Intima-Media Thickness and Pulsatility Index of Common Carotid Arteries in Acute Ischaemic Stroke Patients with Diabetes Mellitus.
Olivier BillMichael V MazyaPatrik MichelTiago Prazeres MoreiraDimitris LambrouIvo A MeyerLorenz HirtPublished in: Journal of clinical medicine (2022)
Ultrasonographic parameters such as the common carotid artery (CCA) pulsatility index (PI) and CCA intima-media thickness (IMT) have been associated with an increased mortality and risk of recurrent stroke, respectively. We hypothesized that these ultrasonographic parameters may be useful for monitoring diabetic patients after an acute stroke. We analysed retrospective data of consecutive acute ischaemic stroke patients from the ASTRAL registry who underwent pre-cerebral ultrasonographic evaluation within 7 days of symptom onset. We compared clinical, demographic, radiological and ultrasonographic parameters in diabetic versus non-diabetic patients (univariable and multivariable analyses) and the association of these parameters with CCA PI and CCA IMT. We analysed 1507 carotid duplex ultrasound examinations from patients with a median age of 74 years. Cardiovascular co-morbidities, including hypertension, hypercholesterolemia, obstructive sleep apnoea syndrome, higher body-mass index (BMI) and peripheral artery disease, were associated with diabetes mellitus (DM). Diabetics were more often under antiplatelet therapy and had atrial fibrillation at admission. Diabetic patients showed an increased CCA PI and IMT in line with more atherosclerotic changes on acute CTA compared to non-diabetic patients. Taking IMT as the dependent variable in a second analysis, DM, higher age, hypertension, smoking and CCA PI were associated with higher IMT. Taking CCA PI as the dependent variable in a third analysis, DM, higher age and higher NIHSS at admission were associated with higher CCA PI values. Increased IMT was also associated with higher PI. We show that CCA PI and IMT are higher in diabetic patients in the first week after an initial stroke.
Keyphrases
- atrial fibrillation
- body mass index
- liver failure
- blood pressure
- antiplatelet therapy
- emergency department
- peripheral artery disease
- randomized controlled trial
- heart failure
- glycemic control
- respiratory failure
- drug induced
- physical activity
- acute coronary syndrome
- computed tomography
- intensive care unit
- metabolic syndrome
- cardiovascular disease
- cardiovascular events
- coronary artery disease
- aortic dissection
- cardiovascular risk factors
- optical coherence tomography
- cross sectional
- weight gain
- optic nerve
- skeletal muscle
- left atrial
- insulin resistance
- adipose tissue
- left ventricular
- wound healing
- electronic health record
- ultrasound guided
- oral anticoagulants
- arterial hypertension