Evidence map›Paper›PMID 25406150›Full record

SynthesisStroke2015

Plaque echolucency and stroke risk in asymptomatic carotid stenosis: a systematic review and meta-analysis.

Ajay Gupta, Kartik Kesavabhotla, Hediyeh Baradaran, Hooman Kamel, Ankur Pandya, Ashley E Giambrone, Drew Wright, Kevin J Pain, Edward E Mtui, Jasjit S Suri and 2 more

Abstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Stroke, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 83 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
83citing papers in PubMed, 8 pooled it
–field-weighted citation impact
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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

83 citing papers in PubMed, 8 syntheses or guidelines pooled it.

  1. Pooled it
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  3. Guideline
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  7. 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
    Pooled it
  8. Pooled it
  9. Trial
  10. Pre-operative Carotid Plaque Echolucency Assessment has no Predictive Value for Long-Term Risk of Stroke or Cardiovascular Death in Patients Undergoing Carotid Endarterectomy.European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery · 2017
    Trial
  11. Article
  12. Review
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  17. Hemodynamics in carotid artery stenosis.International angiology : a journal of the International Union of Angiology · 2025
    Review
  18. Article
  19. Article
  20. Review

23 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

12 authors.

Ajay GuptaFrom the Department of Radiology (A.G., K.K., H.B., E.E.M., P.C.S.), Brain and Mind Research Institute (A.G., H.K.), Department of Neurology (H.K.), Department of Healthcare Policy and Research (A.P., A.E.G., P.C.S., A.I.M.), and Samuel J. Wood Library and C.V. Starr Biomedical Information Center (D.W., K.J.P.), Weill Cornell Medical College, New York, NY; and Stroke Screening and Monitoring Division, AtheroPoint LLC, Roseville, CA (J.S.S.). ajg9004@med.cornell.edu.
Kartik KesavabhotlaFrom the Department of Radiology (A.G., K.K., H.B., E.E.M., P.C.S.), Brain and Mind Research Institute (A.G., H.K.), Department of Neurology (H.K.), Department of Healthcare Policy and Research (A.P., A.E.G., P.C.S., A.I.M.), and Samuel J. Wood Library and C.V. Starr Biomedical Information Center (D.W., K.J.P.), Weill Cornell Medical College, New York, NY; and Stroke Screening and Monitoring Division, AtheroPoint LLC, Roseville, CA (J.S.S.).
Hediyeh BaradaranFrom the Department of Radiology (A.G., K.K., H.B., E.E.M., P.C.S.), Brain and Mind Research Institute (A.G., H.K.), Department of Neurology (H.K.), Department of Healthcare Policy and Research (A.P., A.E.G., P.C.S., A.I.M.), and Samuel J. Wood Library and C.V. Starr Biomedical Information Center (D.W., K.J.P.), Weill Cornell Medical College, New York, NY; and Stroke Screening and Monitoring Division, AtheroPoint LLC, Roseville, CA (J.S.S.).
Hooman KamelFrom the Department of Radiology (A.G., K.K., H.B., E.E.M., P.C.S.), Brain and Mind Research Institute (A.G., H.K.), Department of Neurology (H.K.), Department of Healthcare Policy and Research (A.P., A.E.G., P.C.S., A.I.M.), and Samuel J. Wood Library and C.V. Starr Biomedical Information Center (D.W., K.J.P.), Weill Cornell Medical College, New York, NY; and Stroke Screening and Monitoring Division, AtheroPoint LLC, Roseville, CA (J.S.S.).
Ankur PandyaFrom the Department of Radiology (A.G., K.K., H.B., E.E.M., P.C.S.), Brain and Mind Research Institute (A.G., H.K.), Department of Neurology (H.K.), Department of Healthcare Policy and Research (A.P., A.E.G., P.C.S., A.I.M.), and Samuel J. Wood Library and C.V. Starr Biomedical Information Center (D.W., K.J.P.), Weill Cornell Medical College, New York, NY; and Stroke Screening and Monitoring Division, AtheroPoint LLC, Roseville, CA (J.S.S.).
Ashley E GiambroneFrom the Department of Radiology (A.G., K.K., H.B., E.E.M., P.C.S.), Brain and Mind Research Institute (A.G., H.K.), Department of Neurology (H.K.), Department of Healthcare Policy and Research (A.P., A.E.G., P.C.S., A.I.M.), and Samuel J. Wood Library and C.V. Starr Biomedical Information Center (D.W., K.J.P.), Weill Cornell Medical College, New York, NY; and Stroke Screening and Monitoring Division, AtheroPoint LLC, Roseville, CA (J.S.S.).
Drew WrightFrom the Department of Radiology (A.G., K.K., H.B., E.E.M., P.C.S.), Brain and Mind Research Institute (A.G., H.K.), Department of Neurology (H.K.), Department of Healthcare Policy and Research (A.P., A.E.G., P.C.S., A.I.M.), and Samuel J. Wood Library and C.V. Starr Biomedical Information Center (D.W., K.J.P.), Weill Cornell Medical College, New York, NY; and Stroke Screening and Monitoring Division, AtheroPoint LLC, Roseville, CA (J.S.S.).
Kevin J PainFrom the Department of Radiology (A.G., K.K., H.B., E.E.M., P.C.S.), Brain and Mind Research Institute (A.G., H.K.), Department of Neurology (H.K.), Department of Healthcare Policy and Research (A.P., A.E.G., P.C.S., A.I.M.), and Samuel J. Wood Library and C.V. Starr Biomedical Information Center (D.W., K.J.P.), Weill Cornell Medical College, New York, NY; and Stroke Screening and Monitoring Division, AtheroPoint LLC, Roseville, CA (J.S.S.).
Edward E MtuiFrom the Department of Radiology (A.G., K.K., H.B., E.E.M., P.C.S.), Brain and Mind Research Institute (A.G., H.K.), Department of Neurology (H.K.), Department of Healthcare Policy and Research (A.P., A.E.G., P.C.S., A.I.M.), and Samuel J. Wood Library and C.V. Starr Biomedical Information Center (D.W., K.J.P.), Weill Cornell Medical College, New York, NY; and Stroke Screening and Monitoring Division, AtheroPoint LLC, Roseville, CA (J.S.S.).
Jasjit S SuriFrom the Department of Radiology (A.G., K.K., H.B., E.E.M., P.C.S.), Brain and Mind Research Institute (A.G., H.K.), Department of Neurology (H.K.), Department of Healthcare Policy and Research (A.P., A.E.G., P.C.S., A.I.M.), and Samuel J. Wood Library and C.V. Starr Biomedical Information Center (D.W., K.J.P.), Weill Cornell Medical College, New York, NY; and Stroke Screening and Monitoring Division, AtheroPoint LLC, Roseville, CA (J.S.S.).
Pina C SanelliFrom the Department of Radiology (A.G., K.K., H.B., E.E.M., P.C.S.), Brain and Mind Research Institute (A.G., H.K.), Department of Neurology (H.K.), Department of Healthcare Policy and Research (A.P., A.E.G., P.C.S., A.I.M.), and Samuel J. Wood Library and C.V. Starr Biomedical Information Center (D.W., K.J.P.), Weill Cornell Medical College, New York, NY; and Stroke Screening and Monitoring Division, AtheroPoint LLC, Roseville, CA (J.S.S.).
Alvin I MushlinFrom the Department of Radiology (A.G., K.K., H.B., E.E.M., P.C.S.), Brain and Mind Research Institute (A.G., H.K.), Department of Neurology (H.K.), Department of Healthcare Policy and Research (A.P., A.E.G., P.C.S., A.I.M.), and Samuel J. Wood Library and C.V. Starr Biomedical Information Center (D.W., K.J.P.), Weill Cornell Medical College, New York, NY; and Stroke Screening and Monitoring Division, AtheroPoint LLC, Roseville, CA (J.S.S.).

Funding

Disparities in COVID Disease Severity and Outcomes in New York CityUL1TR002384 · NCATS · WEILL MEDICAL COLL OF CORNELL UNIV · PI JULIANNE L IMPERATO-MCGINLEY · 2017 to 2026
$86.2M
CTSA INFRASTRUCTURE FOR PEDIATRIC RESEARCHUL1RR024996 · NCRR · WEILL MEDICAL COLL OF CORNELL UNIV · PI IMPERATO-MCGINLEY, JULIANNE L · 2007 to 2011
$49.6M
Clinical and Translational Science CenterTL1TR000459 · NCATS · WEILL MEDICAL COLL OF CORNELL UNIV · PI IMPERATO-MCGINLEY, JULIANNE L · 2012 to 2016
$451k
NCATS NIH HHS TL1 TR000459NCATS NIH HHS UL1 TR002384NCRR NIH HHS UL1 RR024996
6 · The paper itself

Abstract

background and purposeUltrasonographic plaque echolucency has been studied as a stroke risk marker in carotid atherosclerotic disease. We performed a systematic review and meta-analysis to summarize the association between ultrasound-determined carotid plaque echolucency and future ipsilateral stroke risk.

methodsWe searched the medical literature for studies evaluating the association between carotid plaque echolucency and future stroke in asymptomatic patients. We included prospective observational studies with stroke outcome ascertainment after baseline carotid plaque echolucency assessment. We performed a meta-analysis and assessed study heterogeneity and publication bias. We also performed subgroup analyses limited to patients with stenosis ≥50%, studies in which plaque echolucency was determined via subjective visual interpretation, studies with a relatively lower risk of bias, and studies published after the year 2000.

resultsWe analyzed data from 7 studies on 7557 subjects with a mean follow-up of 37.2 months. We found a significant positive relationship between predominantly echolucent (compared with predominantly echogenic) plaques and the risk of future ipsilateral stroke across all stenosis severities (0% to 99%; relative risk, 2.31; 95% confidence interval, 1.58-3.39; P<0.001) and in subjects with ≥50% stenosis (relative risk, 2.61; 95% confidence interval, 1.47-4.63; P=0.001). A statistically significant increased relative risk for future stroke was preserved in all additional subgroup analyses. No statistically significant heterogeneity or publication bias was present in any of the meta-analyses.

conclusionsThe presence of ultrasound-determined carotid plaque echolucency provides predictive information in asymptomatic carotid artery stenosis beyond luminal stenosis. However, the magnitude of the increased risk is not sufficient on its own to iden tify patients likely to benefit from surgical revascularization.

Indexed as

Asymptomatic DiseasesCarotid Artery DiseasesCarotid StenosisHumansPlaque, AtheroscleroticRisk AssessmentStrokeUltrasonographycarotid stenosisplaquerisk factorstrokeultrasound

Identifiers

PMID25406150
PMCPMC4280234

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

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.