Influence of Carotid Intima-Media Thickness Levels at Bifurcation on Short-Term Functional Outcomes Among Non-Cardiogenic Ischemic Stroke Patients with and without Type 2 Diabetes Mellitus

Abstract

Purpose The intima-media thickness (IMT) is broadly reported to have relationships with non-cardiogenic ischemic stroke and with diabetes. But how does IMT affect the short-term prognosis of stroke seems unknown yet. We investigated the influence of the intima-media thickness at carotid bifurcation (IMTbif) on short-term functional outcomes among non-cardiogenic ischemic stroke patients with and without type 2 diabetes mellitus (T2DM). Patients and Methods A total of 314 patients with non-cardiogenic ischemic stroke (122 with T2DM and 192 without diabetes) were included in this retrospective study. Poor functional outcome was defined as a modified Rankin Scale (mRS) > 2 at 3 months after stroke onset. Group comparisons were done in favorable and poor outcome groups. Linear regression analysis was utilized to verify the associations between IMTbif and mRS in subgroups with and without diabetes, respectively. Results The median IMTbif of total patients was 1.40mm. Patients with poor outcomes were significantly older, had higher National Institutes of Health Stroke Scale (NIHSS) scores, lower haemoglobin, higher fasting glucose and higher systolic blood pressure values. Their IMTbif levels were also markedly higher. Among 122 included stroke patients with T2DM, IMTbif levels and NIHSS were independently associated with functional outcomes at 3 months, whereas there was no significant association between IMTbif levels and short-term functional outcomes among patients without diabetes. Conclusion The IMTbif levels were significantly associated with 3-month functional outcomes in non-cardiogenic ischemic stroke patients with T2DM. The ultrasound detection of the IMTbif therefore suggests a prognostic value among patients with stroke and T2DM.

Normative Clinical Reference for Intima-media Thickness of Carotid Arteries Among Nigerian Adults

“…The intima-media thickness (IMT) of the carotid arteries is said to be predictive of the risk of cerebrovascular accidents in patients. [ 1 2 3 4 ] Arterial wall thickness affects vascular resistance and can influence the cerebral blood flow velocity and perfusion pressure,[ 5 6 7 ] and in the same vein, they can also be influenced by sex, the size of the body, the size of the neck, and some clinical parameters. [ 8 ] Because carotid IMT is said to provide an index of atherosclerotic vascular process that can be used to study subclinical atherosclerosis,[ 9 ] normative reference values in every society become invaluable data.…”