PT  - JOURNAL ARTICLE
AU  - A.C. van Dijk
AU  - M.T.B. Truijman
AU  - B. Hussain
AU  - T. Zadi
AU  - G. Saiedie
AU  - A.A.J. de Rotte
AU  - M.I. Liem
AU  - A.F.W. van der Steen
AU  - M.J.A.P. Daemen
AU  - P.J. Koudstaal
AU  - P.J. Nederkoorn
AU  - J. Hendrikse
AU  - M.E. Kooi
AU  - A. van der Lugt
TI  - Intraplaque Hemorrhage and the Plaque Surface in Carotid Atherosclerosis: The Plaque At RISK Study (PARISK)
AID  - 10.3174/ajnr.A4414
DP  - 2015 Nov 01
TA  - American Journal of Neuroradiology
PG  - 2127--2133
VI  - 36
IP  - 11
4099  - http://www.ajnr.org/content/36/11/2127.short
4100  - http://www.ajnr.org/content/36/11/2127.full
SO  - Am. J. Neuroradiol.2015 Nov 01; 36
AB  - BACKGROUND AND PURPOSE: An important characteristic of vulnerable plaque, intraplaque hemorrhage, may predict plaque rupture. Plaque rupture can be visible on noninvasive imaging as a disruption of the plaque surface. We investigated the association between intraplaque hemorrhage and disruption of the plaque surface.MATERIALS AND METHODS: We selected the first 100 patients of the Plaque At RISK study, an ongoing prospective noninvasive plaque imaging study in patients with mild-to-moderate atherosclerotic lesions in the carotid artery. In carotid artery plaques, disruption of the plaque surface (defined as ulcerated plaques and/or fissured fibrous cap) and intraplaque hemorrhage were assessed by using MDCTA and 3T MR imaging, respectively. We used a χ2 test and multivariable logistic regression to assess the association between intraplaque hemorrhage and disrupted plaque surface.RESULTS: One hundred forty-nine carotid arteries in 78 patients could be used for the current analyses. Intraplaque hemorrhage and plaque ulcerations were more prevalent in symptomatic compared with contralateral vessels (hemorrhage, 38% versus 11%; P < .001; and ulcerations, 27% versus 7%; P = .001). Fissured fibrous cap was more prevalent in symptomatic compared with contralateral vessels (13% versus 4%; P = .06). After adjustment for age, sex, diabetes mellitus, and degree of stenosis, intraplaque hemorrhage was associated with disrupted plaque surface (OR, 3.13; 95% CI, 1.25–7.84) in all vessels.CONCLUSIONS: Intraplaque hemorrhage is associated with disruption of the plaque surface in patients with a carotid artery stenosis of <70%. Serial studies are needed to investigate whether intraplaque hemorrhage indeed increases the risk of plaque rupture and subsequent ischemic stroke during follow-up.ECSTEuropean Carotid Surgery TrialPARISKPlaque At RISK