Value of Carotid Intima-Media Thickness and Significant Carotid Stenosis as Markers of Stroke Recurrence

Abstract

on behalf of the ARTICO Study Background and Purpose-Data on the predictive value of carotid intima-media thickness (IMT) for stroke recurrence arescarce. We sought to analyze outcome differences in stroke patients with high IMT values compared with patients with significant carotid stenosis (SCS). Methods-The multicenter observational ARTICO study included 620 independent patients older than 60 years with a first-ever noncardioembolic stroke. Patients were followed-up for 1 year. The primary end point was a composite of cardiovascular events and death. The IMT-ARTICO substudy analyzed ultrasonographic data from 599 patients. After Doppler carotid echography, patients were classified into the SCS group (carotid stenosis Ն50%; 117 cases), high IMT group (patients with the common carotid IMT in the highest quartile Ն1.11 mm and without SCS; 110 cases), and control group (stroke patients with an IMT Ͻ1.11 mm and without SCS; 372 cases). We analyzed the impact of both conditions on the primary end point. Results-During follow-up, 88 patients (14.7%) had an end point event. Univariate analysis showed that male gender, diabetes, symptomatic peripheral arterial disease, ankle brachial index Յ0.9, SCS, and high IMT were related to the primary end point.

Elevated fasting glucose as a potential predictor for asymptomatic cerebral artery stenosis: A cross-sectional study in Chinese adults

“…Our study, in agreement with previous studies, demonstrates that asymptomatic cerebral stenosis is not uncommon [28]. Because there is evidence that cerebral artery stenosis is an independent predictor for recurrent stroke and prognosis [10,29], our study by showing that elevated FBG is associated with asymptomatic cerebral stenosis, suggests that FBG control may be a potential target for stroke primary prevention.…”

Impact of Intima–Media Thickness Progression in the Common Carotid Arteries on the Risk of Incident Cardiovascular Disease in the Suita Study

“…28 In contrast, carotid plaque is largely associated with traditional risk factors, namely, endothelial dysfunction, oxidative stress, smooth muscle cell proliferation, and an intimal process (with deposition of cholesterol, inflammation, and cell infiltration) at a later stage of atherogenesis. [29][30][31][32] Epidemiologically, mean IMT is more predictive of stroke than of CHD, and the reverse is true for carotid plaque, 28,29,33 which is compatible with our data ( Table 2).…”

“…Pathologically, IMT represents mainly hypertensive medial hypertrophy and thickening of smooth muscles in the media, which seem to be related to changes in local shear stress and represent partial arterial remodeling at the early stages of atherosclerosis . In contrast, carotid plaque is largely associated with traditional risk factors, namely, endothelial dysfunction, oxidative stress, smooth muscle cell proliferation, and an intimal process (with deposition of cholesterol, inflammation, and cell infiltration) at a later stage of atherogenesis . Epidemiologically, mean IMT is more predictive of stroke than of CHD, and the reverse is true for carotid plaque, which is compatible with our data (Table ).…”

Progression of Intracranial Major Artery Stenosis is Associated with Baseline Carotid and Intracranial Atherosclerosis

“…Although the IMT has been widely used as a surrogate marker of the atherosclerotic burden in clinical practice [23][24][25][26][27] , neither the baseline maxIMT nor the annual increase in the maxIMT was associated with IMAS progression. This discrepancy may be partially explained by the fact that the IMT and carotid stenosis may reflect different phases of atherosclerosis.…”