title: Carotid artery intima-media thickness and lacunar versus nonlacunar infarcts.
abstract: OBJECTIVE
  Increases in the thickness of the intima and media of the carotid artery have been associated with an increased risk of myocardial infarction and stroke in subjects without a history of cardiovascular disease. Lacunar infarcts, one of the most common subtype of ischemic stroke, show unique pathological and clinicoradiological characteristics. The present study examines the relationship between vascular risk factors, including carotid artery intima-media thickness (IMT), and lacunar versus nonlacunar infarcts.
  
  
  METHODS
  We collected data from patients with acute ischemic stroke admitted to hospital. Patients and 129 control subjects underwent B-mode ultrasonographic measurements of IMT of the common carotid artery. We examined the association of lacunar and nonlacunar infarcts with age, sex, and potential vascular risk factors.
  
  
  RESULTS
  Of 292 adult patients with an acute first-ever ischemic stroke, 96 were considered lacunar and 196 were considered nonlacunar strokes. We did not find a significantly different percentage of diabetes, smoking, hypertension, dyslipidemia, myocardial infarction, and previous transient ischemic attack between the 2 groups of patients. The multinomial logistic regression procedure selected carotid artery IMT and atrial fibrillation as the only independent factors able to discriminate between lacunar and nonlacunar patients. IMT values were significantly higher in patients with nonlacunar stroke versus both those with lacunar stroke and control subjects.
  
  
  CONCLUSIONS
  The present results indicate the usefulness of noninvasive measurement of IMT with ultrasonic techniques as a diagnostic tool that may help to identify different subtypes of ischemic stroke patients. The noninvasive measurements may have predictive power with respect to lacunar versus nonlacunar infarcts.
authors.affiliation: Clinica Neurologica, Ospedale S.Eugenio, Universita' di Roma Tor Vergata, Roma, Italy. lecupini@tin.it
authors.forename: L M
authors.initials: LM
authors.lastname: Cupini
authors.forename: P
authors.initials: P
authors.lastname: Pasqualetti
authors.forename: M
authors.initials: M
authors.lastname: Diomedi
authors.forename: F
authors.initials: F
authors.lastname: Vernieri
authors.forename: M
authors.initials: M
authors.lastname: Silvestrini
authors.forename: B
authors.initials: B
authors.lastname: Rizzato
authors.forename: F
authors.initials: F
authors.lastname: Ferrante
authors.forename: G
authors.initials: G
authors.lastname: Bernardi
mesh_terms: D000208:Acute Disease; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D020520:Brain Infarction / Q000145:classification* / Q000175:diagnosis* / Q000453:epidemiology; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012307:Risk Factors; D017678:Sex Distribution; D017539:Tunica Intima / Q000000981:diagnostic imaging*; D017540:Tunica Media / Q000000981:diagnostic imaging*; D018615:Ultrasonography, Doppler, Color