Differential value of intima thickness in ischaemic stroke due to large‐artery atherosclerosis and small‐vessel occlusion

Jin, Suqin; Cheng, Zhenshun; Zhang, Yun; Jia, Guoyong; Mei, Zhang; Xu, Mingjun

doi:10.1111/jcmm.16884

Cited by 4 publications

(4 citation statements)

References 23 publications

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“…Pruissen et al and Jin et al reported higher CIMT values in patients with LAA compared to SVD. 15,30 This is clearly in line with findings from our cohort, as reflected by the univariable, and multivariable logistic regression analysis. In an analysis of the Northern Manhattan study, CIMT was related to the burden of white matter hyperintensities (WMH), independently from vascular risk factors.…”

Section: Discussionsupporting

confidence: 91%

“…CIMT is a measure of subclinical atherosclerosis and was shown to be associated not only with vascular risk factor burden but also with large vessel atherosclerosis, small vessel disease, and AF in the general population, independently from vascular risk factors. [11][12][13][14][15][16] According to previous work by our group and others, CIMT may be of value to identify patients with cryptogenic strokes at high risk for newly detected AF or atrial cardiopathy who therefore should undergo intensified heart rhythm analyses. 17,18 Furthermore, CIMT is easy to measure in a standardized manner via Duplex ultrasound and is commonly integrated into the diagnostic algorithm following stroke.…”

Section: Aims and Hypothesismentioning

confidence: 99%

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Diagnostic value of carotid intima-media thickness and clinical risk scores in determining etiology of ischemic stroke

Sievering,

Grosshennig,

Kottas

et al. 2023

European Stroke Journal

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Background: In the general population, carotid intima-media thickness (CIMT) is associated with atherosclerosis as well as atrial fibrillation (AF). However, the extent to which CIMT might be of diagnostic value in clarifying stroke etiology is currently unclear. Methods: In this retrospective cohort study, we included 800 consecutive patients with acute ischemic stroke. We compared CIMT-values between stroke etiologies. The association between CIMT and cardioembolic stroke was investigated via logistic regression analysis adjusting for vascular risk factors. Receiver operating characteristic analyses were conducted to investigate the diagnostic value of CIMT in comparison to vascular risk factors and clinical AF risk scores (CHA2DS2VASc, HAVOC, and AS5F). Results: CIMT-values were highest in patients with cardioembolic or atherosclerotic stroke origin. CIMT was associated with newly diagnosed AF compared against cryptogenic strokes (crude odds ratio (OR) per 0.1 mm-increase of CIMT: 1.26 (95% confidence interval (CI): 1.13–1.41)). After adjustment for vascular risk factors, the effect of CIMT on AF-diagnosis, however, was weakened (adjusted OR: 1.10 (95% CI: 0.97–1.25)). The diagnostic value of CIMT for detection of AF (AUC: 0.60, 95% CI: 0.54–0.65) was outperformed by AF risk scores. Among the scores investigated, the AS5F-score yielded best accuracy and calibration to predict newly diagnosed AF (AUC: 0.71, 95% CI: 0.65–0.78). Conclusions: CIMT may help in the diagnosis of stroke etiology. However, compared with vascular risk factors or clinical AF risk scores, CIMT does not provide substantial additional information on the risk of newly detected AF. Thus, stratification of AF risk based on scores, such as the AS5F, is advisable.

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Section: Discussionsupporting

confidence: 91%

Section: Aims and Hypothesismentioning

confidence: 99%

Diagnostic value of carotid intima-media thickness and clinical risk scores in determining etiology of ischemic stroke

Sievering,

Grosshennig,

Kottas

et al. 2023

European Stroke Journal

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“…Recent research by Jin et al showed that radial intima thickness plays a significant role in the differential identification of stroke subtypes ( 24 ), indicating the significance of intimal thickness in clinical studies. However, the connection between CIT and the plaque types, which were strongly linked to plaque vulnerability and adverse CV events, was not further explored.…”

Section: Discussionmentioning

confidence: 99%

“…Lipid deposits form in the subintima of arteries throughout the body during the progression of atherosclerosis. Recent studies have also revealed a relationship between the classic atherosclerotic risk factors and CIT, which has good diagnostic value for ischemic stroke and CAD and is helpful in identifying subtypes of ischemic stroke ( 23 , 24 ). Therefore, employing CIT to track the advancement of CP could have great clinical value.…”

Section: Introductionmentioning

confidence: 99%

Value of carotid intima thickness in assessing advanced carotid plaque vulnerability: a study based on carotid artery ultrasonography and carotid plaque histology

Zhao,

Zhang,

Wang

et al. 2024

Quant Imaging Med Surg

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Background Research has shown that carotid intima-media thickness (CIMT) could help to predict carotid plaque (CP) progression in patients with mild carotid stenosis. However, the debate continues as to the value of carotid intima thickness (CIT) in monitoring the development of CP in patients with severe carotid stenosis. This study sought to evaluate the relationships between CIT and the ultrasonic characteristics of CP and to analyze the value of CIT and the ultrasonic parameters of CP in assessing plaque vulnerability in advanced human carotid atherosclerosis. Methods A total of 55 individuals who underwent carotid endarterectomy (CEA) were included in the study (mean age: 65±7 years; female: 9.1%). CIMT and CIT were examined at the common carotid artery (CCA). Plaque textural features, such as the gray-scale median (GSM), superb microvascular imaging (SMI) level, and total plaque area (TPA), were also identified. A Spearman correlation coefficient analysis was performed to examine the relationship between CIT and the ultrasonic parameters of CP. The CIT of various plaque types was compared. Receiver operating characteristic (ROC) curves were used to analyze the diagnostic values of the ultrasound characteristics to evaluate CP vulnerability. Results The mean CIT of all the participants was 0.382±0.095 mm, the mean CIT of the participants with stable plaques was 0.328±0.031 mm, and the mean CIT of participants with vulnerable plaques was 0.424±0.106 mm (P<0.001). CIT was associated with the SMI level (Spearman’s correlation coefficient: r=0.392, P=0.005), TPA (Spearman’s correlation coefficient: r=0.337, P=0.012). Patients with thicker CIT had larger lipid cores, higher levels of plaque vulnerability, and more intraplaque hemorrhages (IPHs). The areas under the ROCs (AUCs) with 95% confidence interval (CI) for CIMT, CIT, the SMI level, the GSM, the TPA, and the combined model for identifying vulnerable plaques were 0.673 (0.533–0.793), 0.849 (0.727–0.932), 0.771 (0.629–0.879), 0.669 (0.529–0.790), 0.858 (0.738–0.938), and 0.949 (0.854–0.990), respectively. Conclusions CIT was associated with both the histology and ultrasonic features of CP. CIT may be helpful in the detection of severe CP development.

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The negative affectivity dimension of Type D personality associated with increased risk for acute ischemic stroke and white matter hyperintensity

Yao

et al. 2022

Journal of Psychosomatic Research

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Differential value of intima thickness in ischaemic stroke due to large‐artery atherosclerosis and small‐vessel occlusion

Cited by 4 publications

References 23 publications

Diagnostic value of carotid intima-media thickness and clinical risk scores in determining etiology of ischemic stroke

Diagnostic value of carotid intima-media thickness and clinical risk scores in determining etiology of ischemic stroke

Value of carotid intima thickness in assessing advanced carotid plaque vulnerability: a study based on carotid artery ultrasonography and carotid plaque histology

The negative affectivity dimension of Type D personality associated with increased risk for acute ischemic stroke and white matter hyperintensity

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