Abstract 15099: Predictive Role of Microwave Radiometry in Identifying Culprit Carotid Arteries Provoking Ischemic Stroke
Background: Carotid atherosclerosis is responsible for 20-40% of ischemic strokes. Inflammation plays an important role in the progression and destabilization of carotid atherosclerotic plaques, leading to clinical events. Microwave Radiometry (MWR) allows in vivo noninvasive measurement of the internal temperatures of tissues, reflecting inflammation. The aim of the present study was to investigate the predictive value of MWR assessment in the identification of the culprit carotid arteries in patients with recent ischemic stroke.
Methods: Consecutive patients with recent acute noncardioembolic anterior circulation ischemic stroke and bilateral carotid plaques were included in the study. All patients underwent within 24 hours from symptoms onset 1) carotid ultrasound, and 2) MWR measurements. During ultrasound study, maximum plaque thickness (MPT) was determined in each carotid artery. Temperature difference (ΔT) by MWR was assigned as maximal temperature along the carotid artery minus minimum. The ipsilateral to cerebral ischemia carotid arteries were assigned as culprit. We considered the following models for culprit carotid artery identification and compared them with the use of Harrel’s c-statistic: traditional risk factors (TRF - sex, age, smoking, dyslipidemia, arterial hypertension, diabetes mellitus and family history) plus MPT, b)TRF plus ΔT and c) TRF plus MPT plus ΔT.
Results: Fifty patients were finally included in the study. Culprit carotid plaques had higher ΔT compared to nonculprit (0.93±0.58 versus 0.58±0.35°C, respectively, p<0.001). The models TRF plus MPT and TRF plus ΔT showed similar predictive capacity for culprit carotid artery identification (c-statistic=0.691, 95% CI 0.588-0.794, p<0.001 vs c-statistic=0.747, 95% CI 0.644-0.850, p<0.001, respectively, pdiff.=0.36). On the contrary the model TRF plus MPT plus ΔT showed the highest predictive capacity (c-statistic=0.768, 95% CI 0.666-0.870, p<0.001, pdiff=0.05).
Conclusions: The evaluation with MWR of inflammatory status of carotid atherosclerotic plaques could be useful in identifying culprit plaques, implying the potential value of this new noninvasive method in risk stratification of asymptomatic patients with intermediate carotid stenosis.
Author Disclosures: G. Benetos: None. K. Toutouzas: None. M. Drakopoulou: None. A. Synetos: None. C. Deligianni: None. I. Koutagiar: None. K. Spengos: None. D. Tousoulis: None. E. Siores: None. C. Stefanadis: None.
- © 2014 by American Heart Association, Inc.