Abstract 15136: Ipsilateral Carotid Arteries Exhibit Higher Inflammation in Patients With Ischemic Stroke and Bilateral Carotid Artery Disease
Background: Carotid atherosclerosis is a major cause of stroke. Current guidelines suggest intervention based on the degree of stenosis and the presence of symptoms. However, inflammation contributes in carotid plaque vulnerability. Microwave radiometry (MWR) evaluates in vivo noninvasively the temperatures of internal tissues. The aim of the present study was to evaluate the ability of Microwave Radiometry to discriminate between culprit and nonculprit carotid arteries, based on their inflammatory activation.
Methods: Consecutive patients with recent acute noncardioembolic anterior circulation ischemic stroke were evaluated within 24 hours from symptoms onset by: 1) carotid ultrasound and 2) microwave radiometry (MWR). During ultrasound study, maximum thickness of carotid plaques (MPT) was evaluated. Only patients with bilateral carotid plaques were included in the study. The ipsilateral to the cerebral infarct carotid arteries were assigned as culprit. Temperature difference (ΔT) by MR was assigned as maximal temperature along the carotid artery minus minimum.
Results: In total 100 carotid arteries of 50 patients were analyzed. Culprit carotid arteries had higher MPT compared to nonculprit carotid arteries (3.76±2.03 versus 2.53±1.09mm, p <0.001). ΔT was higher in culprit carotid arteries compared to nonculprit in both vessel and patient based analysis (0.93±0.58 versus 0.58±0.35°C, p<0.001 and 0.98±0.59 versus 0.52±0.26°C, p<0.001, respectively). In multivariate logistic regression analysis, ΔT was an independent predictor for culprit carotid arteries, when adjusted to sex, age, vascular risk factors and max plaque thickness (OR: 5.94, 95% CI: 1.56-22.63, p=0.01). By ROC curve analysis the optimal cutoff point of ΔT for predicting a culprit carotid artery was ≥0.60°C with a sensitivity of 72% and a specificity of 60% (AUC=0.726, 95% CI: 0.626-0.827, p<0.001)
Conclusions: Microwave radiometry can discriminate between culprit and noculprit carotid arteries in patients with recent ischemic stroke. In asymptomatic patients with intermediate carotid artery stenosis, MWR can also recognize vulnerable carotid plaques suggesting a useful tool in risk stratification of such patients.
Author Disclosures: G. Benetos: None. K. Toutouzas: None. A. Synetos: None. M. Drakopoulou: None. C. Deligianni: None. A. Katsaros: None. G. Latsios: None. K. Spengos: None. E. Siores: None. C. Stefanadis: None.
- © 2014 by American Heart Association, Inc.