Identification of vulnerable carotid plaque as a predictor of stroke Cardiovascular diseases are the main cause of death in Italy, in Europe and in Western Countries. 150.000 cases of myocardial infarction and 100.000 cases of cerebral infarction (ischemic ictus or stroke) are registered every year in Italy: these cases result in death of patient or often in serious disablement with permanent invalidity associated to elevated social costs.
The event leading to myocardial or cerebral infarction is mainly represented by a rupture and embolization of an atherosclerotic plaque, with following occlusion and thrombosis of coronary or carotid arteries and ischemic death of parenchyma because of absence of blood.
The factors responsible for the onset and development of atherosclerotic plaque are still unknown and only in some cases they are related to the so called risk factors of atherosclerotic disease (hypertension, diabetes, dyslipidemia, smoke, obesity, stress, inactivity, age, gender); in fact, hemorheological parameters, inflammatory and autoimmune factors contribute to the pathogenic process of the disease. Atherosclerotic diseases are increasingly diffused within the population, not only because of the obvious increase of life span.
Since the high percentage of mortality associated to the acute form of the disease, an effective treatment should be preventive, by means of an early diagnosis allowing a progressive adjustment of risk factors and the application of pharmacological therapies. These therapies, associated with some other treatments, demonstrated to be effective in significant reduction of correlated main pathological events.
The study herein proposed would identify a population of high-risk persons and allow directing that population towards a diagnostic screening and a specific treatment, with a costs-benefits ratio truly efficacious at population level.
Stroke is the third cause of death and the most important cause of disability in Western Countries. About 50% of all ischemic strokes are due to atherothrombotic disease of the carotid arteries. One of the most important aim for stroke prevention is the identification of carotid plaques at higher risk of brain embolization.
Echographic examination of carotid arteries allows to study non-invasively the carotid plaque, distinguishing echolucent from echogenic plaques. Several studies including more than 8000 patients have shown that carotid echolucency is a risk factor for stroke.
In the ICAROS study, our team identified a new algorithm for the prevention of stroke, using an innovative computerized method for the analysis of plaque echogenicity, i.e. the Gray Scale Median (GSM).
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