Doppler Ultrasound Monitoring of Echogenicity in Asymptomatic Subcritical Carotid Stenosis and Assessment of Response to Oral Supplementation of Vitamin K2 (PLAK2 Randomized Controlled Trial)
, Domenico Baccellieri 2,*, Niccolò Carta 2, Giuseppe Cilli 2, Vincenzo Ardita 2, Luca Apruzzi 2, Diletta Loschi 2, Andrea Kahlberg 2, Luca Bertoglio 2, Renata Castellano 2, Elisa Simonini 2, Felicita Andreotti 3 and Roberto Chiesa 2Round 1
Reviewer 1 Report
This study is a prospective randomized clinical trial.
The authors used dopper US and GSM values to monitor the therapeutic efficacy of standard therapy or standard therapy with vitamin K2 on patients with subcritical carotid artery stenosis.
They suggested that GSM method would be helpful in monitoring plaque composition and they found that low-medium dosage statin showed atheroprotective effect assessed by GSM method whereas vitamin K2 supplement showed no significant change.
I have some comments about this article.
- Baseline clinical characteristics of enrolled patients in each treatment group (statin, statin +vit.K2) should be addressed as separate table
- Dose patients receive other atheroprotetice drugs such as omega-3 or fibrate in addition to standard therapy or vitamin K2? This point should be clarified to interpret the results.
- In discussion, as vitamin K2 is known to act on vascular calcification, what about the relation of GBM with specific vascular calcification image such as F-18 NaF PET?
Author Response
Please see the attachment
Author Response File: 
Author Response.pdf
Reviewer 2 Report
A well written manuscript focusing:
1) the role of US in the qualitative evaluation of carotid plaques.
2) the relative usefulness of VitK2 in the evolution of carotid plaques.
Two main criticisms:
1) check the format of all the references (the title of the journal before the title of the article)
2) just one plaque is shown in the 4 figures. The morphology of that plaque is perfect to show how to calculate its echogenicity (homogeneous, regular profile). in clinical practice, greater part of carotid plaques are not homogeneous and show irregular profile. Accordingly:
- please, include other(s) example(s) with not-homogenous plaques (at least one) to show how to calculate mean echogenicity
- please, include pre- and post- treatment US images of at least one carotid plaque showing variations of echogenicity
Author Response
Please see the attachment
Author Response File: Author Response.pdf
