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Plaque Volume Rather than Echogenicity for Identification of Active Carotid Plaques

2026/06/13 by Majken Lyhne Jessen, Karin Yeung, Antoine Collet‐Billon +6
Medicine · #Cardiovascular Health and Disease Prevention #Cerebrovascular and Carotid Artery Diseases #Coronary Interventions and Diagnostics

paper · doi:10.1177/00033197261460096

crossref issued 2026/06/13 · crossref published 2026/06/13 · crossref published-online 2026/06/13 · openalex publication_date 2026/06/13 · crossref created 2026/06/13 · openalex created_date 2026/06/14 · crossref deposited 2026/06/18 · crossref indexed 2026/07/29 · openalex updated_date 2026/07/30

Abstract

This single-center prospective observational follow-up study aimed to evaluate 2-year changes in carotid plaque volume and echogenicity and to explore whether clinical and biochemical baseline factors are associated with plaque progression. It was an exploratory observational follow-up of patients with echolucent plaques previously enrolled in a 12-month randomized controlled trial. Plaque volume and grayscale median were measured at baseline and at 3, 6, 12, and 24 months using three-dimensional ultrasound (3D-US). Associations between baseline characteristics and plaque progression were evaluated using mixed-effects models with time-predictor interactions, adjusted for baseline plaque volume. Medication adherence from 12 to 24 months was examined. Plaque echogenicity remained stable over 24 months, whereas mean plaque volume increased with heterogeneous patterns. Approximately 20% of plaques were classified as progressors, 70% as stable, and 10% as regressors. Higher mean arterial pressure, low density lipoprotein cholesterol (LDL-C), and larger baseline volume were significantly associated with plaque progression. Poor statin adherence showed a non-significant trend toward greater progression. In conclusion, echolucent carotid plaques demonstrated stable echogenicity but volumetric progression over 24 months. Blood pressure, LDL-C, and baseline plaque size were associated with progression, although limited by sample size, supporting a role for longitudinal 3D-US plaque volume assessment in individualized cardiovascular prevention.

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