ORIGINAL RESEARCH article
Front. Neurol.
Sec. Neuroepidemiology
Volume 16 - 2025 | doi: 10.3389/fneur.2025.1622941
Predictive Value of the Product Term BRI×Carotid Plaque Thickness for Stroke and Transient Ischemic Attack: A Prospective Cohort Study
Provisionally accepted
- Binzhou People’s Hospital, Binzhou, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Background Carotid plaque thickness and BRI are each associated with an increased risk of stroke. However, the value of their interaction in predicting stroke remains unclear. This study aimed to investigate the predictive performance of maximum carotid plaque thickness, BRI, and their interaction for the occurrence of stroke or TIA. Methods In this prospective cohort study, 230 elderly Chinese adults were enrolled. Baseline measurements included maximum carotid plaque thickness and BRI, and an interaction term was calculated. Participants were followed for one year, during which the incidence of stroke or TIA was recorded. Multivariable logistic regression was used to assess the predictive value of each variable. Receiver operating characteristic curve analysis with 95% confidence intervals was conducted to determine the area under the curve (AUC) for model performance, and internal validation using bootstrap resampling (B=1000) was performed to correct for potential optimism. Results Both maximum plaque thickness (3.305±0.515mm vs. 2.245±0.820mm, p<0.001) and BRI (4.872±1.240 vs. 3.751±0.916, p<0.001) were significantly higher in the stroke group than in the non-stroke group. Logistic regression analysis showed that maximum plaque thickness (Full multivariable adjustment:OR=3.619, 95%CI:1.781–7.355, p=0.00038) and BRI (Full multivariable adjustment:OR=3.116, 95% CI:1.784–5.444, p=0.00006) were both independent predictors. ROC analysis revealed that the interaction term yielded the highest AUC (0.9192, 95% CI: 0.8772–0.9612), compared with maximum plaque thickness (0.8819, 95% CI: 0.8353–0.9285) and BRI (0.7632, 95% CI: 0.6266–0.8997). Statistical comparisons indicated that the interaction model significantly outperformed BRI, while its advantage over maximum plaque thickness was numerically higher but did not reach statistical significance, likely due to the limited number of events. After bootstrap correction (B=1000), the optimism-corrected AUC of the interaction model was 0.897 (95% CI: 0.788–0.954). Conclusion Both maximum carotid plaque thickness and BRI independently predict the risk of stroke and TIA after adjusting for confounders. Their interaction further improves predictive performance. Combined assessment of these indicators may optimize early stroke risk stratification and warrants further validation in clinical practice.
Keywords: Stroke, transient ischemic attack, carotid plaque, Body RoundnessIndex, Interaction, predictive model
Received: 19 May 2025; Accepted: 28 Aug 2025.
Copyright: © 2025 Yan, Xing, He and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Zedong Zhang, Binzhou People’s Hospital, Binzhou, China
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.