If a strong association between intima-media thickness of the common carotid artery (CCA-IMT) and ischemic stroke can be determined in diabetic subjects, it may be a useful predictor to help identify patients at high risk of ischemic stroke. To investigate the relative contribution of CCA-IMT to ischemic stroke in patients with type 2 diabetes, we measured CCA-IMT and other conventional risk factors in 438 Japanese patients with type 2 diabetes, including 45 with ischemic stroke and 393 controls. Stroke patients were characteristically and significantly older with higher body mass index, longer duration of diabetes, likely to be smokers, higher blood pressure, and higher total cholesterol compared with the controls. CCA-IMT in stroke patients (1.23 +/- 0.04 mm) was significantly greater than in control patients (0.95 +/- 0.01 mm, P <.01). CCA-IMT in stroke patients was still significantly greater than controls after adjustment for age, sex, body mass index, and smoking status (P <.05). A 0.1-mm increase in CCA-IMT was associated with 1.80-fold increase in the odds ratio of stroke in diabetic patients (95%confidence interval [CI], 1.49 to 2.17; P <.01). Four independent factors were found to correlate significantly with CCA-IMT: age, systolic blood pressure, HbA(1c), and high-density lipoprotein (HDL) cholesterol. Thus, thickening of the intima-media of common carotid arteries is associated with ischemic stroke in type 2 diabetic patients. To prevent ischemic stroke, strict control of diabetes, hypertension, and dyslipidemia and monitoring of CCA-IMT may be important.
Copyright 2002 by W.B. Saunders Company