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CORRELATION OF CAROTID INTIMA-MEDIA THICKNESS WITH VASCULAR RISK FACTORS IN ISCHEMIC STROKE PATIENTS AND DISTRIBUTION AMONG STROKE TYPES

Year 2024, Volume: 63 Issue: 3, 350 - 355, 09.09.2024
https://doi.org/10.19161/etd.1422822

Abstract

Aim: Stroke is one of the leading neurological emergencies and a significant cause of mortality and morbidity. Determining the underlying vascular risk factors and etiological stroke type is important in preventing ischemic stroke. This study aimed to investigate the correlation of carotid intima-media thickness increase with vascular risk factors and stroke type in patients with ischemic stroke.
Materials and Methods: Ischemic stroke patients between the ages of 40 and 90 were included in the study, and the data were evaluated retrospectively from patient files.
Results: A total of 273 ischemic stroke patients, 161 women and 112 men, were included in the study. A significant relationship was found between the presence of diabetes and increased carotid intima-media thickness, but no relationship was found with other risk factors (p:0,03). And, it has been shown that the increase in carotid intima-media thickness is significantly higher in strokes due to large artery atheroclerosis.
Conclusion: This study emphasizes that evaluation of carotid intima-media thickness with vascular risk factors may contribute significantly to clarifying the etiology of stroke and therefore preventing stroke.

References

  • 1. Kim J, Thayabaranathan T, Donnan GA, Howard G, Howard VJ, Rothwell PM, et al. Global Stroke Statistics 2019. Int J Stroke. 2020;15(8):819-38.
  • 2. Bos D, van Dam-Nolen DHK, Gupta A, Saba L, Saloner D, Wasserman BA, et al. Advances in Multimodality Carotid Plaque Imaging: AJR Expert Panel Narrative Review. AJR Am J Roentgenol. 2021;217(1):16-26.
  • 3. Saba L, Antignani PL, Gupta A, Cau R, Paraskevas KI, Poredos P, et al. International Union of Angiology (IUA) consensus paper on imaging strategies in atherosclerotic carotid artery imaging: From basic strategies to advanced approaches. Atherosclerosis. 2022;354:23-40.
  • 4. Raggi P, Stein JH. Carotid intima-media thickness should not be referred to as subclinical atherosclerosis: A recommended update to the editorial policy at Atherosclerosis. Atherosclerosis. 2020;312:119-20.
  • 5. Zaidi NR, Gilani SA, Mehboob R, Waseem H, Hassan A. Diagnostic accuracy of carotid intima media thickness by B-mode ultrasonography in coronary artery disease patients. Arch Med Sci Atheroscler Dis. 2020;5:e79-e84.
  • 6. Yang T, Wang Y, Zhang X, Xiang S, Wen J, Wang W, et al. Prevalence and influencing factors of abnormal carotid artery intima-media thickness in Henan Province in China. Front Endocrinol (Lausanne). 2023;14:1266207.
  • 7. Sun P, Liu L, Liu C, Zhang Y, Yang Y, Qin X, et al. Carotid Intima-Media Thickness and the Risk of First Stroke in Patients With Hypertension. Stroke. 2020;51(2):379-86.
  • 8. Touboul PJ, Hennerici MG, Meairs S, Adams H, Amarenco P, Bornstein N, et al. Mannheim carotid intima media thickness and plaque consensus (2004-2006-2011). An update on behalf of the advisory board of the 3rd, 4th and 5th watching the risk symposia, at the 13th, 15th and 20th European Stroke Conferences, Mannheim, Germany, 2004, Brussels, Belgium, 2006, and Hamburg, Germany, 2011. Cerebrovasc Dis. 2012;34(4):290-6.
  • 9. Sievering EM, Grosshennig A, Kottas M, Ernst J, Ringlstetter R, Koch A, et al. Diagnostic value of carotid intima-media thickness and clinical risk scores in determining etiology of ischemic stroke. Eur Stroke J. 2023;8(3):738-46.
  • 10. Fernandez-Alvarez V, Linares Sanchez M, Lopez Alvarez F, Suarez Nieto C, Makitie AA, Olsen KD, et al. Evaluation of Intima-Media Thickness and Arterial Stiffness as Early Ultrasound Biomarkers of Carotid Artery Atherosclerosis. Cardiol Ther. 2022;11(2):231-47.
  • 11. Muzurovic EM, Mikhailidis DP. Diabetes Mellitus and Noncardiac Atherosclerotic Vascular Disease Pathogenesis and Pharmacological Treatment Options. J Cardiovasc Pharmacol Ther. 2021;26(1):25-39.
  • 12. Jiang P, Chen Z, Hippe DS, Watase H, Sun B, Lin R, et al. Association Between Carotid Bifurcation Geometry and Atherosclerotic Plaque Vulnerability: A Chinese Atherosclerosis Risk Evaluation Study. Arterioscler Thromb Vasc Biol. 2020;40(5):1383-91.
  • 13. Guo XJ, Wu M, Pei SF, Xie P, Wu MY. Influence of Carotid Intima-Media Thickness Levels at Bifurcation on Short-Term Functional Outcomes Among Non-Cardiogenic Ischemic Stroke Patients with and without Type 2 Diabetes Mellitus. Diabetes Metab Syndr Obes. 2022;15:897-906.
  • 14. Bill O, Mazya MV, Michel P, Prazeres Moreira T, Lambrou D, Meyer IA, et al. Intima-Media Thickness and Pulsatility Index of Common Carotid Arteries in Acute Ischaemic Stroke Patients with Diabetes Mellitus. J Clin Med. 2022;12(1).
  • 15. Touboul PJ, Elbaz A, Koller C, Lucas C, Adrai V, Chedru F, et al. Common carotid artery intima-media thickness and brain infarction : the Etude du Profil Genetique de l'Infarctus Cerebral (GENIC) case-control study. The GENIC Investigators. Circulation. 2000;102(3):313-8.
  • 16. Nagai Y, Kitagawa K, Yamagami H, Kondo K, Hougaku H, Hori M, et al. Carotid artery intima-media thickness and plaque score for the risk assessment of stroke subtypes. Ultrasound Med Biol. 2002;28(10):1239-43.
  • 17. Wang M, Wang S, Wang X, Wu J, Wu Y, Wang Z, et al. Carotid Intima-Media Thickness, Genetic Risk, and Ischemic Stroke: A Family-Based Study in Rural China. Int J Environ Res Public Health. 2020;18(1).
  • 18. Ohira T, Shahar E, Iso H, Chambless LE, Rosamond WD, Sharrett AR, et al. Carotid artery wall thickness and risk of stroke subtypes: the atherosclerosis risk in communities study. Stroke. 2011;42(2):397-403.
  • 19. Shimoda S, Kitamura A, Imano H, Cui R, Muraki I, Yamagishi K, et al. Associations of Carotid Intima-Media Thickness and Plaque Heterogeneity With the Risks of Stroke Subtypes and Coronary Artery Disease in the Japanese General Population: The Circulatory Risk in Communities Study. J Am Heart Assoc. 2020;9(19):e017020.
  • 20. Kumar P, Sharma R, Misra S, Kumar A, Nath M, Nair P, et al. CIMT as a risk factor for stroke subtype: A systematic review. Eur J Clin Invest. 2020;50(11):e13348.

İskemik inmeli hastalarda karotis intima-media kalınlığının vasküler risk faktörleri ile korelasyonu ve inme tipleri arasındaki dağılımı

Year 2024, Volume: 63 Issue: 3, 350 - 355, 09.09.2024
https://doi.org/10.19161/etd.1422822

Abstract

Amaç: Nörolojik acillerin başında gelen, önemli bir mortalite ve morbidite nedeni olan iskemik inmeden korunmada altta yatan vasküler risk faktörlerinin ve etiyolojik inme tipinin belirlenmesi önem taşımaktadır. Bu çalışmada aterosklerozun erken bulgusu olan karotis intima-media kalınlık artışının iskemik inmeli hastalarda vasküler risk faktörleri ile korelasyonu ve inme tipi ile ilişkisini araştırmak amaçlanmıştır.
Gereç ve Yöntem: Çalışmaya iskemik inme nedenli takip edilmiş 40-90 yaş arası hastalar dahil edilmiş olup veriler hasta dosyalarından taranarak retrospektif olarak değerlendirilmiştir.
Bulgular: Çalışmaya 161 kadın, 112 erkek olmak üzere toplam 273 iskemik inmeli hasta dahil edildi. Karotis intima-media kalınlık artışının vasküler risk faktörleri ile korelasyonuna bakıldığında diyabet varlığı ile anlamlı ilişki saptanırken diğer risk faktörleri ile istatistiksel olarak anlamlı bir ilişki saptanmadı (p:0,03). İnme tipleri ile ilişkisi değerlendirildiğinde büyük arter aterosklerozuna bağlı inmelerde karotis intima-media kalınlık artışının anlamlı olarak daha fazla olduğu gösterildi.
Sonuç: Bu çalışmada karotis intima-media kalınlığının vasküler risk faktörleri ile birlikte değerlendirilmesinin inme etiyolojisini aydınlatmada ve dolayısıyla inmeden korunmada önemli katkısı olabileceği vurgulanmaktadır.

Ethical Statement

Bu çalışmada herhangi bir etik ihlal söz konusu değildir.

Supporting Institution

yok

References

  • 1. Kim J, Thayabaranathan T, Donnan GA, Howard G, Howard VJ, Rothwell PM, et al. Global Stroke Statistics 2019. Int J Stroke. 2020;15(8):819-38.
  • 2. Bos D, van Dam-Nolen DHK, Gupta A, Saba L, Saloner D, Wasserman BA, et al. Advances in Multimodality Carotid Plaque Imaging: AJR Expert Panel Narrative Review. AJR Am J Roentgenol. 2021;217(1):16-26.
  • 3. Saba L, Antignani PL, Gupta A, Cau R, Paraskevas KI, Poredos P, et al. International Union of Angiology (IUA) consensus paper on imaging strategies in atherosclerotic carotid artery imaging: From basic strategies to advanced approaches. Atherosclerosis. 2022;354:23-40.
  • 4. Raggi P, Stein JH. Carotid intima-media thickness should not be referred to as subclinical atherosclerosis: A recommended update to the editorial policy at Atherosclerosis. Atherosclerosis. 2020;312:119-20.
  • 5. Zaidi NR, Gilani SA, Mehboob R, Waseem H, Hassan A. Diagnostic accuracy of carotid intima media thickness by B-mode ultrasonography in coronary artery disease patients. Arch Med Sci Atheroscler Dis. 2020;5:e79-e84.
  • 6. Yang T, Wang Y, Zhang X, Xiang S, Wen J, Wang W, et al. Prevalence and influencing factors of abnormal carotid artery intima-media thickness in Henan Province in China. Front Endocrinol (Lausanne). 2023;14:1266207.
  • 7. Sun P, Liu L, Liu C, Zhang Y, Yang Y, Qin X, et al. Carotid Intima-Media Thickness and the Risk of First Stroke in Patients With Hypertension. Stroke. 2020;51(2):379-86.
  • 8. Touboul PJ, Hennerici MG, Meairs S, Adams H, Amarenco P, Bornstein N, et al. Mannheim carotid intima media thickness and plaque consensus (2004-2006-2011). An update on behalf of the advisory board of the 3rd, 4th and 5th watching the risk symposia, at the 13th, 15th and 20th European Stroke Conferences, Mannheim, Germany, 2004, Brussels, Belgium, 2006, and Hamburg, Germany, 2011. Cerebrovasc Dis. 2012;34(4):290-6.
  • 9. Sievering EM, Grosshennig A, Kottas M, Ernst J, Ringlstetter R, Koch A, et al. Diagnostic value of carotid intima-media thickness and clinical risk scores in determining etiology of ischemic stroke. Eur Stroke J. 2023;8(3):738-46.
  • 10. Fernandez-Alvarez V, Linares Sanchez M, Lopez Alvarez F, Suarez Nieto C, Makitie AA, Olsen KD, et al. Evaluation of Intima-Media Thickness and Arterial Stiffness as Early Ultrasound Biomarkers of Carotid Artery Atherosclerosis. Cardiol Ther. 2022;11(2):231-47.
  • 11. Muzurovic EM, Mikhailidis DP. Diabetes Mellitus and Noncardiac Atherosclerotic Vascular Disease Pathogenesis and Pharmacological Treatment Options. J Cardiovasc Pharmacol Ther. 2021;26(1):25-39.
  • 12. Jiang P, Chen Z, Hippe DS, Watase H, Sun B, Lin R, et al. Association Between Carotid Bifurcation Geometry and Atherosclerotic Plaque Vulnerability: A Chinese Atherosclerosis Risk Evaluation Study. Arterioscler Thromb Vasc Biol. 2020;40(5):1383-91.
  • 13. Guo XJ, Wu M, Pei SF, Xie P, Wu MY. Influence of Carotid Intima-Media Thickness Levels at Bifurcation on Short-Term Functional Outcomes Among Non-Cardiogenic Ischemic Stroke Patients with and without Type 2 Diabetes Mellitus. Diabetes Metab Syndr Obes. 2022;15:897-906.
  • 14. Bill O, Mazya MV, Michel P, Prazeres Moreira T, Lambrou D, Meyer IA, et al. Intima-Media Thickness and Pulsatility Index of Common Carotid Arteries in Acute Ischaemic Stroke Patients with Diabetes Mellitus. J Clin Med. 2022;12(1).
  • 15. Touboul PJ, Elbaz A, Koller C, Lucas C, Adrai V, Chedru F, et al. Common carotid artery intima-media thickness and brain infarction : the Etude du Profil Genetique de l'Infarctus Cerebral (GENIC) case-control study. The GENIC Investigators. Circulation. 2000;102(3):313-8.
  • 16. Nagai Y, Kitagawa K, Yamagami H, Kondo K, Hougaku H, Hori M, et al. Carotid artery intima-media thickness and plaque score for the risk assessment of stroke subtypes. Ultrasound Med Biol. 2002;28(10):1239-43.
  • 17. Wang M, Wang S, Wang X, Wu J, Wu Y, Wang Z, et al. Carotid Intima-Media Thickness, Genetic Risk, and Ischemic Stroke: A Family-Based Study in Rural China. Int J Environ Res Public Health. 2020;18(1).
  • 18. Ohira T, Shahar E, Iso H, Chambless LE, Rosamond WD, Sharrett AR, et al. Carotid artery wall thickness and risk of stroke subtypes: the atherosclerosis risk in communities study. Stroke. 2011;42(2):397-403.
  • 19. Shimoda S, Kitamura A, Imano H, Cui R, Muraki I, Yamagishi K, et al. Associations of Carotid Intima-Media Thickness and Plaque Heterogeneity With the Risks of Stroke Subtypes and Coronary Artery Disease in the Japanese General Population: The Circulatory Risk in Communities Study. J Am Heart Assoc. 2020;9(19):e017020.
  • 20. Kumar P, Sharma R, Misra S, Kumar A, Nath M, Nair P, et al. CIMT as a risk factor for stroke subtype: A systematic review. Eur J Clin Invest. 2020;50(11):e13348.
There are 20 citations in total.

Details

Primary Language Turkish
Subjects Central Nervous System
Journal Section Research Articles
Authors

Bedriye Karaman 0000-0001-6364-1911

Rasim Tunçel 0000-0001-7394-3366

Emre Kumral 0000-0002-3105-7734

Publication Date September 9, 2024
Submission Date January 20, 2024
Acceptance Date February 7, 2024
Published in Issue Year 2024Volume: 63 Issue: 3

Cite

Vancouver Karaman B, Tunçel R, Kumral E. İskemik inmeli hastalarda karotis intima-media kalınlığının vasküler risk faktörleri ile korelasyonu ve inme tipleri arasındaki dağılımı. EJM. 2024;63(3):350-5.