Main Article Content
Objectives: To determine significant intima-media thickness (IMT) of common carotid artery (CCA) in male and femalepatients with hemorrhagic and ischemic stroke and to see the risk factors of stroke.
Methodology: A total of 150 patients aged > 40 years of age and of both sexes with hemorrhagic and ischaemicstroke were included in this study. Patients with history of endartectomy, head injury, space occupying lesion and onanticoagulation were excluded. Thickness of common carotid artery intima-media of > 0.5 mm was considered significant.Analysis was performed through SPSS-10.0. Chi-square test was applied to see association of increased wallthickness of common carotid artery with stroke and gender.
Results: Male predominance was observed with M: F=1.23: 1. Mean age was 59.54±12.1 years. Among 150 patientsof stroke, 13 (8.7%) patients had CCA-IMT of > 0.5 mm on the left side and 8 (5.3%) patients had CCA-IMT of > 0.5mm on the right side. All patients with significant CCA-IMT thickness were of increasing age. The difference betweenproportions of an increased left and right wall thickness of common carotid artery between genders (p=0.225 &p=0.484) was not significant. Hypertension was the commonest risk factor in 93 (62%) patients followed by diabetesmellitus in 36 (24%) patients and smoking in 32 (21.3%) patients.
Conclusion: There was no significant association between intima-media thickness of common carotid artery withgender in patients with hemorrhagic and ischemic stroke. Hypertension and diabetes were the commonest risk factorsof stroke.
Key Words: Stroke, Carotid Artery, Intima-Media Thickness, Ischaemic Stroke, Haemorrhagic Stroke.
Work published in KMUJ is licensed under a
Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.
intima-media thickness, plaques and
Framingham risk score as independent determinants
of stroke risk. Stroke 2005; 36: 1741-45.
2. Touboul PJ, Elbaz A, Koller C, Lucas C, Adrai V,
Chedru F, et al. Common carotid artery intima-media
thickness and brain infarction. Circulation 2000; 102:
3. Zureik M, Touboul PJ, Bonithon-Kop C, Courbon D,
Berr C, Leroux C, et al. Cross-sectional and 4-year
longitudinal associations between brachial pulse pressure
and common carotid intima-media thickness in
a general population: The EVA study. Stroke 1999;
4. O’Leary DH, Polak JF, Kronmal RA, Manolio TA, Burke
GL, Wolfson SK. Carotid artery intima and media thickness
as a risk factor for myocardial infarction and
stroke in older adults. N Engl J Med 1999; 340:
5. Zanchetti A, Bond MG, Hennig M, Neiss A, Mancia G,
Dal Palu C, et al. Calcium antagonist lacidipine slows
down progression of asymptomatic carotid atherosclerosis.
Circulation 2002; 106: 2422-7.
6. Smilde TJ, Van Wissen S, Wollersheim H, Kastelein
JJP, Stalenhoef AFH. Effect of aggressive versus conventional
lipid lowering on atherosclerosis progression
in familial hypercholesterolemia (ASAP). Lancet
2001; 357: 577-81.
7. The diabetes and complications trial/epidemiology of
diabetes intervention and complication research
group. Intensive diabetes therapy of carotid intimamedia
thickness in type-I diabetes mellitus. N Engl J
Med 2003; 348: 2294-303.
8. Kitamura A, Iso H, Imano H, Ohira T, Okada T, Sato S,
et al. Carotid intima media thickness and plaque characteristics as a risk factor for stroke in Japanese elderly
men. Stroke 2004; 35: 2788-94.
9. Sahoo R, Krishna MV, Subrahmaniyan DKS, Dutte
TK, Elangoven S. Common carotid intima-media thickness
in acute ischaemic stroke: A case control study.
Neurol India 2009; 57(5): 627-30.
10. Goyal A, Yousuf S. The burden of cardiovascular disease
in Indian sub-continent. Indian J Med Res 2007;
11. Alam I, Haider I, Wahab F, Khan W, Taqweem MA,
Nowsherwan. Risk factors stratification in 100 patients
of acute stroke. J Postgrad Med Inst 2004; 18(4):
12. Vohra EA. Stroke: The challenge and response. Pak
J Med Sci 2001; 17(2): 65-6.
13. Vohra EA, Ahmed WU, Ali M. Aetiology and prognostic
factors for outcome of patients admitted in stroke.
J Pak Med Assoc 2000; 50: 234-6.
14. Sherin A, Khan A, Rehman S, Shah NH, Shabbier G, Zarif M. Comparability and validity of Siriraj stroke score and Allen stroke score in differentiation of acute ischemic and haemorrhagic stroke. J Postgrad Med Inst 2011; 25: 206-16.
15. Khan SP, Ahmed KZ, Yaqub Z, Ghani R. Carotid intima-
media thickness correlation with lipid profile in patients with familial hypercholesterolemia versus controls. J Coll Physicians Surg Pak 2011; 21(1): 30-3.
16. Sarwar HJ, Tahira QUA, Kubra KT. Assessment of common
carotid artery intima media thickness in diabetics
compared with non diabetics by b-mode ultrasonography.
Pak Armed Forces Med J 2012; 62(3):
17. Rosenkranz M, Thomalla G, Havemeister S, Wittkugel
O, Cheng B, Krutzelmann A, et al. Older age and
greater carotid intima-media thickness predict
ischaemic events associated with carotid artery
stenting. Cerebrovasc Dis 2010; 30: 567-72.
18. Sridharan SE, Unnikrishan JP, Sukumaran S, Sylaja
PN, Nayak SD, Sarma PS. et al. Incidence, types, risk
factors and outcome of stroke in developing country:
The trivandrum stroke registry. Stroke 2009; 40:
19. Zhang LF, Yang J, Hong Z, Yuan GG, Zhou BF, Zhao
LC, Huang YH, et al. Proportion of different subtypes
of stroke in China. Stroke 2003; 34: 2091-96.
20. Sherin A, Shabbier G, Rehman S, Shah NH, Zarif M. Hypertension in acute ischemic and haemorrhagic stroke. J Postgrad Med Inst 2005; 19(2): 220-5.
21. Strong K, Mathers C, Bonita R. Preventing stroke:
saving lives around the world. Lancet Neurol 2007; 6:
22. Sol AID, Moons KGM, Hollander M, Hoffman A,
Koudstaal PJ, Grobbee DE, et al. Is carotid intimamedia
thickness useful in cardiovascular disease risk
assessment?: The Rotterdam study. Stroke 2001; 32:
23. Bots ML, Hoes AW, Koudstaal PJ, Hofman A, Grobbee
DE. Common carotid intima-media thickness and risk
of stroke and myocardial infarction: The Rotterdam
study. Circulation 1997; 96: 1432-37.
24. Chuang SY, Bai CH, Chen JR, Yeh WT, Chen HJ, Chiu
HC, Shiu RS, et al. Common carotid end diastolic
velocity and intima-media thickness jointly predict
ischaemic stroke in Taiwan. Stroke 2011; 42:
25. Su TC, Chien KL, Jeng JS, Chen MF, Hsu HC, Torng
PL, et al. Age and gender associated determinants of
carotid intima media thickness: A community based
study. J Atheroscler Thromb 2012; 19: 872-80.