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Common carotid intima media thickness as a marker of clinical severity in patients with symptomatic extracranial carotid artery stenosis.
Clin Neurol Neurosurg 2009; 111(3):246-50CN

Abstract

OBJECTIVES

Increased common carotid artery intima-media thickness (CCA-IMT) is a risk factor for ischemic stroke and especially large vessel atherothrombotic infarction. However, the potential association of stroke severity with the intima-media thickening has not been previously studied. We sought to investigate the association between CCA-IMT and clinical severity of ischemic stroke in patients with symptomatic extracranial carotid artery stenosis (SCAS).

PATIENTS AND METHODS

Consecutive patients with acute, first-ever ischemic stroke and SCAS (50%-99%) were prospectively evaluated. All subjects underwent IMT measurements at the far wall of CCA. Stroke severity was assessed using the National Institute of Health Stroke Scale (NIHSS) on hospital admission and Barthel Ambulatory Index (BI) at hospital discharge.

RESULTS

CCA-IMT was strongly correlated to NIH (Spearman's correlation coefficient: r=0.546, p<0.001) and BI (r=-0.450, p<0.001) in the study population (n=102). A 0.1mm increase in CCA-IMT was independently associated with increasing NIHSS-scores on hospital admission (beta: 0.510; p<0.001) and decreasing BI-scores at hospital discharge (beta: -0.483; p<0.001) even after adjustment for demographic characteristics and cardiovascular risk factors. After including baseline stroke severity (NIHSS) in the multivariate linear regressions models evaluating early functional outcome, only NIHSS was independently related to BI (standardized linear regression coefficient: -0.776, p<0.001), while the initial association between IMT and BI did not retain its statistical significance (beta: -0.074, p=0.276).

CONCLUSIONS

Increased CCA-IMT is independently associated with more severe stroke on admission in patients with SCAS.

Authors+Show Affiliations

Department of Neurology, Democritus University of Thrace, Alexandroupoli, Greece.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

19036498

Citation

Heliopoulos, Ioannis, et al. "Common Carotid Intima Media Thickness as a Marker of Clinical Severity in Patients With Symptomatic Extracranial Carotid Artery Stenosis." Clinical Neurology and Neurosurgery, vol. 111, no. 3, 2009, pp. 246-50.
Heliopoulos I, Papaoiakim M, Tsivgoulis G, et al. Common carotid intima media thickness as a marker of clinical severity in patients with symptomatic extracranial carotid artery stenosis. Clin Neurol Neurosurg. 2009;111(3):246-50.
Heliopoulos, I., Papaoiakim, M., Tsivgoulis, G., Chatzintounas, T., Vadikolias, K., Papanas, N., & Piperidou, C. (2009). Common carotid intima media thickness as a marker of clinical severity in patients with symptomatic extracranial carotid artery stenosis. Clinical Neurology and Neurosurgery, 111(3), pp. 246-50. doi:10.1016/j.clineuro.2008.10.007.
Heliopoulos I, et al. Common Carotid Intima Media Thickness as a Marker of Clinical Severity in Patients With Symptomatic Extracranial Carotid Artery Stenosis. Clin Neurol Neurosurg. 2009;111(3):246-50. PubMed PMID: 19036498.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Common carotid intima media thickness as a marker of clinical severity in patients with symptomatic extracranial carotid artery stenosis. AU - Heliopoulos,Ioannis, AU - Papaoiakim,Miltiadis, AU - Tsivgoulis,Georgios, AU - Chatzintounas,Thomas, AU - Vadikolias,Konstantinos, AU - Papanas,Nikolaos, AU - Piperidou,Charitomeni, Y1 - 2008/11/25/ PY - 2008/03/09/received PY - 2008/10/06/revised PY - 2008/10/09/accepted PY - 2008/11/28/pubmed PY - 2009/4/18/medline PY - 2008/11/28/entrez SP - 246 EP - 50 JF - Clinical neurology and neurosurgery JO - Clin Neurol Neurosurg VL - 111 IS - 3 N2 - OBJECTIVES: Increased common carotid artery intima-media thickness (CCA-IMT) is a risk factor for ischemic stroke and especially large vessel atherothrombotic infarction. However, the potential association of stroke severity with the intima-media thickening has not been previously studied. We sought to investigate the association between CCA-IMT and clinical severity of ischemic stroke in patients with symptomatic extracranial carotid artery stenosis (SCAS). PATIENTS AND METHODS: Consecutive patients with acute, first-ever ischemic stroke and SCAS (50%-99%) were prospectively evaluated. All subjects underwent IMT measurements at the far wall of CCA. Stroke severity was assessed using the National Institute of Health Stroke Scale (NIHSS) on hospital admission and Barthel Ambulatory Index (BI) at hospital discharge. RESULTS: CCA-IMT was strongly correlated to NIH (Spearman's correlation coefficient: r=0.546, p<0.001) and BI (r=-0.450, p<0.001) in the study population (n=102). A 0.1mm increase in CCA-IMT was independently associated with increasing NIHSS-scores on hospital admission (beta: 0.510; p<0.001) and decreasing BI-scores at hospital discharge (beta: -0.483; p<0.001) even after adjustment for demographic characteristics and cardiovascular risk factors. After including baseline stroke severity (NIHSS) in the multivariate linear regressions models evaluating early functional outcome, only NIHSS was independently related to BI (standardized linear regression coefficient: -0.776, p<0.001), while the initial association between IMT and BI did not retain its statistical significance (beta: -0.074, p=0.276). CONCLUSIONS: Increased CCA-IMT is independently associated with more severe stroke on admission in patients with SCAS. SN - 1872-6968 UR - https://www.unboundmedicine.com/medline/citation/19036498/Common_carotid_intima_media_thickness_as_a_marker_of_clinical_severity_in_patients_with_symptomatic_extracranial_carotid_artery_stenosis_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0303-8467(08)00376-4 DB - PRIME DP - Unbound Medicine ER -