Korean Circ J.  2010 Jun;40(6):272-276. 10.4070/kcj.2010.40.6.272.

Carotid Intima-Media Thickness, Not Carotid Plaque, is Associated With Large Territory Cerebral Infarction in Patients With Ischemic Stroke

• Yoon HJ
• Jeong MH
• Kim KH
• Ahn Y
• Cho JG
• Park JC
• Kang JC
• Bae JH

• KMID: 2225187
• DOI: http://doi.org/10.4070/kcj.2010.40.6.272

Abstract

BACKGROUND AND OBJECTIVES
Carotid intima-media thickness (IMT) has been associated with an increased risk of ischemic stroke. To better understand this association, we evaluated the relationships of vascular risk factors, including carotid IMT and carotid plaque, and large territory cerebral infarction and small vessel stroke.
SUBJECTS AND METHODS
A total of 502 patients with acute ischemic stroke were divided into two groups according to neurologic examinations and imaging studies; 1) a large territory infarction group (group I: n=126, 64.4+/-11 years, 78 males) and 2) a small vessel stroke group (group II: n=376, 62.5+/-11 years, 242 males). We evaluated associations between (a) territory and non-territory strokes and (b) age, sex, potential vascular risk factors, carotid image and cardiac function (by echocardiography).
RESULTS
We did not find significant between group differences of age, sex, diabetes, previous history of ischemic stroke, plaque (presence, site and size of carotid plaque), and velocity of carotid blood flow and left ventricle ejection fraction. However, group I had a higher incidence of hypertension (p=0.006), smoking (p=0.003), and dyslipidemia (p=0.001). Group I had thicker carotid IMT than group II (right carotid: 0.81+/-0.21 mm vs. 0.76+/-0.19 mm, p=0.035; left carotid: 0.88+/-0.23 mm vs. 0.80+/-0.20 mm, p=0.014) and a higher e/e' level (12.08 vs. 9.66, p<0.001). Dyslipidemia, thicker carotid IMT and elevated E/E' ratios were significant independent predictors for large territory infarction in patients with ischemic stroke.
CONCLUSION
Carotid IMT is significantly increased in patients with large territory infarction compared with those with small vessel stroke.

Keyword

Cerebral infarction; Stroke; Carotid arteries

MeSH Terms

Carotid Arteries
Carotid Intima-Media Thickness
Cerebral Infarction
Dyslipidemias
Glycosaminoglycans
Heart Ventricles
Humans
Hypertension
Incidence
Infarction
Neurologic Examination
Risk Factors
Smoke
Smoking
Stroke
Glycosaminoglycans
Smoke

Figure

• 

  Fig. 1 Correlation of descending thoracic aortic intima-media thickness (IMT) and common carotid artery (CCA) IMT.

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