Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • News & Views
  • Published:

Cerebrovascular disease

Identifying high-risk patients from carotid plaque composition

Nature Reviews Cardiology volume 7, pages 426–428 (2010)Cite this article

Subjects

The ability to identify which patients with atherosclerosis are at higher risk of future cardiovascular events is important not only for decisions about medical therapy, but also for decisions about surgical or percutaneous intervention. Pathological findings of plaque features that predict cardiovascular events may point the way to noninvasive imaging approaches to identify high-risk plaques.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

References

  1. Marquardt, L., Geraghty, O. C., Mehta, Z. & Rothwell, P. M. Low risk of ipsilateral stroke in patients with asymptomatic carotid stenosis on best medical treatment: a prospective, population-based study. Stroke 41, e11–e17 (2010).

    PubMed  Google Scholar 

  2. Abbott, A. L. Medical (nonsurgical) intervention alone is now best for prevention of stroke associated with asymptomatic severe carotid stenosis: results of a systematic review and analysis. Stroke 40, e573–e583 (2009).

    Article  Google Scholar 

  3. Spence, J. D. et al. Effects of Intensive medical therapy on microemboli and cardiovascular risk in asymptomatic carotid stenosis. Arch. Neurol. 67, 180–186 (2010).

    Article  Google Scholar 

  4. Spence, J. D. Asymptomatic carotid stenosis: mainly a medical condition. Vascular 18, 123–126 (2010).

    Article  Google Scholar 

  5. Markus, H. S. et al. Asymptomatic embolisation for prediction of stroke in the Asymptomatic Carotid Emboli Study (ACES): a prospective observational study. Lancet Neurol. (in press).

  6. Spence, J. D., Tamayo, A., Lownie, S. P., Ng, W. & Ferguson, G. G. Absence of microemboli on transcranial Doppler identifies low-risk patients with asymptomatic carotid stenosis who do not warrant endarterectomy or stenting. Stroke 36, 2373–2378 (2005).

    Article  Google Scholar 

  7. Hellings, W. E. et al. Composition of carotid atherosclerotic plaque is associated with cardiovascular outcome: a prognostic study. Circulation 121, 1941–1950 (2010).

    Article  Google Scholar 

  8. Brott, T. G. et al. Stenting versus endarterectomy for treatment of carotid-artery stenosis. N. Engl. J. Med. doi:10.1056/NEJMoa0912321.

    Article  CAS  Google Scholar 

  9. Altaf, N. et al. Detection of intraplaque hemorrhage by magnetic resonance imaging in symptomatic patients with mild to moderate carotid stenosis predicts recurrent neurological events. J. Vasc. Surg. 47, 337–342 (2008).

    Article  Google Scholar 

  10. Schminke, U., Motsch, L., Hilker, L. & Kessler, C. Three-dimensional ultrasound observation of carotid artery plaque ulceration. Stroke 31, 1651–1655 (2000).

    Article  CAS  Google Scholar 

Download references

Acknowledgements

The author has received grants from the Heart & Stroke Foundation of Ontario and the Canadian Institutes of Health Research that are related to the subject matter of this commentary.

Author information

Authors and Affiliations

  1. Stroke Prevention & Atherosclerosis Research Centre, Robarts Research Institute, University of Western Ontario, 1400 Western Road, London, N6G 2V2, ON, Canada

    J. David Spence

Authors
  1. J. David Spence
    View author publications

    You can also search for this author in PubMed Google Scholar

Ethics declarations

Competing interests

The author declares no competing financial interests.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Spence, J. Identifying high-risk patients from carotid plaque composition. Nat Rev Cardiol 7, 426–428 (2010). https://doi.org/10.1038/nrcardio.2010.100

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1038/nrcardio.2010.100

Search

Advanced search

Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing