Intima-media thickness of common carotid artery, carotid atherosclerosis and subtypes of ischemic cerebral disease

P Nikić, M Savić, V Jakovljević, D Djurić
Romanian Journal of Internal Medicine 2004, 42 (1): 149-60
It has been shown that common carotid intima-media thickness (CCA-IMT) is a useful outcome measure in clinical studies and intervention trials reflecting early stage of atherosclerosis and cardiovascular risk. The present study examined the association between CCA-IMT and incident ischemic stroke and its subtypes in 75 cases and 21 controls. Cases with ischemic brain infarctions (IBI) were consecutively recruited and classified into subtypes by CT and Bamford's classification (the size and site of infarct) like total anterior circulation infarcts (TACIs), partial anterior circulation infarcts (PACIs), posterior circulation infarcts (POCIs) or lacunar infarcts (LACIs). Controls were recruited among individuals hospitalized at the same institutions and matched for age and sex. Patients and control subjects underwent B-mode ultrasonographic measurements of IMT of the distal wall of both common carotid arteries. Of 75 patients with an acute ischemic stroke, 10 (14%) were classified as TACIs, 34 (45%) with PACIs, 12 (16%) with POCIs and 19 (25%) with LACIs. Mean CCA-IMT was higher in cases (1.03+/-0.18 mm) than in controls (0.85+/-0.18 mm; p<0.0001). The difference in CCA-IMT between cases and controls was significant and the relation between CCA-IMT and IBI remained after adjustment for main cardiovascular risk factors. Regarding the subtypes of IBI, IMT values were significantly higher in patients with TACIs and PACIs versus those with LACIs and POCIs. An increased CCA-IMT was associated with the all subtypes IBI and was significantly higher in those with anterior circulation infarcts versus posterior circulation and lacunar infarcts.

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