“Stroke-Stop” Formula: A Tool for Risk Index Determination in Development of Acute Cerebrovascular Disease in Patients with Asymptomatic Internal Carotid Artery Stenosis

Background: Extracranial carotid artery disease is considered a risk factor for developing acute cerebrovascular diseases. The paper presents the “Stroke-Stop” formula proposed for the determination of the risk of developing stroke in patients with asymptomatic internal carotid artery (ICA) stenosis. The formula is based on a mathematical calculation of the major risk factors for stroke: the degree of ICA stenosis, the morphological structure of the atherosclerotic plaque and the level of lipoprotein-associated phospholipase A2 (Lp-PLA2) concentration. Methods: The study included 70 patients with atherosclerotic ICA stenosis. Among vascular inflammatory markers, Lp-PLA2 was determined with concentration 252.7-328.6 mg/l. The obtained results were evaluated using descriptive statistics (the frequency, percentage ratio) as well as the one-way analysis of variance (ANOVA) and chi-square test. Results: The risk of stroke development is eminently increasing with the progression of ICA stenosis and elevation of Lp-PLA2 levels. In patients with soft atherosclerotic plaque, the risk of stroke development was significantly higher in correlation with patients with hard atherosclerotic plaque. Based on calculations using “Stroke-Stop” formula, three main groups were generated: low (100 points) risk of stroke development. Conclusions: The “Stroke-Stop” formula may serve as an additional criterion for individual selection of patients with asymptomatic ICA stenosis for carotid endarterectomy. This model could be used as a diagnostic and prognostic tool to identify patients with potentially high risk development of ischemic stroke in clinical praxis.