Usefulness of Carotid Plaque and Intima-Media Thickness Measurement in Patients with Acute Ischemic Stroke

Original Article

Journal of Neurosonology 2010;2(1):19-26.

급성 뇌경색 환자에서 경동맥 죽상경화판과 내중막 두께 측정의 유용성

Abstract

Background
Patients with risk factors for atherosclerosis is prone to develop carotid plaque or increased intima-media thickness (IMT). We explored the association of carotid plaque, atherosclerotic risk factors, frequency of large artery atherosclerosis (LAA) stroke mechanism, and IMT in acute ischemic stroke patients.
Methods
From November 2005 to March 2008, total 633 acute ischemic stroke patients, who were examined with a carotid sonography, were enrolled. The atherosclerotic risk factors and number of plaque, maximum plaque size, and maximum IMT were compared.
Results
Of the 633 patients, 496 (78.3%) had one or more carotid plaques [median 2, interquartile range (IQR) 2-5]. Patients with carotid plaques were older (p<0.001), male predominance (p=0.014), more frequent history of hypertension (p<0.001), diabetes (p<0.001), higher Framingham Stroke Risk Score (14.1±4.5 vs. 10.3±4.6, p<0.001), and increased IMT (0.99±0.16 vs. 0.87±0.24, p<0.001) than patients without carotid plaque. Comparing other subtypes of stroke classification, LAA were more frequently found in higher quartiles of number of plaques (p=0.005), or maximum plaque size (p=0.016) but IMT had no significant difference (p=0.214).

Conclusion
s
Carotid plaques were associated with atherosclerotic risk factors, and LAA of stroke classification. Either carotid plaque distribution (number) or severity (maximal thickness) in carotid sonography might be used as a predictor of atherothrombotic infarction in patients with acute ischemic stroke.