Document Detail

Higher carotid intima media thickness predicts extracranial vascular events and not stroke recurrence among transient ischemic attack patients.
MedLine Citation:
PMID:  22264364     Owner:  NLM     Status:  In-Data-Review    
BACKGROUND: Increased common carotid artery intima-media thickness has been associated with an increased risk of vascular ischemic events. We investigated the relationship between common carotid artery intima-media thickness and extracranial vascular events (coronary heart disease and peripheral arterial disease) or stroke recurrence in a cohort of transient ischemic attack patients from the REGITELL registry.
METHODS: High-resolution B-mode ultrasonographic measurements of the common carotid artery intima-media thickness were performed in a series of 283 consecutive transient ischemic attack patients. Clinical, neuroimaging, ultrasonographic, and etiological data were collected. Patients were followed prospectively for six-months or more. Extracranial vascular events and stroke recurrence were recorded.
RESULTS: Fifteen extracranial vascular events (12 coronary heart disease and three peripheral arterial disease) and 29 recurrent strokes occurred during a median follow-up period of 12·3 months. Patients who experienced extracranial vascular events had significantly (P < 0·001) higher common carotid artery intima-media thickness values (1·087 (standard deviation 0·189) mm) than subjects who were free of extracranial vascular events (0·887 (standard deviation 0·195) mm). Nevertheless, common carotid artery intima-media thickness was not found to correlate with stroke recurrence. Cox proportional hazards multivariate analyses identified hypercholesterolemia (hazard ratio 6·87, 95% confidence interval: 1·93-24·39, P = 0·003) and common carotid artery intima-media thickness >0·939 mm (hazard ratio 8·90, 95% confidence interval: 2·00-39·49, P = 0·004) as independent predictors of extracranial vascular events after transient ischemic attack. Almost one of every three patients with hypercholesterolemia and high common carotid artery intima-media thickness had extracranial vascular events.
CONCLUSIONS: An elevated common carotid artery intima-media thickness value was associated with a higher long-term risk of extracranial vascular events but no with stroke recurrence. Hypercholesterolemia was the main risk factor for extracranial vascular events. The combination of hypercholesterolemia and common carotid artery intima-media thickness >0·939 mm justify the establishment of aggressive therapies and the study of subclinical coronary heart disease and peripheral arterial disease.
Francisco Purroy; Josep Montserrat; Robert Begué; Maria Isabel Gil; Alejandro Quílez; Jordi Sanahuja; Luis Brieva; Marina Pardina; Gerard Piñol-Ripoll
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  International journal of stroke : official journal of the International Stroke Society     Volume:  7     ISSN:  1747-4949     ISO Abbreviation:  Int J Stroke     Publication Date:  2012 Feb 
Date Detail:
Created Date:  2012-01-23     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101274068     Medline TA:  Int J Stroke     Country:  England    
Other Details:
Languages:  eng     Pagination:  125-32     Citation Subset:  IM    
Copyright Information:
© 2012 The Authors. International Journal of Stroke © 2012 World Stroke Organization.
Stroke Unit, Department of Neurology, Universitat de Lleida, Hospital Universitari Arnau de Vilanova de Lleida, IRBLLEIDA, Lleida, Spain.
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