Impact of risk factors on the morphology of carotid artery plaques and stroke

S. Podobnik-Sarkanji, V. Demarin, T. Rundek

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Atherosclerosis of carotid arteries causes stroke in 30%-40% of patients with cerebrovascular disease. A slight decline of the incidence and mortality from cerebrovascular disease which has been observed in recent years, can be explained by earlier diagnosis, follow-up and elimination of risk factors of carotid artery atherosclerosis. Morphological variability and histologic composition of carotid plaques play an important part in their development. A group of 83 patients with symptomatic and asymptomatic carotid atherosclerotic lesions were analyzed. The morphology of carotid plaques was determined using color Doppler flow imaging, Acuson 128XP. In each patient, the history of stroke and putative risk factors such as age, sex, hypertension, obesity, cigarette smoking, use of oral contraceptives, diabetes and alcohol consumption was collected. The values of cholesterol, triglycerides, HDL-cholesterol, LDL-cholesterol, apoprotein A and apoprotein B were determined by laboratory tests. The risk factors were correlated with the plaque morphology. Analysis of the most common risk factors with respect to the plaque morphology revealed the following: - in soft plaques, the most common risk factors are elevated cholesterol, low HDL-cholesterol and cigarette smoking; -in heterogeneous plaques, the most common risk factor is low HDL-cholesterol;- in fibrous plaques, the most common risk factors are elevated cholesterol and cigarette smoking; - in calcified plaques, the presence of cigarette smoking, hypertension, elevated cholesterol and low HDL-cholesterol are equally important; and -in case of hemorrhage into the plaque, the most important factor is hypertension. A significant correlation was found between the severity of carotid atherosclerotic lesions and stroke. The patients with stroke had significantly more soft and heterogeneous plaques. The plaques with hemorrhage were present only in patients who had suffered a stroke. The most important risk factors for extracranial cerebrovascular disease are elevated cholesterol, low HDL-cholesterol, cigarette smoking and hypertension.

Original languageEnglish (US)
Pages (from-to)77-83
Number of pages7
JournalActa Clinica Croatica
Issue number2-3
StatePublished - Jan 1 1997
Externally publishedYes


  • Carotid arteries
  • Carotid artery diseases
  • Cerebrovascular disorders
  • Complications
  • Etiology
  • Risk factors
  • Ultrasonography

ASJC Scopus subject areas

  • Medicine(all)


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