Carotid intima-media thickness is different in large- and small-vessel ischemic stroke: the SMART study.
OBJECTIVE
The role of athersclerosis in the difference between the pathogenesis of large-vessel disease (LVD) and small-vessel disease (SVD) is a matter of debate. Common carotid artery intima-media thickness (CCA IMT) is a marker of atherosclerosis. Our aim was to compare CCA IMT between SVD and LVD patients.


METHODS
Two independent observers classified ischemic stroke or transient ischemic attack as caused by SVD or LVD, primarily based on imaging and in addition on clinical features. Mean CCA IMT was calculated based on 6 measurements for each patient.


RESULTS
Four hundred and seventeen patients were classified LVD and 115 SVD. Mean CCA IMT was higher in patients with LVD (1.08 mm) than in patients with SVD (0.92 mm). The crude mean difference was 0.16 mm (95% CI, 0.09 to 0.23). After adjustment for age, sex and hypertension, the mean difference was 0.11 mm (95% CI, 0.05 to 0.18).


CONCLUSIONS
CCA IMT is higher in LVD patients than in SVD patients supporting the hypothesis that LVD and SVD have a different pathogenesis.
Pruissen
D Martijn O
DM
Department of Neurology, Rudolf Magnus Institute of Neuroscience, Utrecht, The Netherlands.
Gerritsen
Susan A M
SA
Prinsen
Talitha J
TJ
Dijk
Joke M
JM
Kappelle
L Jaap
LJ
Algra
Ale
A
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000209:etiology / Q000473:pathology* / Q000503:physiopathology; D002340:Carotid Artery Diseases / Q000150:complications / Q000473:pathology* / Q000503:physiopathology; D017536:Carotid Artery, Common / Q000473:pathology* / Q000503:physiopathology; D002536:Cerebral Arteries / Q000473:pathology / Q000503:physiopathology; D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D002546:Ischemic Attack, Transient / Q000209:etiology / Q000473:pathology / Q000503:physiopathology; D008297:Male; D008833:Microcirculation / Q000473:pathology / Q000503:physiopathology; D008875:Middle Aged; D011446:Prospective Studies; D012737:Sex Factors; D020521:Stroke / Q000209:etiology / Q000473:pathology* / Q000503:physiopathology; D017539:Tunica Intima / Q000473:pathology / Q000503:physiopathology; D017540:Tunica Media / Q000473:pathology / Q000503:physiopathology