Common carotid artery intima-media thickness and the risk of stroke recurrence

• Published in: Stroke (1970) 2006-07, Vol.37 (7), p.1913-1916
• Main Authors: TSIVGOULIS, Georgios, VEMMOS, Konstantinos, PAPAMICHAEL, Christos, SPENGOS, Konstantinos, MANIOS, Efstathios, STAMATELOPOULOS, Kimon, VASSILOPOULOS, Demetrios, ZAKOPOULOS, Nikolaos
• Format: Article
• Language: English
• Subjects: Acute Disease; Age Factors; Aged; Aged, 80 and over; Atherosclerosis (general aspects, experimental research); Biological and medical sciences; Blood and lymphatic vessels; Cardiology. Vascular system; Carotid Artery, Common - diagnostic imaging; Carotid Artery, Common - pathology; Carotid Stenosis - complications; Carotid Stenosis - diagnostic imaging; Carotid Stenosis - pathology; Disease-Free Survival; Female; Follow-Up Studies; Greece - epidemiology; Hospitals, University - statistics & numerical data; Humans; Hyperplasia; Life Tables; Male; Medical sciences; Middle Aged; Neurology; Neurosurgery; Prognosis; Prospective Studies; Recurrence; Risk; Skull, brain, vascular surgery; Stroke - classification; Stroke - epidemiology; Stroke - etiology; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Tunica Intima - diagnostic imaging; Tunica Intima - ultrastructure; Tunica Media - diagnostic imaging; Tunica Media - ultrastructure; Ultrasonography; Vascular diseases and vascular malformations of the nervous system
• ISSN: 0039-2499; 1524-4628
• DOI: 10.1161/01.STR.0000226399.13528.0a

Increased common carotid artery intima-media thickness (CCA-IMT) has been associated with an increased risk of myocardial infarction and stroke. We investigated the relationship between CCA-IMT and recurrent stroke in a cohort of ischemic stroke patients. High-resolution B-mode ultrasonographic measurements of the CCA-IMT were performed in a consecutive series of 238 patients hospitalized in our institution with first-ever ischemic stroke. Stroke risk factors and secondary prevention therapies were documented. Patients were followed-up prospectively and the outcome event of interest was recurrent stroke. During a mean follow-up period of 28.9 months (range: 6 to 60 months), 27 recurrent strokes were documented. Patients who experienced recurrent cerebrovascular events had significantly (P=0.005) higher CCA-IMT values (1.01 mm, 95% CI:0.92 to 1.11 mm) than subjects who were free of stroke recurrence (0.88 mm, 95% CI:0.85 to 0.91 mm). After adjustment for baseline characteristics, risk factors and stroke subtypes and secondary prevention therapies increasing CCA-IMT was found to be an independent predictor of stroke recurrence. For each increment of 0.1 mm in CCA-IMT the probability of experiencing recurrent stroke increased by 18.0% (95% CI:2.0% to 36.0%, P=0.027). Increased CCA-IMT values are associated with a higher risk of long-term stroke recurrence.