště autorů: Department of Emergency Medicine, Rui Jin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China ^aff001; Department of Neurology & Institute of Neurology, Rui Jin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China ^aff002; Department of Ultrasound, Rui Jin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China ^aff003
Vyšlo v časopise: PLoS ONE 15(1)
Kategorie: Research Article
prolekare.web.journal.doi_sk: https://doi.org/10.1371/journal.pone.0226961

Souhrn

Objective

To determine whether the coexistence of carotid atherosclerosis plaque affects the neurological function of cerebral infarction.

Methods

A total of 1078 patients with acute cerebral infarction were enrolled, all patients were divided into carotid plaque group (n = 702) and non-carotid plaque group (n = 376). Meanwhile, all patients were divided into mild group (n = 624) and moderate to severe group (n = 454). The difference of the incidence of carotid plaque between the mild and moderate to severe group was analyzed.

Results

In the 1078 patients with cerebral infarction, the NIHSS score in the carotid plaque group was significantly higher than that in the non-carotid plaque group (P<0.05). The number of mild cases without carotid artery plaque group was larger than that of plaque group (P<0.05), and the number of moderate to severe cases in carotid plaque group was larger than that in non-plaque group (P<0.05). In patients with carotid atherosclerotic plaque, the risk of moderate to severe cerebral infarction was 2.11 times higher than that without carotid artery plaque. Lastly, patients with single plaques were 1.82 times more likely to develop moderate to severe cerebral infarction than those without carotid plaque, while patients with multiple carotid plaques were 2.41 times higher to get moderate or severe cerebral infarction than those without carotid plaque.

Conclusions

The incidence of carotid atherosclerotic plaques may be related to neurological deficits in patients with acute cerebral infarction.

Klíčová slova:

stroke – Cholesterol – Ischemic stroke – Hypertension – Ultrasound imaging – Lipoproteins – Infarction – diabetes mellitus

Zdroje

1. Lloyd-Jones D, Adams R, Carnethon M, De Simone G, Ferguson TB, Flegal K, et al. Heart disease and stroke statistics—2009 update: a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation. 2009;119(3):480–486. Epub:2009/01/28. doi: 10.1161/CIRCULATIONAHA.108.191259 19171871.

2. Liu M, Wu B, Wang WZ, Lee LM, Zhang SH, Kong LZ. Stroke in China: epidemiology, prevention, and management strategies. Lancet Neurol. 2007;6(5):456–464. Epub:2007/04/17. doi: 10.1016/S1474-4422(07)70004-2 17434100.

3. Mozaffarian D, Benjamin EJ, Go AS, Arnett DK, Blaha MJ, Cushman M, et al. Heart disease and stroke statistics—2015 update: a report from the American Heart Association. Circulation. 2015;131(4):e29–322. Epub:2014/12/19. doi: 10.1161/CIR.0000000000000152 25520374.

4. Jiang B, Wang WZ, Chen H, Hong Z, Yang QD, Wu SP, et al. Incidence and trends of stroke and its subtypes in China: results from three large cities. Stroke. 2006;37(1):63–68. Epub:2005/11/25. doi: 10.1161/01.STR.0000194955.34820.78 16306469.

5. Tong J, Zhu Y, Jie J, Huixin L, Jin Q, Tao R, et al. Analysis of current situation of Chinese health care reform by studying emergency overcrowding in a typical Shanghai hospital. Am J Emerg Med. 2012;30(7):1313–1318. Epub:2012/07/24. doi: 10.1016/j.ajem.2012.05.012 22818562.

6. Guidelines for management of ischaemic stroke and transient ischaemic attack 2008. Cerebrovasc Dis. 2008;25(5):457–507. Epub:2008/05/15. doi: 10.1159/000131083 18477843.

7. Mozaffarian D, Benjamin EJ, Go AS, Arnett DK, Blaha MJ, Cushman M, et al. Heart Disease and Stroke Statistics-2016 Update: A Report From the American Heart Association. Circulation. 2016;133(4):e38–360. Epub:2015/12/18. doi: 10.1161/CIR.0000000000000350 26673558.

8. Lorenz MW, Polak JF, Kavousi M, Mathiesen EB, Volzke H, Tuomainen TP, et al. Carotid intima-media thickness progression to predict cardiovascular events in the general population (the PROG-IMT collaborative project): a meta-analysis of individual participant data. Lancet. 2012;379(9831):2053–2062. Epub:2012/05/01. doi: 10.1016/S0140-6736(12)60441-3 22541275.

9. Polak JF, Pencina MJ, Pencina KM, O'Donnell CJ, Wolf PA, D'Agostino RB Sr. Carotid-wall intima-media thickness and cardiovascular events. N Engl J Med. 2011;365(3):213–221. Epub:2011/07/22. doi: 10.1056/NEJMoa1012592 21774709.

10. Polak JF, Pencina MJ, O'Leary DH, D'Agostino RB. Common carotid artery intima-media thickness progression as a predictor of stroke in multi-ethnic study of atherosclerosis. Stroke. 2011;42(11):3017–3021. Epub:2011/09/03. doi: 10.1161/STROKEAHA.111.625186 21885840.

11. Lorenz MW, von Kegler S, Steinmetz H, Markus HS, Sitzer M. Carotid intima-media thickening indicates a higher vascular risk across a wide age range: prospective data from the Carotid Atherosclerosis Progression Study (CAPS). Stroke. 2006;37(1):87–92. Epub:2005/12/13. doi: 10.1161/01.STR.0000196964.24024.ea 16339465.

12. Gupta A, Baradaran H, Schweitzer AD, Kamel H, Pandya A, Delgado D, et al. Carotid plaque MRI and stroke risk: a systematic review and meta-analysis. Stroke. 2013;44(11):3071–3077. Epub:2013/08/31. doi: 10.1161/STROKEAHA.113.002551 23988640.

13. Li GW, Zheng GY, Li JG, Sun XD. Relationship between carotid atherosclerosis and cerebral infarction. Chin Med Sci J. 2010;25(1):32–37. Epub:2010/05/11. doi: 10.1016/s1001-9294(10)60017-x 20449951.

14. Johnsen SH, Mathiesen EB. Carotid plaque compared with intima-media thickness as a predictor of coronary and cerebrovascular disease. Curr Cardiol Rep. 2009;11(1):21–27. Epub:2008/12/19. doi: 10.1007/s11886-009-0004-1 19091171.

15. Hollander M, Bots ML, Del Sol AI, Koudstaal PJ, Witteman JC, Grobbee DE, et al. Carotid plaques increase the risk of stroke and subtypes of cerebral infarction in asymptomatic elderly: the Rotterdam study. Circulation. 2002;105(24):2872–2877. Epub:2002/06/19. doi: 10.1161/01.cir.0000018650.58984.75 12070116.

16. Polak JF, Szklo M, Kronmal RA, Burke GL, Shea S, Zavodni AE, et al. The value of carotid artery plaque and intima-media thickness for incident cardiovascular disease: the multi-ethnic study of atherosclerosis. J Am Heart Assoc. 2013;2(2):e000087. Epub:2013/04/10. doi: 10.1161/JAHA.113.000087 23568342.

17. Spence JD, Eliasziw M, DiCicco M, Hackam DG, Galil R, Lohmann T. Carotid plaque area: a tool for targeting and evaluating vascular preventive therapy. Stroke. 2002;33(12):2916–2922. Epub:2002/12/07. doi: 10.1161/01.str.0000042207.16156.b9 12468791.

18. Huibers A, de Borst GJ, Bulbulia R, Pan H, Halliday A. Plaque Echolucency and the Risk of Ischaemic Stroke in Patients with Asymptomatic Carotid Stenosis Within the First Asymptomatic Carotid Surgery Trial (ACST-1). Eur J Vasc Endovasc Surg. 2016;51(5):616–621. Epub:2016/01/05. doi: 10.1016/j.ejvs.2015.11.013 26725253.

19. Kakkos SK, Griffin MB, Nicolaides AN, Kyriacou E, Sabetai MM, Tegos T, et al. The size of juxtaluminal hypoechoic area in ultrasound images of asymptomatic carotid plaques predicts the occurrence of stroke. J Vasc Surg. 2013;57(3):609–618.e601; discussion 617–608. Epub:2013/01/23. doi: 10.1016/j.jvs.2012.09.045 23337294.

20. Touze E, Trinquart L, Chatellier G, Mas JL. Systematic review of the perioperative risks of stroke or death after carotid angioplasty and stenting. Stroke. 2009;40(12):e683–693. Epub:2009/11/07. doi: 10.1161/STROKEAHA.109.562041 19892997.

21. Parodi JC, Ferreira LM, Sicard G, La Mura R, Fernandez S. Cerebral protection during carotid stenting using flow reversal. J Vasc Surg. 2005;41(3):416–422. Epub:2005/04/20. doi: 10.1016/j.jvs.2005.01.003 15838474.

22. Halliday A, Harrison M, Hayter E, Kong X, Mansfield A, Marro J, et al. 10-year stroke prevention after successful carotid endarterectomy for asymptomatic stenosis (ACST-1): a multicentre randomised trial. Lancet. 2010;376(9746):1074–1084. Epub:2010/09/28. doi: 10.1016/S0140-6736(10)61197-X 20870099.

23. Brott TG, Halperin JL, Abbara S, Bacharach JM, Barr JD, Bush RL, et al. 2011 ASA/ACCF/AHA/AANN/AANS/ACR/ASNR/CNS/SAIP/SCAI/SIR/SNIS/SVM/SVS guideline on the management of patients with extracranial carotid and vertebral artery disease: executive summary. Stroke. 2011;42(8):e420–463. Epub:2011/02/02. doi: 10.1161/STR.0b013e3182112d08 21282494.

24. Wannarong T, Parraga G, Buchanan D, Fenster A, House AA, Hackam DG, et al. Progression of carotid plaque volume predicts cardiovascular events. Stroke. 2013;44(7):1859–1865. Epub:2013/06/06. doi: 10.1161/STROKEAHA.113.001461 23735956.

25. Nagai Y, Matsumoto M, Metter EJ. The carotid artery as a noninvasive window for cardiovascular risk in apparently healthy individuals. Ultrasound Med Biol. 2002;28(10):1231–1238. Epub:2002/12/07. doi: 10.1016/s0301-5629(02)00578-1 12467848.

26. Perk J, De Backer G, Gohlke H, Graham I, Reiner Z, Verschuren WM, et al. European Guidelines on cardiovascular disease prevention in clinical practice (version 2012): The Fifth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of nine societies and by invited experts). Atherosclerosis. 2012;223(1):1–68. Epub:2012/06/16. doi: 10.1016/j.atherosclerosis.2012.05.007 22698795.

27. Goff DC Jr., Lloyd-Jones DM, Bennett G, Coady S, D'Agostino RB, Gibbons R, et al. 2013 ACC/AHA guideline on the assessment of cardiovascular risk: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation. 2014;129(25 Suppl 2):S49–73. Epub:2013/11/14. doi: 10.1161/01.cir.0000437741.48606.98 24222018.

28. Anderson TJ, Gregoire J, Hegele RA, Couture P, Mancini GB, McPherson R, et al. 2012 update of the Canadian Cardiovascular Society guidelines for the diagnosis and treatment of dyslipidemia for the prevention of cardiovascular disease in the adult. Can J Cardiol. 2013;29(2):151–167. Epub:2013/01/29. doi: 10.1016/j.cjca.2012.11.032 23351925.

29. Plichart M, Celermajer DS, Zureik M, Helmer C, Jouven X, Ritchie K, et al. Carotid intima-media thickness in plaque-free site, carotid plaques and coronary heart disease risk prediction in older adults. The Three-City Study. Atherosclerosis. 2011;219(2):917–924. Epub:2011/10/19. doi: 10.1016/j.atherosclerosis.2011.09.024 22005196.

30. Jauch EC, Saver JL, Adams HP Jr., Bruno A, Connors JJ, Demaerschalk BM, et al. Guidelines for the early management of patients with acute ischemic stroke: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2013;44(3):870–947. Epub:2013/02/02. doi: 10.1161/STR.0b013e318284056a 23370205.

31. Brott T, Adams HP Jr., Olinger CP, Marler JR, Barsan WG, Biller J, et al. Measurements of acute cerebral infarction: a clinical examination scale. Stroke. 1989;20(7):864–870. Epub:1989/07/01. doi: 10.1161/01.str.20.7.864 2749846.

32. Fischer U, Baumgartner A, Arnold M, Nedeltchev K, Gralla J, De Marchis GM, et al. What is a minor stroke? Stroke. 2010;41(4):661–666. Epub:2010/02/27. doi: 10.1161/STROKEAHA.109.572883 20185781.

33. Stein JH, Korcarz CE, Hurst RT, Lonn E, Kendall CB, Mohler ER, et al. Use of carotid ultrasound to identify subclinical vascular disease and evaluate cardiovascular disease risk: a consensus statement from the American Society of Echocardiography Carotid Intima-Media Thickness Task Force. Endorsed by the Society for Vascular Medicine. J Am Soc Echocardiogr. 2008;21(2):93–111; quiz 189–190. Epub:2008/02/12. doi: 10.1016/j.echo.2007.11.011 18261694.

34. Lusis AJ. Atherosclerosis. Nature. 2000;407(6801):233–241. Epub:2000/09/23. doi: 10.1038/35025203 11001066.

35. Lorenz MW, Price JF, Robertson C, Bots ML, Polak JF, Poppert H, et al. Carotid intima-media thickness progression and risk of vascular events in people with diabetes: results from the PROG-IMT collaboration. Diabetes Care. 2015;38(10):1921–1929. Epub:2015/07/17. doi: 10.2337/dc14-2732 26180107.

36. Usman A, Ribatti D, Sadat U, Gillard JH. From Lipid Retention to Immune-Mediate Inflammation and Associated Angiogenesis in the Pathogenesis of Atherosclerosis. J Atheroscler Thromb. 2015;22(8):739–749. Epub:2015/07/15. doi: 10.5551/jat.30460 26156748.

37. Libby P. Inflammation in atherosclerosis. Arterioscler Thromb Vasc Biol. 2012;32(9):2045–2051. Epub:2012/08/17. doi: 10.1161/ATVBAHA.108.179705 22895665.

38. O'Donnell MJ, Xavier D, Liu L, Zhang H, Chin SL, Rao-Melacini P, et al. Risk factors for ischaemic and intracerebral haemorrhagic stroke in 22 countries (the INTERSTROKE study): a case-control study. Lancet. 2010;376(9735):112–123. Epub:2010/06/22. doi: 10.1016/S0140-6736(10)60834-3 20561675.

39. Jung KW, Shon YM, Yang DW, Kim BS, Cho AH. Coexisting carotid atherosclerosis in patients with intracranial small- or large-vessel disease. J Clin Neurol. 2012;8(2):104–108. Epub:2012/07/13. doi: 10.3988/jcn.2012.8.2.104 22787493.

40. Ois A, Martinez-Rodriguez JE, Munteis E, Gomis M, Rodriguez-Campello A, Jimenez-Conde J, et al. Steno-occlusive arterial disease and early neurological deterioration in acute ischemic stroke. Cerebrovasc Dis. 2008;25(1–2):151–156. Epub:2008/01/24. doi: 10.1159/000113732 18212520.

41. Winship IR. Cerebral collaterals and collateral therapeutics for acute ischemic stroke. Microcirculation. 2015;22(3):228–236. Epub:2014/10/30. doi: 10.1111/micc.12177 25351102.

42. Alawneh JA, Moustafa RR, Baron JC. Hemodynamic factors and perfusion abnormalities in early neurological deterioration. Stroke. 2009;40(6):e443–450. Epub:2009/04/25. doi: 10.1161/STROKEAHA.108.532465 19390076.

43. Mughal MM, Khan MK, DeMarco JK, Majid A, Shamoun F, Abela GS. Symptomatic and asymptomatic carotid artery plaque. Expert Rev Cardiovasc Ther. 2011;9(10):1315–1330. Epub:2011/10/12. doi: 10.1586/erc.11.120 21985544.

44. Fisher M, Paganini-Hill A, Martin A, Cosgrove M, Toole JF, Barnett HJ, et al. Carotid plaque pathology: thrombosis, ulceration, and stroke pathogenesis. Stroke. 2005;36(2):253–257. Epub:2005/01/18. doi: 10.1161/01.STR.0000152336.71224.21 15653581.

45. Wang B, Sun S, Liu G, Li Y, Pang J, Zhang J, et al. Correlation between aortic/carotid atherosclerotic plaques and cerebral infarction. Exp Ther Med. 2013;6(2):407–410. Epub:2013/10/19. doi: 10.3892/etm.2013.1129 24137198.

46. Ho SS. Current status of carotid ultrasound in atherosclerosis. Quant Imaging Med Surg. 2016;6(3):285–296. Epub:2016/07/19. doi: 10.21037/qims.2016.05.03 27429912.

47. Arnold JA, Modaresi KB, Thomas N, Taylor PR, Padayachee TS. Carotid plaque characterization by duplex scanning: observer error may undermine current clinical trials. Stroke. 1999;30(1):61–65. Epub:1999/01/08. doi: 10.1161/01.str.30.1.61 9880389.

48. Sabetai MM, Tegos TJ, Nicolaides AN, Dhanjil S, Pare GJ, Stevens JM. Reproducibility of computer-quantified carotid plaque echogenicity: can we overcome the subjectivity? Stroke. 2000;31(9):2189–2196. Epub:2000/09/08. doi: 10.1161/01.str.31.9.2189 10978050.

49. Ouhlous M, Flach HZ, de Weert TT, Hendriks JM, van Sambeek MR, Dippel DW, et al. Carotid plaque composition and cerebral infarction: MR imaging study. AJNR Am J Neuroradiol. 2005;26(5):1044–1049. Epub:2005/05/14. 15891157.