Evidence map›Paper›PMID 23988640›Full record

SynthesisStroke2013

Carotid plaque MRI and stroke risk: a systematic review and meta-analysis.

Ajay Gupta, Hediyeh Baradaran, Andrew D Schweitzer, Hooman Kamel, Ankur Pandya, Diana Delgado, Allison Dunning, Alvin I Mushlin, Pina C Sanelli

2 registry-linked trialsOpen access · bronzeAbstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Stroke, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 227 papers, 22 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
227citing papers in PubMed, 22 pooled it
21.8field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03507374 early_phase1terminatedstarted 2018, after this paper: background citation

PCSK9 Inhibition in Patients With Symptomatic Intracranial Atherosclerosis

Ran2018Enrolled20Registered outcomes5Posted comparisons0ConditionsIntracranial Atherosclerosis, Intraplaque Hemorrhage, StrokeArmsAlirocumab, Placebo
PMID 26346855PMID 15800226PMID 16239630PMID 16439704PMID 17312027PMID 19807851PMID 21164126PMID 21536995PMID 21958949PMID 22872053PMID 23404720PMID 23463579other papers from this trial
Open the trial in the graph
NCT05566080 completednot on this mapstarted 2021, after this paper: background citation

Preoperative Identification of the Histologically "Vulnerable" Plaque Using Non-invasive Imaging, Biomechanical Assessment and Baroreflex Evaluation in Patients With Severe Carotid Stenosis

TypeobservationalSponsorIRCCS Policlinico S. DonatoRan2021 to 2023Enrolled100ConditionsCarotid Artery Plaque, DiagnosisArmsCarotid endarterectomy
3 · Its place in the literature

Who cites it

227 citing papers in PubMed, 22 syntheses or guidelines pooled it, 542 citations in OpenAlex.

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  19. The Association between Carotid Artery Atherosclerosis and Silent Brain Infarction: A Systematic Review and Meta-analysis.Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association · 2017
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167 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 1 institution in 1 country.

Ajay GuptaFrom the Departments of Radiology (A.G., H.B., A.D.S., P.C.S.), Neurology (H.K.), and Public Health (A.P., A.D., A.I.M., P.C.S.) and Samuel J. Wood Library & C.V. Starr Biomedical Information Center (D.D.), Weill Cornell Medical College, New York, NY.
Hediyeh Baradaran
Andrew D Schweitzer
Hooman Kamel
Ankur Pandya
Diana Delgado
Allison Dunning
Alvin I Mushlin
Pina C Sanelli
Cornell University · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

background and purposeMRI characterization of carotid plaque has been studied recently as a potential tool to predict stroke caused by carotid atherosclerosis. We performed a systematic review and meta-analysis to summarize the association of MRI-determined intraplaque hemorrhage, lipid-rich necrotic core, and thinning/rupture of the fibrous cap with subsequent ischemic events.

methodsWe performed a comprehensive literature search evaluating the association of carotid plaque composition on MRI with ischemic outcomes. We included cohort studies examining intraplaque hemorrhage, lipid-rich necrotic core, or thinning/rupture of the fibrous cap with mean follow-up of ≥1 month and an outcome measure of ipsilateral stroke or transient ischemic attack. A meta-analysis using a random-effects model with assessment of study heterogeneity and publication bias was performed.

resultsOf the 3436 articles screened, 9 studies with a total of 779 subjects met eligibility for systematic review. The hazard ratios for intraplaque hemorrhage, lipid-rich necrotic core, and thinning/rupture of the fibrous cap as predictors of subsequent stroke/transient ischemic attack were 4.59 (95% confidence interval, 2.91-7.24), 3.00 (95% confidence interval, 1.51-5.95), and 5.93 (95% confidence interval, 2.65-13.20), respectively. No statistically significant heterogeneity or publication bias was present in the 3 main meta-analyses performed.

conclusionsThe presence of intraplaque hemorrhage, lipid-rich necrotic core, and thinning/rupture of the fibrous cap on MRI of carotid plaque is associated with increased risk of future stroke or transient ischemic attack in patients with carotid atherosclerotic disease. Dedicated MRI of plaque composition offers stroke risk information beyond measurement of luminal stenosis in carotid atherosclerotic disease.

Indexed as

Magnetic Resonance ImagingCarotid StenosisCohort StudiesHumansLipidsNecrosisPlaque, AtheroscleroticProportional Hazards ModelsRisk FactorsStrokeTreatment OutcomeLipidscarotid arteriescarotid artery plaque ▪ ischemic attack, transientMRIriskstroke

Identifiers

PMID23988640
OpenAlexW2117693547

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.