The Relationship Between Carotid Atherosclerosis And Risk Stratification Of Ischemic Stroke

Objective To examine the relationship between carotid atherosclerosis in acuteischemic stroke and risk stratification of the recurrent ischemic stroke.Methods the risk factors were evaluated by ESRS in82patients with the acute ischemicstroke and divided into ESRS≥3group(n=40) and ESRS0～2group(n=42).Carotidartery were assessed by color Doppler ultrasound in both groups,the difference of thecharacteristics of carotid atherosclerosis between the both groups were compared.Result The age was higher in ESRS≥3group than ESRS0~2group〔(71.15±8.33)year vs.(58.74±9.67) year, t＝6.212,P＝0.000〕.Compared with ESRS0～2group,the proportions of Arterial hypertension,Diabetes mellitus and Previous TIA orischemic stroke in addition to qualifying event in ESRS≥3group were significantlyhigher (χ~2＝4.30,8.99and6.71，all P＜0.05). The logistic regression analysis showedthat the OR of age≥65,Arterial hypertension,Diabetes mellitus and Previous TIA orischemic stroke in addition to qualifying event were7.684,2.901,4.524and6.667,allP<0.05. Compared the incidence rates of homocysteine, fibrinogen, low-densitylipoprotein cholesterol, triglyceride, total cholesterol level in ESRS≥3group withESRS0～2group (t=0.521,1.483,0.031,0.887,0.172，all P＞0.05),the difference wasnot statistically significant.The common carotid artery IMT, internal carotid artery IMT,carotid bifurcation IMT were much more in ESRS≥3group than ESRS0~2group〔(1.09±0.12) mm vs.(0.92±0.16) mm,(1.10±0.15) mm vs.(0.95±0.16)mm,(1.19±0.12) mm, vs.(1.05±0.16) mm,t＝5.316,4.160and4.378, all P＝0.000〕. Theratios of the carotid lipid, calcified plaques,moderate and severe carotid atherosclerosiswere significantly higher in the ESRS≥3group than in ESRS0~2group (χ~2=8.27,8.22,6.14and10.08,all P＜0.05).Incidence of carotid stenosis less than50%was significantly higher in ESRS≥3group(52/80,65.00%) than ESRS0~2group(27/84,32.10%,χ~2=17.718,P＝0.000).Compared the ratios of50%～70%carotidstenosis,70%～99%carotid stenosis and occlusion in ESRS≥3group with ESRS0～2group(χ~2=1.658,1.844and1.844,all P＞0.05), the difference were not statisticallysignificant. The ratios of the carotid lipid and calcified plaques,moderate and severecarotid atherosclerosis in the ESRS≥3group were significantly higher than ESRS0～2group (χ~2=8.27,8.22,6.14,10.08,all P＜0.05). The logistic regression analysis showedcommon carotid artery IMT≥1.0mm,lipid plaques,calcific plaques, the moderate andsevere carotid atherosclerosis were positively related to high risk recurrent ischemicstroke(OR＝5.080,3.193,3.617,4.900,8.167,all P＜0.05)..Conclusions There is a positively relationship between carotid atherosclerosis and highrisk recurrent ischemic stroke.common carotid artery IMT and the severity carotidatherosclerosis may be a risk predictor in high risk recurrent ischemic stroke.