| Higher carotid intima media thickness predicts extracranial vascular events and not stroke recurrence among transient ischemic attack patients. | |
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MedLine Citation:
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PMID: 22264364 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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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. |
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Authors:
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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:
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Type: Journal Article |
Journal Detail:
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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:
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Created Date: 2012-01-23 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101274068 Medline TA: Int J Stroke Country: England |
Other Details:
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Languages: eng Pagination: 125-32 Citation Subset: IM |
Copyright Information:
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© 2012 The Authors. International Journal of Stroke © 2012 World Stroke Organization. |
Affiliation:
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Stroke Unit, Department of Neurology, Universitat de Lleida, Hospital Universitari Arnau de Vilanova de Lleida, IRBLLEIDA, Lleida, Spain. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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