Factors Associated with Intima-Media Complex Thickness of the Common Carotid Artery in Japanese Noncardioembolic Stroke Patients with Hyperlipidemia: The J-STARS Echo Study

Abstract

Aims: There may be ethnic differences in carotid atherosclerosis and its contributing factors between Asian and other populations. The purpose of this study was to examine intima-media complex thickness (IMT) of the carotid artery and associated clinical factors in Japanese stroke patients with hyperlipidemia from a cohort of the Japan Statin Treatment Against Recurrent Stroke Echo Study.Methods: Patients with hyperlipidemia, not on statins, who developed noncardioembolic ischemic stroke were included in this study. Mean IMT and maximum IMT of the distal wall of the common carotid artery were centrally measured using carotid ultrasonography. Significant factors related to mean IMT and maximum IMT were examined using multivariable analysis.Results: In 793 studied patients, mean IMT was 0.89 ± 0.15 mm and maximum IMT was 1.19 ± 0.32 mm. Age (per 10 years, parameter estimate = 0.044, p < 0.001), smoking (0.022, p = 0.004), category of blood pressure (0.022, p = 0.006), HDL cholesterol (per 10 mg/dl, −0.009, p = 0.008), and diabetes mellitus (0.033, p = 0.010) were independently associated with mean IMT. Age (per 10 years, 0.076, p < 0.001), smoking (0.053, p = 0.001), HDL cholesterol (−0.016, p = 0.036), and diabetes mellitus (0.084, p = 0.002) were independently associated with maximum IMT.Conclusion: Baseline mean and maximum values of carotid IMT in Japanese noncardioembolic stroke patients with hyperlipidemia were 0.89 ± 0.15 mm and 1.19 ± 0.32 mm, respectively, which were similar to those previously reported from Western countries. Age, smoking, hypertension, HDL cholesterol, and diabetes mellitus were associated with mean IMT, and those, except for hypertension, were associated with maximum IMT.

Clinical Utility of Carotid Ultrasonography in the Prediction of Cardiovascular Events in Patients with Diabetes: A Combined Analysis of Data Obtained in Five Longitudinal Studies

“…Carotid ultrasonography is a simple and noninvasive procedure that has allowed clinicians to visualize the characteristics of the carotid wall and lumen surfaces to quantify the severity of atherosclerosis 1 ) . In particular, carotid intima–media thickness (IMT) is related to multiple conventional risk factors 1 – 3 ) and can be a simple and useful marker of subclinical arterial damage, an index located somewhere between risk factors and “hard” clinical endpoint events such as myocardial infarction and stroke. IMT has indeed been shown to be a predictor of cardiovascular disease (CVD) 1 , 4 – 11 ) .…”

Small Dense Low-Density Lipoprotein Cholesterol and Carotid Intimal Medial Thickness Progression

“…Images were obtained 20 mm proximal to the bulb origin and analyzed off-line using innovative IMT measurement software (Intima-Scope; MEDIA CROSS Co., Ltd., Tokyo, Japan). This system was specifically designed to assess carotid intimal medial thickness levels and allows one to obtain the average of approximately 250 points of cIMT values in the measurement segment in the order of 0.01 mm 39 , 40 ) . Segments with plaque were excluded from assessment of cIMT levels.…”

Is the Carotid Intima-Media Thickness a Reliable Predictor of Future Cardiovascular Events?

“…As mentioned above, because of the large population that needs CVD risk assessment, the availability of marker(s) that are simple to measure is important. The carotid intima-media thickness (IMT) is a simple-to-measure marker to assess the severity of carotid atherosclerosis 4) . Atherosclerosis is characterized by focal rather than diffuse lesions in the arterial wall.…”