Evidence map›Paper›PMID 28651865›Full record

Trial reportEuropean journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery2017

Pre-operative Carotid Plaque Echolucency Assessment has no Predictive Value for Long-Term Risk of Stroke or Cardiovascular Death in Patients Undergoing Carotid Endarterectomy.

D de Waard, G J de Borst, R Bulbulia, H Pan, A Halliday, ACST-1 collaborative group

Abstract readMulticenter StudyRandomized Controlled Trial
In one paragraph

Trial report in European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–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

2 citing papers in PubMed.

  1. Article
  2. Article
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

6 authors.

D de WaardNuffield Department of Surgical Sciences, University of Oxford, Oxford, UK; Department of Vascular Surgery, University Medical Centre Utrecht, Utrecht, The Netherlands.
G J de BorstDepartment of Vascular Surgery, University Medical Centre Utrecht, Utrecht, The Netherlands.
R BulbuliaMedical Research Council Population Health Research Unit, Clinical Trial Service Unit & Epidemiological Studies Unit, Nuffield Department of Population Health, Oxford, UK.
H PanMedical Research Council Population Health Research Unit, Clinical Trial Service Unit & Epidemiological Studies Unit, Nuffield Department of Population Health, Oxford, UK.
A HallidayNuffield Department of Surgical Sciences, University of Oxford, Oxford, UK. Electronic address: Alison.halliday@nds.ox.ac.uk.
ACST-1 collaborative group

Funding

Department of Health 06/301/233Medical Research Council
6 · The paper itself

Abstract

introductionIn patients with carotid stenosis receiving medical treatment, carotid plaque echolucency has been thought to predict risk of future stroke and of other cardiovascular events. This study evaluated the prognostic value of pre-operative plaque echolucency for future stroke and cardiovascular death in patients undergoing carotid endarterectomy in the first Asymptomatic Carotid Surgery Trial (ACST-1).

methodsIn ACST-1, 1832/3120 patients underwent carotid endarterectomy (CEA), of whom 894 had visual echolucency assessment according to the Gray-Weale classification. During follow-up patients were monitored both for peri-procedural (i.e. within 30 days) death, stroke, or MI, and for long-term risk of stroke or cardiovascular death. Unconditional maximum likelihood estimation was used to calculate odds ratios of peri-procedural risk and Kaplan-Meier statistics with log-rank test were used to compare cumulative long-term risks.

resultsOf 894 operated patients in whom echolucency was assessed, 458 plaques (51%) were rated as echolucent and peri-procedural risk of death/stroke/MI in these patients was non-significantly higher when compared with patients with non-echolucent plaques (OR 1.48 [95% CI 0.76-2.88], p = .241). No differences were found in the 10 year risk of any stroke (30/447 [11.6%] vs. 29/433 [11.0%], p = .900) or cardiovascular (non-stroke) death (85/447 [27.9%] vs. 93/433 [32.1%], p = .301).

conclusionIn ACST-1, carotid plaque echolucency assessment in patients undergoing CEA offered no predictive value with regard to peri-operative or long-term stroke risk or of cardiovascular (non-stroke) death.

Indexed as

Plaque, AtheroscleroticUltrasonographyAgedAsymptomatic DiseasesCarotid ArteriesCarotid StenosisChi-Square DistributionEndarterectomy, CarotidFemaleHumansKaplan-Meier EstimateMaleMiddle AgedMyocardial InfarctionOdds RatioPredictive Value of TestsCarotid artery stenosisCarotid endarterectomyPlaque echolucencyRandomised controlled trialStroke

Identifiers

PMID28651865
PMCPMC5542040

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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.