Published Online
on May 25, 2006

A more recent version of this article appeared on July 1, 2006

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Submitted on March 7, 2006
Accepted on April 6, 2006

Common Carotid Artery Intima-Media Thickness and the Risk of Stroke Recurrence

Georgios Tsivgoulis MD^*; Konstantinos Vemmos MD; Christos Papamichael MD; Konstantinos Spengos MD; Efstathios Manios MD; Kimon Stamatelopoulos MD; Demetrios Vassilopoulos MD, PhD; and Nikolaos Zakopoulos MD

From the Department of Neurology (G.T., K.Spengos, D.V.), University of Athens, "Eginition" Hospital, Athens, Greece; and the Acute Stroke Unit (K.V., C.P., E.M., K.Stamatelopoulos, N.Z.), Department of Clinical Therapeutics, University of Athens, "Alexandra" Hospital, Athens, Greece.

^* To whom correspondence should be addressed. E-mail: tsivgoulisgiorg{at}yahoo.gr.

Background and Purpose--Increased common carotid artery intima-media thickness (CCA-IMT) has been associated with an increased risk of myocardial infarction and stroke. We investigated the relationship between CCA-IMT and recurrent stroke in a cohort of ischemic stroke patients.

Methods--High-resolution B-mode ultrasonographic measurements of the CCA-IMT were performed in a consecutive series of 238 patients hospitalized in our institution with first-ever ischemic stroke. Stroke risk factors and secondary prevention therapies were documented. Patients were followed-up prospectively and the outcome event of interest was recurrent stroke.

Results--During a mean follow-up period of 28.9 months (range: 6 to 60 months), 27 recurrent strokes were documented. Patients who experienced recurrent cerebrovascular events had significantly (P=0.005) higher CCA-IMT values (1.01 mm, 95% CI:0.92 to 1.11 mm) than subjects who were free of stroke recurrence (0.88 mm, 95% CI:0.85 to 0.91 mm). After adjustment for baseline characteristics, risk factors and stroke subtypes and secondary prevention therapies increasing CCA-IMT was found to be an independent predictor of stroke recurrence. For each increment of 0.1 mm in CCA-IMT the probability of experiencing recurrent stroke increased by 18.0% (95% CI:2.0% to 36.0%, P=0.027).

Conclusions--Increased CCA-IMT values are associated with a higher risk of long-term stroke recurrence.

Key words: atherosclerosis • carotid arteries • recurrence • stroke

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