Aortic & peripheral vascular diseaseCohort study
Incremental Prognostic Value of Carotid Plaque–RADS Over Stenosis Degree in Relation to Stroke Risk
- Retrospective cohort study
Authors' conclusion
Carotid Plaque-RADS significantly improves stroke risk stratification over traditional stenosis grading, especially in mild/moderate stenosis cases.
Study context
- Population
- Subjects with carotid MRI, CT angiography and ultrasound, January 2010 to December 2021
- Participants
- 1,378 subjects
- Exposure
- Carotid Plaque-RADS plus stenosis degree vs stenosis degree alone
- Asymptomaticn = 987
- Stroke historyn = 391
- Outcome
- Incremental prognostic value of Carotid Plaque-RADS over stenosis degree for stroke risk (DFS and RFS)
Main finding
As reported in the abstract
Stroke risk reclassification (Carotid Plaque-RADS added to stenosis grading) · follow-up 57 ± 25 months
| Group | Value | NRI, initial stroke | Correct reclassification, mild/moderate stenosis | NRI, recurrent stroke |
|---|---|---|---|---|
| Asymptomatic | 4.6% | 63.8% | 3.3% (32 of 979) | |
| Stroke history | 16.9% | 9.7% (37 of 381) | 47.8% |
- Likelihood ratio test: Carotid Plaque-RADS significantly enhanced prognostic accuracy of stenosis degree in both groups
- P < 0.001
Observational data: associations, not effects.
Further findings
Disease-free survival (DFS) and recurrence-free survival (RFS), mild/moderate vs severe stenosis
- Significant differences in DFS and RFS rates
- P < 0.001
DFS across Carotid Plaque-RADS categories 1 to 4
- DFS rates decreased as categories increased; similar trend in stroke history
- P < 0.001
DFS and RFS in mild/moderate stenosis, Carotid Plaque-RADS ≥3 vs <3
- Significant differences in DFS and RFS rates
- P < 0.001
Original publication
Incremental Prognostic Value of Carotid Plaque–RADS Over Stenosis Degree in Relation to Stroke Risk. JACC Cardiovasc Imaging. Published 4 September 2024. doi:10.1016/j.jcmg.2024.07.004
Summarised from the published abstract; every number is checked against it