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


METHODS
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.


RESULTS
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).


CONCLUSIONS
Increased CCA-IMT values are associated with a higher risk of long-term stroke recurrence.
Tsivgoulis
Georgios
G
Department of Neurology, University of Athens, Eginition Hospital, Athens, Greece. tsivgoulisgiorg@yahoo.gr
Vemmos
Konstantinos
K
Papamichael
Christos
C
Spengos
Konstantinos
K
Manios
Efstathios
E
Stamatelopoulos
Kimon
K
Vassilopoulos
Demetrios
D
Zakopoulos
Nikolaos
N
D000208:Acute Disease; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging / Q000473:pathology*; D016893:Carotid Stenosis / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology*; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006115:Greece / Q000453:epidemiology; D006785:Hospitals, University / Q000706:statistics & numerical data; D006801:Humans; D006965:Hyperplasia; D015993:Life Tables; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012008:Recurrence; D012306:Risk; D020521:Stroke / Q000145:classification / Q000453:epidemiology* / Q000209:etiology; D017539:Tunica Intima / Q000000981:diagnostic imaging / Q000648:ultrastructure*; D017540:Tunica Media / Q000000981:diagnostic imaging / Q000648:ultrastructure*; D014463:Ultrasonography