Study of Carotid Intima Media Thickness in Patients With Acute Ischemic Stroke and Its Correlation With Risk Factors of Ischemic Stroke - A Case Control Study

Stroke is the leading cause of mortality worldwide. Carotid Intima Media Thickness (CIMT) is a marker of atherosclerosis and is also a marker for ischemic stroke. AIMS: 1) To assess the value of carotid intima media thickness at which patients with risk factors can develop acute ischemic stroke. 2) To correlate carotid intima media thickness with risk factors of acute ischemic stroke. MATERIAL & METHODS: This study was done at KIMS Hospital, Bangalore between December 2010 to September 2012. This is a case control observational study which has a sample size of 50 cases and 50 controls. Method of collection of data was by patient evaluation which was done by taking detailed history, clinical examination and laboratory investigations through a proforma specially designed for this study. Cases were subjects who had ischemic stoke and Infarct proven by CT/MRI of brain, Controls were subjects without stroke matched to cases by age, gender and risk factors like diabetes, hypertension, smoking and dyslipidemia. Subjects in both groups underwent carotid Doppler investigation with 7.5 Mhz linear superficial array probe to determine CIMT and presence of plaques. RESULTS: Out of 50 cases, 46 had CIMT between 0.06-0.20 cm [92%] and out of 50 controls, 45 had CIMT between 0.06-0.20 cm[90%]. Most of our cases had CIMT above 0.06 cm, so we can hypothesize that people with risk factors having CIMT above 0.06 cm are more prone for ischemic cerebro vascular accidents. Mean CIMT in cases with risk factors is significantly increased when compared to controls with risk factors. CONCLUSION: People with risk factors [ age > 50 years, DM , HTN , Smoking and Dyslipidemia] having CIMT above 0.06 cm are more prone for ischemic CVA, so people with risk factors should undergo screening for CIMT measurement by Carotid Doppler which is non invasive and cost effective and if their CIMT is above 0.06 cm they should undergo early medical intervention to take care of risk factors and lifestyle modifications, so that they can be prevented from ischemic CVA in future.