Carotid Artery Intima-Media Thickness and Lacunar Versus Nonlacunar Infarcts

  • L.M. Cupini
    From Clinica Neurologica, Ospedale S.Eugenio, Universita’ di Roma Tor Vergata (L.M.C., M.D., M.S., B.R., F.F., G.B.); AFaR, Dipartimento di Neurologia, Fatebenefratelli Hospital, Isola Tiberina (P.P., F.V.); and Istituto di Ricovero e Cura a Carattere Scientifico “S. Lucia” (P.P., G.B.), Rome, Italy.
  • P. Pasqualetti
    From Clinica Neurologica, Ospedale S.Eugenio, Universita’ di Roma Tor Vergata (L.M.C., M.D., M.S., B.R., F.F., G.B.); AFaR, Dipartimento di Neurologia, Fatebenefratelli Hospital, Isola Tiberina (P.P., F.V.); and Istituto di Ricovero e Cura a Carattere Scientifico “S. Lucia” (P.P., G.B.), Rome, Italy.
  • M. Diomedi
    From Clinica Neurologica, Ospedale S.Eugenio, Universita’ di Roma Tor Vergata (L.M.C., M.D., M.S., B.R., F.F., G.B.); AFaR, Dipartimento di Neurologia, Fatebenefratelli Hospital, Isola Tiberina (P.P., F.V.); and Istituto di Ricovero e Cura a Carattere Scientifico “S. Lucia” (P.P., G.B.), Rome, Italy.
  • F. Vernieri
    From Clinica Neurologica, Ospedale S.Eugenio, Universita’ di Roma Tor Vergata (L.M.C., M.D., M.S., B.R., F.F., G.B.); AFaR, Dipartimento di Neurologia, Fatebenefratelli Hospital, Isola Tiberina (P.P., F.V.); and Istituto di Ricovero e Cura a Carattere Scientifico “S. Lucia” (P.P., G.B.), Rome, Italy.
  • M. Silvestrini
    From Clinica Neurologica, Ospedale S.Eugenio, Universita’ di Roma Tor Vergata (L.M.C., M.D., M.S., B.R., F.F., G.B.); AFaR, Dipartimento di Neurologia, Fatebenefratelli Hospital, Isola Tiberina (P.P., F.V.); and Istituto di Ricovero e Cura a Carattere Scientifico “S. Lucia” (P.P., G.B.), Rome, Italy.
  • B. Rizzato
    From Clinica Neurologica, Ospedale S.Eugenio, Universita’ di Roma Tor Vergata (L.M.C., M.D., M.S., B.R., F.F., G.B.); AFaR, Dipartimento di Neurologia, Fatebenefratelli Hospital, Isola Tiberina (P.P., F.V.); and Istituto di Ricovero e Cura a Carattere Scientifico “S. Lucia” (P.P., G.B.), Rome, Italy.
  • F. Ferrante
    From Clinica Neurologica, Ospedale S.Eugenio, Universita’ di Roma Tor Vergata (L.M.C., M.D., M.S., B.R., F.F., G.B.); AFaR, Dipartimento di Neurologia, Fatebenefratelli Hospital, Isola Tiberina (P.P., F.V.); and Istituto di Ricovero e Cura a Carattere Scientifico “S. Lucia” (P.P., G.B.), Rome, Italy.
  • G. Bernardi
    From Clinica Neurologica, Ospedale S.Eugenio, Universita’ di Roma Tor Vergata (L.M.C., M.D., M.S., B.R., F.F., G.B.); AFaR, Dipartimento di Neurologia, Fatebenefratelli Hospital, Isola Tiberina (P.P., F.V.); and Istituto di Ricovero e Cura a Carattere Scientifico “S. Lucia” (P.P., G.B.), Rome, Italy.

抄録

<jats:p> <jats:bold> <jats:italic> <jats:bold> <jats:italic>Background and Purpose</jats:italic> </jats:bold> — </jats:italic> </jats:bold> Increases in the thickness of the intima and media of the carotid artery have been associated with an increased risk of myocardial infarction and stroke in subjects without a history of cardiovascular disease. Lacunar infarcts, one of the most common subtype of ischemic stroke, show unique pathological and clinicoradiological characteristics. The present study examines the relationship between vascular risk factors, including carotid artery intima-media thickness (IMT), and lacunar versus nonlacunar infarcts. </jats:p> <jats:p> <jats:bold> <jats:italic> <jats:bold> <jats:italic>Methods</jats:italic> </jats:bold> — </jats:italic> </jats:bold> We collected data from patients with acute ischemic stroke admitted to hospital. Patients and 129 control subjects underwent B-mode ultrasonographic measurements of IMT of the common carotid artery. We examined the association of lacunar and nonlacunar infarcts with age, sex, and potential vascular risk factors. </jats:p> <jats:p> <jats:bold> <jats:italic> <jats:bold> <jats:italic>Results</jats:italic> </jats:bold> — </jats:italic> </jats:bold> Of 292 adult patients with an acute first-ever ischemic stroke, 96 were considered lacunar and 196 were considered nonlacunar strokes. We did not find a significantly different percentage of diabetes, smoking, hypertension, dyslipidemia, myocardial infarction, and previous transient ischemic attack between the 2 groups of patients. The multinomial logistic regression procedure selected carotid artery IMT and atrial fibrillation as the only independent factors able to discriminate between lacunar and nonlacunar patients. IMT values were significantly higher in patients with nonlacunar stroke versus both those with lacunar stroke and control subjects. </jats:p> <jats:p> <jats:bold> <jats:italic> <jats:bold> <jats:italic>Conclusions</jats:italic> </jats:bold> — </jats:italic> </jats:bold> The present results indicate the usefulness of noninvasive measurement of IMT with ultrasonic techniques as a diagnostic tool that may help to identify different subtypes of ischemic stroke patients. The noninvasive measurements may have predictive power with respect to lacunar versus nonlacunar infarcts. </jats:p>

収録刊行物

  • Stroke

    Stroke 33 (3), 689-694, 2002-03

    Ovid Technologies (Wolters Kluwer Health)

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