Atherosclerosis all around: no plaque is innocent

Stroke caused by large artery atherosclerosis is often associated with worse outcomes than stroke from other causes, 1 Amarenco P Lavallée PC Monteiro Tavares L et al. Five-year risk of stroke after TIA or minor ischemic stroke. N Engl J Med. 2018; 378: 2181-2190 Crossref Scopus (195) Google Scholar and has a high risk of recurrence despite medical management. It remains to be understood whether atherosclerosis that is identified incidentally and might not have been causative for the index stroke is associated with increased risk of subsequent cerebrovascular events. Effect of atherosclerosis on 5-year risk of major vascular events in patients with transient ischaemic attack or minor ischaemic stroke: an international prospective cohort studyIn patients with transient ischaemic attack or minor ischaemic stroke, those with atherosclerosis have a much higher risk of major vascular events within 5 years than do those without atherosclerosis. Preventive strategies addressing complications of atherosclerosis should focus on individuals with atherosclerosis rather than grouping together all people who have had a transient ischaemic attack or minor ischaemic stroke (including those without atherosclerosis). Full-Text PDF