Increased intima-media thickness is independently associated with ischemic stroke.

BACKGROUND Stroke is one of the major causes of death worldwide. The importance of increased intima-media thickness in cardiovascular risk stratification has been recurrently studied. The relationship between them, however, is still controversial. OBJECTIVES To determine whether increased common carotid artery (CCA) intima-media thickness can be used as an independent high-risk marker for the occurrence of stroke. METHODS This study sample comprised 948 patients consecutively assessed by use of cervical triplex scan from January 2004 to June 2009. Those patients were divided into groups according to the presence or absence of recent stroke as follows: a group of patients with ischemic stroke (n = 452, 48%); a group of patients with hemorrhagic stroke (n = 22, 2%); and a group of patients with no events (n = 474, 50%). RESULTS On logistic regression analysis adjusted for the classic cardiovascular risk factors, increased CCA intima-media thickness associated significantly and on an approximately linear way with ischemic stroke (Odds Ratio = 1.808, confidence interval: 1.291-2.534, p = 0.01), but not with hemorrhagic stroke (p = ns). A significant interaction with age was also found, showing a greater discriminative capacity for the risk of ischemic stroke in individuals aged less than 50 years. CONCLUSIONS The increased CCA intima-media thickness was identified as an independent predictor of the risk for ischemic stroke, but not for hemorrhagic stroke, emphasizing the usefulness of its assessment on clinical practice.