TY - JOUR
T1 - The relationship between fibrous cap status or plaque surface morphology and intraplaque hemorrhage volume over time
T2 - The PARISK Study
AU - Kassem, Mohamed
AU - Gorissen, Tahnee
AU - Albenwan, Mohammad
AU - Bierens, Juul
AU - van Dam-Nolen, Dianne H.K.
AU - Liem, Madieke I.
AU - Hofman, Paul A.M.
AU - Wildberger, Joachim E.
AU - Hendrikse, Jeroen
AU - Mess, Werner
AU - Nederkoorn, Paul J.
AU - Bos, Daniel
AU - Nelemans, Patty
AU - van Oostenbrugge, Robert J.
AU - Kooi, M. Eline
N1 - Publisher Copyright:
© 2025
PY - 2025/5
Y1 - 2025/5
N2 - Background: Carotid intraplaque hemorrhage (IPH) is a strong predictor of stroke, but factors contributing to IPH development are incompletely understood. Therefore, we investigate the longitudinal relationship between a thin/ruptured fibrous cap (TRFC)/disrupted plaque surface and IPH volume. Methods: 116 ischemic TIA/stroke patients with ipsilateral carotid plaques underwent baseline and two-year follow-up MRI. IPH and fibrous cap status (thick versus TRFC) on MRI and disruption of the plaque surface (smooth versus fissure/ulceration) on CTA were assessed. Results: In the TRFC and disrupted plaque surface groups, the median IPH volume (tended) to decrease during follow-up (baseline: 97.3 IQR: [3.2-193.3] mm3 versus follow-up: 29.7 [0.0-115.1] mm3, p = 0.09, and baseline: 25.1 [0.0-166.2] mm3 versus follow-up: 11.2 [0.0-68.3] mm3, p = 0.04, respectively). In the group with a thick fibrous cap/smooth plaque surface, the median IPH volumes were zero at baseline and follow-up. The risk of IPH progression was higher in the TRFC/disrupted plaque groups (risk ratio (RR): 2.9 and 2.0, respectively) than in patients with a thick fibrous cap/smooth plaque surface. Conclusion: TIA/stroke patients with a TRFC/disrupted plaque showed a net decrease in IPH volume over time, indicating plaque healing in some patients, but patients with a TRFC/disrupted plaque are still at increased risk for IPH progression. Trial registration: ClinicalTrials.gov NCT01208025.
AB - Background: Carotid intraplaque hemorrhage (IPH) is a strong predictor of stroke, but factors contributing to IPH development are incompletely understood. Therefore, we investigate the longitudinal relationship between a thin/ruptured fibrous cap (TRFC)/disrupted plaque surface and IPH volume. Methods: 116 ischemic TIA/stroke patients with ipsilateral carotid plaques underwent baseline and two-year follow-up MRI. IPH and fibrous cap status (thick versus TRFC) on MRI and disruption of the plaque surface (smooth versus fissure/ulceration) on CTA were assessed. Results: In the TRFC and disrupted plaque surface groups, the median IPH volume (tended) to decrease during follow-up (baseline: 97.3 IQR: [3.2-193.3] mm3 versus follow-up: 29.7 [0.0-115.1] mm3, p = 0.09, and baseline: 25.1 [0.0-166.2] mm3 versus follow-up: 11.2 [0.0-68.3] mm3, p = 0.04, respectively). In the group with a thick fibrous cap/smooth plaque surface, the median IPH volumes were zero at baseline and follow-up. The risk of IPH progression was higher in the TRFC/disrupted plaque groups (risk ratio (RR): 2.9 and 2.0, respectively) than in patients with a thick fibrous cap/smooth plaque surface. Conclusion: TIA/stroke patients with a TRFC/disrupted plaque showed a net decrease in IPH volume over time, indicating plaque healing in some patients, but patients with a TRFC/disrupted plaque are still at increased risk for IPH progression. Trial registration: ClinicalTrials.gov NCT01208025.
KW - Atherosclerosis
KW - Computed tomography angiography
KW - Fibrous cap
KW - Intraplaque hemorrhage
KW - Magnetic resonance imaging
KW - Plaque surface morphology
UR - http://www.scopus.com/inward/record.url?scp=86000514506&partnerID=8YFLogxK
U2 - 10.1016/j.jstrokecerebrovasdis.2025.108283
DO - 10.1016/j.jstrokecerebrovasdis.2025.108283
M3 - Article
AN - SCOPUS:86000514506
SN - 1052-3057
VL - 34
JO - Journal of Stroke and Cerebrovascular Diseases
JF - Journal of Stroke and Cerebrovascular Diseases
IS - 5
M1 - 108283
ER -