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Incremental clinical value of intraplaque neovascularization in predicting recurrent ischemic stroke

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机构： [1]Department of Vascular Ultrasound, Xuanwu Hospital, Capital Medical University, Beijing, China. [2]Department of Neurology, The First Hospital of Jilin University, Changchun, China. [3]Beijing Diagnostic Center of Vascular Ultrasound, Beijing, China. [4]Center of Vascular Ultrasound, Beijing Institute of Brain Disorders, Collaborative Innovation Center for Brain Disorders, Capital Medical University, Beijing, China.

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Carotid intraplaque neovascularization (IPN) detected by contrast-enhanced ultrasound (CEUS) is a risk factor for recurrent ischemic stroke. However, it is still unclear whether IPN can be used to accurately identify patients with recurrent ischemic stroke in clinical practice. Herein, we investigated the clinical predictive value of IPN for recurrent ischemic stroke in a real-world setting.We enrolled 200 patients with ischemic stroke and atherosclerotic carotid stenosis who were followed up for 2 years. The endpoint was recurrent ischemic stroke. Cox regression and subgroup analyses were employed to assess whether treatment affected the relationship between IPN and recurrent ischemic stroke. The net classification index (NRI) and integrated discriminant improvement index (IDI) were used to validate the additional clinical value of IPN in identifying recurrent ischemic stroke.During the 2-year follow-up, 36 patients experienced recurrent ischemic stroke. Cox regression analyses showed that IPN (grade 2), hypoechoic plaque, high homocysteine levels, and smoking were independent risk factors for recurrent ischemic stroke. Additional IPN evaluation may increase the NRI (0.512; 95% confidence interval [CI]: 0.083-0.624) and IDI (0.151; 95% CI: 0.010-0.213) for identifying high-risk patients with recurrent ischemic stroke. In addition, in the subgroup undergoing revascularization, the proportion of IPN (grade 2) was significantly higher in patients with recurrent ischemic stroke than in patients with nonrecurrent ischemic stroke (p = 0.001).In clinical settings, IPN, assessed by CEUS, may provide additional clinical value for predicting recurrent ischemic stroke, helping to identify patients with ischemic stroke who require close follow-up.© 2024 The Author(s). Annals of Clinical and Translational Neurology published by Wiley Periodicals LLC on behalf of American Neurological Association.

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出版当年[2023]版：

大类 | 2 区医学

小类 | 2 区临床神经病学 2 区神经科学

最新[2023]版：

大类 | 2 区医学

小类 | 2 区临床神经病学 2 区神经科学

第一作者：

第一作者机构： [1]Department of Vascular Ultrasound, Xuanwu Hospital, Capital Medical University, Beijing, China. [2]Department of Neurology, The First Hospital of Jilin University, Changchun, China.

通讯作者：

通讯机构： [1]Department of Vascular Ultrasound, Xuanwu Hospital, Capital Medical University, Beijing, China. [3]Beijing Diagnostic Center of Vascular Ultrasound, Beijing, China. [4]Center of Vascular Ultrasound, Beijing Institute of Brain Disorders, Collaborative Innovation Center for Brain Disorders, Capital Medical University, Beijing, China.

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