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| 1 | Chinese Atherosclerosis Risk Evaluation(CARE II)study:a novel cross-sectional,multicentre study of the prevalence of high-risk atherosclerotic carotid plaque in Chinese patients with ischaemic cerebrovascular events-design and rationale显示文摘Background:Carotid atherosclerotic plaque is identified as one of the main sources of ischaemic stroke.However,the prevalence of carotid high-risk atherosclerotic plaque in Chinese patients with ischaemic cerebrovascular events has been inconsistently reported and needs to be investigated in a large population.Objectives:The primary objective of CARE II study was to determine the prevalence and characteristics of high-risk features of atherosclerotic plaques in the carotid arteries in Chinese patients with recent ischaemic stroke or transient ischaemia attack(TIA).The relationship between carotid plaque features and cerebral infarcts,the differences of carotid plaque patterns among different regions of China and the gender specific characteristics of carotid plaque will be also determined.Study design:The CARE II study will enrol 1000 patients with recent ischaemic stroke or TIA and carotid plaque from 13 hospitals and medical centres across China.In this cross-sectional,non-randomised,observational,multicentre study,all patients will undergo carotid artery MRI of bilateral carotid arteries and routine brain MRI with standardised protocols.The MRI will be interpreted at core reading centres to evaluate the characteristics of morphology and compositions of carotid plaque.Conclusions:This is a cross-sectional,multicentre study to investigate the prevalence and characteristics of high-risk atherosclerotic carotid plaque in Chinese patients with stroke and TIA by using high-resolution MRI of vessel wall.This trial is sufficiently powered to demonstrate the prevalence of carotid high-risk plaque and to explore regional differences in Chinese patients who suffered stroke. | Xihai Zhao Rui Li Daniel S Hippe Thomas S Hatsukami Chun Yuan CARE-II Investigators | 2017 | Stroke & Vascular Neurology2017，2，1： | 21 |
| 2 | Differences in atheroma between Caucasian and Asian subjects with anterior stroke:A vessel wall MRI study显示文摘Background and purpose While extracranial carotid artery stenosis is more common among Caucasians and intracranial artery stenosis is more common among Asians,the differences in atherosclerotic plaque characteristics have not yet been extensively examined.We sought to investigate plaque location and characteristics within extracranial carotid and intracranial arteries in symptomatic Caucasians and Chinese using vessel wall MRI.Methods Subjects with recent anterior circulation ischaemic stroke were recruited and imaged at two sites in the USA and China using similar protocols.Both extracranial carotid and intracranial arteries were reviewed to determine plaque location and characteristics.Results The prevalence of extracranial carotid plaque in Caucasians and Chinese was 73.1%and 49.1%,respectively(p=0.055).Prevalence of intracranial plaque was 38.5%and 69.1%in Caucasians and Chinese,respectively(p=0.02).Furthermore,42% of Caucasians and 16%of Chinese had high-risk plaque(HRP)features(intraplaque haemorrhage,luminal surface disruption)in the extracranial carotid artery(p=0.03).The prevalence of HRP features in intracranial arteries was not significantly different between the two cohorts(4%vs 11%;p=0.42).Conclusions Differences in the location and characteristics of cerebrovascular atherosclerosis were identified by vessel wall MRI in US Caucasian and Chinese subjects with recent anterior circulation ischaemic stroke.Extracranial carotid plaques with HRP features were more common in Caucasians.Intracranial plaques were more common in Chinese subjects,but no significant difference between the two cohorts in intracranial HRP prevalence was found.Larger studies using vessel wall imaging to investigate racial differences in cerebrovascular disease may inform underlying mechanisms of HRP development and may ultimately help guide appropriate therapy. | Hiroko Watase Mi Shen Binbin Sui Peiyi Gao Dong Zhang Jie Sun Niranjan Balu Daniel S Hippe Gail P Jarvik Xihai Zhao Rui Li Shuo Chen Chun Yuan Thomas S Hatsukami | 2021 | Stroke & Vascular Neurology2021，6，1： | 4 |
| 3 | Comparison of carotid atherosclerotic plaques between subjects in Northern and Southern China: a Chinese atherosclerosis risk evaluation study显示文摘Background and purpose To investigate differences in the characteristics of carotid atherosclerotic plaques of symptomatic subjects in northern and southern China using MRI.Methods Sixty-three subjects in northern China(mean age:59.1±8.6 years,45 men)and 56 subjects in southern China(mean age:60.4±8.6 years,38 men)were included.All subjects underwent carotid artery multicontrast vessel wall MRI.Plaque morphology,calcification,lipid-rich necrotic core,intraplaque haemorrhage,luminal surface disruption and high-risk plaque were measured and identified.All plaque characteristics were compared between subjects in northern and southern China using Mann-Whitney U test or χ^(2) test.results Compared with subjects in southern China,those in northern China had significantly greater areas for lumen(57.7±14.9 mm^(2) vs 50.4±18.3 mm^(2),p=0.009),wall(38.4±13.1 mm^(2) vs 31.9±11.7 mm^(2),p<0.001)and total vessel(96.1±20.2 mm^(2) vs 82.4±22.7 mm^(2),p=0.001)and mean wall thickness(1.25±0.43 mm vs 1.13±0.40 mm,p=0.019).χ^(2) analysis showed that subjects in northern China tended to have a higher prevalence of intraplaque haemorrhage(14.3%vs 5.4%,p=0.106)and high-risk plaque(20.6%vs 10.7%,p=0.140)than those in southern China,although these differences were not statistically significant(all p>0.05).Conclusion Subjects in northern China have significantly larger vessel size and may have a higher prevalence of vulnerable plaques than those in southern China.Our findings provide additional perspective to optimise the management of cerebrovascular disease in individuals in different regions in China. | Dandan Yang Yang Ji Dan Wang Hiroko Watase Daniel S Hippe Xihai Zhao Chun Yuan | 2020 | Stroke & Vascular Neurology2020，5，2： | 1 |
| 4 | Differences in left and right carotid plaque vulnerability in patients with bilateral carotid plaques:a CARE-II study显示文摘Background and purpose Atherosclerosis is a very complex process influenced by various systemic and local factors.Therefore,in patients with bilateral carotid plaques(BCPs),there may be differences in carotid plaque vulnerability between the sides.We aimed to investigate the differences in BCP characteristics in patients with BCPs using magnetic resonance vessel wall imaging(MR-VWI).Methods Participants with BCPs were selected for subanalysis from a multicentre study of Chinese Atherosclerosis Risk Evaluation II.We measured carotid plaque burden,identified each plaque component and measured their volume or area bilaterally on MR-VWI.Paired comparisons of the burden and components of BCPs were performed.Results In all,540 patients with BCPs were eligible for analysis.Compared with the right carotid artery(CA),larger mean lumen area(p<0.001),larger mean wall area(p=0.025),larger mean total vessel area(p<0.001)and smaller normalised wall index(p=0.006)were found in the left CA.Regarding plaque components,only the prevalence of lipid-rich necrotic core(LRNC)in the left CA was higher(p=0.026).For patients with a vulnerable plaque component coexisting on both sides,only the intraplaque haemorrhage(IPH)volume(p=0.011)was significantly greater in the left CA than in the right CA.Conclusions There were asymmetries in plaque growth and evolution between BCPs.The left carotid plaques were more likely to have larger plaque burden,higher prevalence of LRNC and greater IPH volume,which may contribute to the lateralisation of ischaemic stroke in the cerebral hemispheres. | Sai Shao Honglu Shi Guangbin Wang Rui Li Qinjian Sun Bin Yao Hiroko Watase Daniel S Hippe Chun Yuan Xihai Zhao | 2023 | Stroke & Vascular Neurology2023，8，4： | 1 |
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