Is the common carotid artery intima-media thickness associated with functional outcome after acute ischaemic stroke?

J Ellul, P Talelli, G Terzis, A Chrysanthopoulou, G Gioldasis, T Papapetropoulos
Journal of Neurology, Neurosurgery, and Psychiatry 2004, 75 (8): 1197-9

BACKGROUND: Common carotid artery intima-media thickness (CCA-IMT) is an independent and early marker of generalised atherosclerosis. Brain affected by atherosclerosis may be more vulnerable to an ischaemic insult.

OBJECTIVE: To investigate the association between CCA-IMT and functional outcome after an acute ischaemic stroke.

DESIGN: Prospective cohort analysis.

METHODS: 284 consecutive patients (mean (SD) age, 68.7 (12.7) years, 126 (44%) female) with an acute ischaemic stroke had carotid ultrasonography, carried out by a single operator. Demographic data, vascular risk factors, initial stroke severity, and brain imaging findings were recorded. Outcome was assessed at seven days from stroke onset, at discharge from hospital, and at one year post-stroke.

RESULTS: CCA-IMT was not significantly associated with adverse short or long term functional outcome in univariate analysis, or after adjustment in a multivariate logistic regression analysis for demographic data, initial stroke severity, conventional vascular risk factors, and the characteristics of the ischaemic lesion. Age and initial stroke severity were the only independent predictors of outcome.

CONCLUSIONS: CCA-IMT was not associated with adverse functional outcome after an ischaemic stroke. Adding CCA-IMT in a prediction model for stroke outcome would probably not improve the power of the model.

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