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(Stroke. 2006;37:1913.)
© 2006 American Heart Association, Inc.

Research Reports

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 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.

Correspondence to Georgios Tsivgoulis, MD, Iofontos 2, 11634 Athens, Greece. 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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