Clustering of risk factors increases the incidence of echolucent carotid plaque in stroke patients.
BACKGROUND
The purpose of this study was to assess the influence of clusters of risk factors on the incidence of echolucent carotid plaque in stroke patients.


METHODS
A retrospective analysis of 413 stroke patients who had undergone carotid ultrasonography was performed. High-resolution B-mode ultrasonography was used to evaluate the characteristics of carotid plaque. We investigated the relationships between the incidence of echolucent carotid plaque and clustering of risk factors (hypertension, diabetes mellitus and hyperlipidemia) and stroke subtypes and transient ischemic attack (TIA).


RESULTS
Echolucent plaques were present in 10.5% of patients free of risk factors, in 18.8% with a single risk factor (NS), in 27.7% with two risk factors (p <0.01) and in 50.0% with three risk factors (p <0.001), and were significantly more common in patients with multiple risk factors (odds ratio 1.79; 95% CI, 1.05-3.06; p = 0.045). Echolucent plaques were observed in 41.2% of patients with atherothrombotic infarction, in 17.6% with lacunar infarction, in 11.5% with cardioembolic stroke, and in 25.0% with TIA, and were significantly more common in patients with atherothrombotic infarction than in those with lacunar infarction or cardioembolic stroke (p<0.001), or in those with TIA (p <0.05).


CONCLUSIONS
The clustering of risk factors increased the incidence of echolucent carotid plaque. Patients with multiple risk factors were at increased risk of echolucent plaque, and these had a significant relationship with atherothrombotic infarction compared with other stroke subtypes and TIA.
Yamashiro
Kazuo
K
Department of Neurology, Juntendo University School of Medicine, Tokyo, Japan. kazuo-y@med.juntendo.ac.jp
Watanabe
Terubumi
T
Tanaka
Ryota
R
Komine-Kobayashi
Miki
M
Mizuno
Yoshikuni
Y
Urabe
Takao
T
D000368:Aged; D020520:Brain Infarction / Q000000981:diagnostic imaging / Q000209:etiology; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging*; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging*; D016893:Carotid Stenosis / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000209:etiology*; D016000:Cluster Analysis; D048909:Diabetes Complications / Q000000981:diagnostic imaging / Q000209:etiology; D005260:Female; D006801:Humans; D006949:Hyperlipidemias / Q000150:complications; D006973:Hypertension / Q000150:complications; D015994:Incidence; D002537:Intracranial Arteriosclerosis / Q000000981:diagnostic imaging / Q000209:etiology; D020766:Intracranial Embolism / Q000000981:diagnostic imaging / Q000209:etiology; D020767:Intracranial Thrombosis / Q000000981:diagnostic imaging / Q000209:etiology; D002546:Ischemic Attack, Transient / Q000000981:diagnostic imaging / Q000209:etiology; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012189:Retrospective Studies; D012307:Risk Factors; D020521:Stroke / Q000150:complications* / Q000000981:diagnostic imaging; D014463:Ultrasonography