title: Common carotid end-diastolic velocity and intima-media thickness jointly predict ischemic stroke in Taiwan.
abstract: OBJECTIVE
  In Asian populations, few studies investigated the association between stroke and common carotid artery intima-media thickness (IMT). Our previous case-control studies showed that low end-diastolic velocity (EDV) in common carotid artery, a potential hemodynamic marker of intracranial resistance, was associated with ischemic stroke. Therefore, we investigated the relationship between both EDV and IMT and incident ischemic stroke in an Asian population.
  
  
  METHODS
  Baseline data from 3175 adults (30 years or older) in the Cardiovascular Diseases Risk Factor Two-Township Study were linked to incidental ischemic stroke status derived from insurance claims and death certificate records. Hazard ratios for risk of ischemic stroke for high IMT and low EDV values measured in common carotid artery were calculated using Cox proportional hazard models.
  
  
  RESULTS
  With 9.85 years (median) of follow-up, 184 persons had ischemic stroke develop. Compared with the first tertile of IMT, hazard ratios were 2.03 (95% confidence intervals, 1.27-3.25) for the second tertile and 3.87 (95% confidence intervals, 2.36-5.69) for the third tertile. Hazard ratios of EDV were 5.31 (95% confidence intervals, 3.52-7.99; first tertile) and 1.94 (95% confidence intervals, 1.21-3.09; second tertile) compared with the third tertile. The individuals with high IMT and low EDV had >2-fold ischemic stroke risk compared to those with low IMT and high EDV (2.10; 95% confidence intervals, 1.35-3.26) after adjusting for age, sex, and traditional cardiovascular risk.
  
  
  CONCLUSIONS
  Common carotid IMT and EDV jointly and independently predicted future ischemic stroke in this Taiwanese population. More prospective studies are required in various ethnic groups to understand the significance and implication of the current findings, particularly with respect to EDV.
authors.affiliation: Institute of Biomedical Sciences, Academica Sinica, Taipei 11529, Taiwan.
authors.forename: Shao-Yuan
authors.initials: SY
authors.lastname: Chuang
authors.forename: Chyi-Huey
authors.initials: CH
authors.lastname: Bai
authors.forename: Jiunn-Rong
authors.initials: JR
authors.lastname: Chen
authors.forename: Wen-Ting
authors.initials: WT
authors.lastname: Yeh
authors.forename: Hsin-Jen
authors.initials: HJ
authors.lastname: Chen
authors.forename: Hou-Chang
authors.initials: HC
authors.lastname: Chiu
authors.forename: Ruei-Shiang
authors.initials: RS
authors.lastname: Shiu
authors.forename: Wen-Harn
authors.initials: WH
authors.lastname: Pan
mesh_terms: D000328:Adult; D000368:Aged; D001783:Blood Flow Velocity / Q000502:physiology*; D017536:Carotid Artery, Common / Q000502:physiology*; D003971:Diastole / Q000502:physiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012189:Retrospective Studies; D012307:Risk Factors; D020521:Stroke / Q000453:epidemiology* / Q000208:ethnology; D013624:Taiwan / Q000453:epidemiology; D017539:Tunica Intima / Q000000981:diagnostic imaging*; D017540:Tunica Media / Q000000981:diagnostic imaging*; D018615:Ultrasonography, Doppler, Color