TY - JOUR
T1 - Imaging biomarkers of vulnerable carotid plaques for stroke risk prediction and their potential clinical implications
AU - Saba, Luca
AU - Saam, Tobias
AU - Jäger, H. Rolf
AU - Yuan, Chun
AU - Hatsukami, Thomas S.
AU - Saloner, David
AU - Wasserman, Bruce A.
AU - Bonati, Leo H.
AU - Wintermark, Max
N1 - Funding Information:
TSH reports grants from Philips Healthcare, outside of the submitted work. LHB reports grants from the Swiss National Science Foundation, the University of Basel, and the Swiss Heart Foundation, during the conduct of the study; personal fees and non-financial support from Amgen and Bayer, outside of the submitted work; grants from AstraZeneca, outside of the submitted work; and personal fees from Bristol-Myers Squibb and Claret Medical, outside of the submitted work. MW reports fees (equities) from MoreHealth (second opinion service), Magnetic Insight (imaging technique for rodents, technique not mentioned in the Review), and Icometrix (multiple sclerosis focus), outside of the submitted work. LS, TS, HRJ, CY, DS, and BAW declare no competing interests.
Publisher Copyright:
© 2019 Elsevier Ltd
PY - 2019/6
Y1 - 2019/6
N2 - Stroke represents a massive public health problem. Carotid atherosclerosis plays a fundamental part in the occurence of ischaemic stroke. European and US guidelines for prevention of stroke in patients with carotid plaques are based on quantification of the percentage reduction in luminal diameter due to the atherosclerotic process to select the best therapeutic approach. However, better strategies for prevention of stroke are needed because some subtypes of carotid plaques (eg, vulnerable plaques) can predict the occurrence of stroke independent of the degree of stenosis. Advances in imaging techniques have enabled routine characterisation and detection of the features of carotid plaque vulnerability. Intraplaque haemorrhage is accepted by neurologists and radiologists as one of the features of vulnerable plaques, but other characteristics—eg, plaque volume, neovascularisation, and inflammation—are promising as biomarkers of carotid plaque vulnerability. These biomarkers could change current management strategies based merely on the degree of stenosis.
AB - Stroke represents a massive public health problem. Carotid atherosclerosis plays a fundamental part in the occurence of ischaemic stroke. European and US guidelines for prevention of stroke in patients with carotid plaques are based on quantification of the percentage reduction in luminal diameter due to the atherosclerotic process to select the best therapeutic approach. However, better strategies for prevention of stroke are needed because some subtypes of carotid plaques (eg, vulnerable plaques) can predict the occurrence of stroke independent of the degree of stenosis. Advances in imaging techniques have enabled routine characterisation and detection of the features of carotid plaque vulnerability. Intraplaque haemorrhage is accepted by neurologists and radiologists as one of the features of vulnerable plaques, but other characteristics—eg, plaque volume, neovascularisation, and inflammation—are promising as biomarkers of carotid plaque vulnerability. These biomarkers could change current management strategies based merely on the degree of stenosis.
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U2 - 10.1016/S1474-4422(19)30035-3
DO - 10.1016/S1474-4422(19)30035-3
M3 - Review article
C2 - 30954372
AN - SCOPUS:85065804792
SN - 1474-4422
VL - 18
SP - 559
EP - 572
JO - The Lancet Neurology
JF - The Lancet Neurology
IS - 6
ER -