Carotid atherosclerosis score may help predict stroke risk

An elevated carotid atherosclerosis score (CAS) could indicate increasing plaque progression and a disrupted luminal surface (DLS) and ultimately help stratify stroke risk, a study published online March 13 in the Journal of the American College of Cardiology: Cardiovascular Imaging found.

In a prospective study, Dongxiang Xu, PhD, of the University of Washington in Seattle, performed carotid magnetic resonance imaging on 120 asymptomatic patients with 50 percent to 79 percent carotid stenosis at the start of the study and three years later. They measured carotid intraplaque hemorrhage, DLS, wall volume, maximum wall thickness and maximum percent lipid-rich necrotic core area at both times. They also calculated CAS at baseline.

There were 73 participants without intraplaque hemorrhage or DLS at baseline, and nine of them developed intraplaque hemorrhage and/or DLS three years later. The researchers found a significant association between increasing CAS and the development of DLS as well as with plaque progression. However, there was no significant association between increasing CAS and incident intraplaque hemorrhage.

They also did not find a significant association between percent of carotid stenosis and new DLS, new intraplaque hemorrhage or plaque progression.

Based on their findings, the authors argued that CAS could help with risk stratification “beyond luminal stenosis and may allow more effective of targeting of patients for specific treatment to prevent future stroke.”