The predictive value of Plaque-RADS classification in two-dimensional carotid ultrasound for stroke risk stratification

Background: The Carotid Plaque Reporting and Data System (Plaque-RADS) standardizes plaque risk assessment, but its ability to predict the prevalence of stroke has not yet been fully investigated. This study aimed to evaluate the association between the Plaque-RADS categories and stroke prevalence in a large prospective cohort using two-dimensional (2D) carotid ultrasound. Methods: In total, 2,023 patients undergoing carotid ultrasound were enrolled in this prospective cohort study. Stroke risk was stratified using Plaque-RADS categories 1-4. Based on clinical diagnosis, the patients were categorized into stroke and non-stroke groups. The associations between the Plaque-RADS categories and stroke prevalence/recurrence were analyzed by multivariate logistic regression, adjusted for gender, age, and diabetes mellitus. A linear trend test was performed across the ordinal categories. Results: 29.3%, P