Association Between Cardiometabolic Index and Carotid Intima-Media Thickness in Patients With Lacunar Stroke

Objective: The aim of this study is to examine the association between the cardiometabolic index (CMI) and carotid intima-media thickness (cIMT) in patients with lacunar stroke (LS). Methods: A retrospective analysis was conducted on 155 patients with LS who underwent carotid ultrasonography at Zhongshan Hospital affiliated with Xiamen University between March 2022 and May 2024. Based on cIMT measurements, participants were categorized into 3 groups: normal (n=54), thickening (n=57), and plaque (n=44). Clinical data were collected, CMI was calculated, intergroup comparisons were performed, and the correlation between CMI and the severity of carotid lesions was evaluated. Results: A total of 155 patients with LS, comprising 72 males and 83 females, with a mean age of 65.83±12.34 years, were included in this study. CMI levels were significantly elevated in the cIMT thickening and plaque groups compared with the normal group. Multiple logistic regression analysis demonstrated a significant positive association between CMI and cIMT progression (β=0.13, 95% CI: 0.08–0.17, P <0.001), and this association remained significant after adjustment for covariates, including age, sex, body mass index, smoking, alcohol consumption, hypertension, diabetes, and ischemic heart disease. Quartile analysis of CMI indicated that patients in the highest quartile of CMI exhibited a significantly increased risk of cIMT progression (β=0.27, 95% CI: 0.05–0.49, P =0.02). Receiver operating characteristic analysis demonstrated that CMI was an effective predictor of cIMT progression (area under the curve=0.706, 95% CI: 0.61–0.80). Conclusions: The independent association between CMI and cIMT progression indicates that CMI may serve as a potential indicator for assessing the risk of carotid lesions in patients with LS, providing a basis for early screening and intervention.