Incident stroke is associated with common carotid artery diameter and not common carotid artery intima-media thickness

Joseph F. Polak, Ralph L. Sacco, Wendy S Post, Dhananjay Vaidya, Martinson Kweku Arnan, Daniel H. O'Leary

Research output: Contribution to journalArticle

Abstract

BACKGROUND AND PURPOSE-: The common carotid artery interadventitial diameter is measured on ultrasound images as the distance between the media-adventitia interfaces of the near and far walls. It is associated with common carotid intima-media thickness (IMT) and left ventricular mass and might therefore also have an association with incident stroke. METHODS-: We studied 6255 individuals free of coronary heart disease and stroke at baseline with mean age of 62.2 years (47.3% men), members of a multiethnic community-based cohort of whites, blacks, Hispanics, and Chinese. Ischemic stroke events were centrally adjudicated. Common carotid artery interadventitial diameter and IMT were measured. Cases with incident atrial fibrillation (n=385) were excluded. Multivariable Cox proportional hazards models were generated with time to ischemic event as outcome, adjusting for risk factors. RESULTS-: There were 115 first-time ischemic strokes at 7.8 years of follow-up. Common carotid artery interadventitial diameter was a significant predictor of ischemic stroke (hazard ratio, 1.86; 95% confidence interval, 1.59-2.17 per millimeter) and remained so after adjustment for risk factors and common carotid IMT with a hazard ratio of 1.52/mm (95% confidence interval, 1.22-1.88). Common carotid IMT was not an independent predictor after adjustment (hazard ratio, 0.14; 95% confidence interval, 0.14-1.19). CONCLUSIONS-: Although common carotid IMT is not associated with stroke, interadventitial diameter of the common carotid artery is independently associated with first-time incident ischemic stroke even after adjusting for IMT. Our hypothesis that this is in part attributable to the effects of exposure to blood pressure needs confirmation by other studies.

Original languageEnglish (US)
Pages (from-to)1442-1446
Number of pages5
JournalStroke
Volume45
Issue number5
DOIs
StatePublished - 2014

Fingerprint

Carotid Intima-Media Thickness
Common Carotid Artery
Stroke
Confidence Intervals
Adventitia
Hispanic Americans
Proportional Hazards Models
Atrial Fibrillation
Coronary Disease
Blood Pressure

Keywords

  • Carotid arteries
  • Risk factors
  • Stroke
  • Ultrasonography

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Clinical Neurology
  • Advanced and Specialized Nursing

Cite this

Incident stroke is associated with common carotid artery diameter and not common carotid artery intima-media thickness. / Polak, Joseph F.; Sacco, Ralph L.; Post, Wendy S; Vaidya, Dhananjay; Kweku Arnan, Martinson; O'Leary, Daniel H.

In: Stroke, Vol. 45, No. 5, 2014, p. 1442-1446.

Research output: Contribution to journalArticle

Polak, Joseph F. ; Sacco, Ralph L. ; Post, Wendy S ; Vaidya, Dhananjay ; Kweku Arnan, Martinson ; O'Leary, Daniel H. / Incident stroke is associated with common carotid artery diameter and not common carotid artery intima-media thickness. In: Stroke. 2014 ; Vol. 45, No. 5. pp. 1442-1446.
@article{8110f27f79c241d4a53638ebe285a7c7,
title = "Incident stroke is associated with common carotid artery diameter and not common carotid artery intima-media thickness",
abstract = "BACKGROUND AND PURPOSE-: The common carotid artery interadventitial diameter is measured on ultrasound images as the distance between the media-adventitia interfaces of the near and far walls. It is associated with common carotid intima-media thickness (IMT) and left ventricular mass and might therefore also have an association with incident stroke. METHODS-: We studied 6255 individuals free of coronary heart disease and stroke at baseline with mean age of 62.2 years (47.3{\%} men), members of a multiethnic community-based cohort of whites, blacks, Hispanics, and Chinese. Ischemic stroke events were centrally adjudicated. Common carotid artery interadventitial diameter and IMT were measured. Cases with incident atrial fibrillation (n=385) were excluded. Multivariable Cox proportional hazards models were generated with time to ischemic event as outcome, adjusting for risk factors. RESULTS-: There were 115 first-time ischemic strokes at 7.8 years of follow-up. Common carotid artery interadventitial diameter was a significant predictor of ischemic stroke (hazard ratio, 1.86; 95{\%} confidence interval, 1.59-2.17 per millimeter) and remained so after adjustment for risk factors and common carotid IMT with a hazard ratio of 1.52/mm (95{\%} confidence interval, 1.22-1.88). Common carotid IMT was not an independent predictor after adjustment (hazard ratio, 0.14; 95{\%} confidence interval, 0.14-1.19). CONCLUSIONS-: Although common carotid IMT is not associated with stroke, interadventitial diameter of the common carotid artery is independently associated with first-time incident ischemic stroke even after adjusting for IMT. Our hypothesis that this is in part attributable to the effects of exposure to blood pressure needs confirmation by other studies.",
keywords = "Carotid arteries, Risk factors, Stroke, Ultrasonography",
author = "Polak, {Joseph F.} and Sacco, {Ralph L.} and Post, {Wendy S} and Dhananjay Vaidya and {Kweku Arnan}, Martinson and O'Leary, {Daniel H.}",
year = "2014",
doi = "10.1161/STROKEAHA.114.004850",
language = "English (US)",
volume = "45",
pages = "1442--1446",
journal = "Stroke",
issn = "0039-2499",
publisher = "Lippincott Williams and Wilkins",
number = "5",

}

TY - JOUR

T1 - Incident stroke is associated with common carotid artery diameter and not common carotid artery intima-media thickness

AU - Polak, Joseph F.

AU - Sacco, Ralph L.

AU - Post, Wendy S

AU - Vaidya, Dhananjay

AU - Kweku Arnan, Martinson

AU - O'Leary, Daniel H.

PY - 2014

Y1 - 2014

N2 - BACKGROUND AND PURPOSE-: The common carotid artery interadventitial diameter is measured on ultrasound images as the distance between the media-adventitia interfaces of the near and far walls. It is associated with common carotid intima-media thickness (IMT) and left ventricular mass and might therefore also have an association with incident stroke. METHODS-: We studied 6255 individuals free of coronary heart disease and stroke at baseline with mean age of 62.2 years (47.3% men), members of a multiethnic community-based cohort of whites, blacks, Hispanics, and Chinese. Ischemic stroke events were centrally adjudicated. Common carotid artery interadventitial diameter and IMT were measured. Cases with incident atrial fibrillation (n=385) were excluded. Multivariable Cox proportional hazards models were generated with time to ischemic event as outcome, adjusting for risk factors. RESULTS-: There were 115 first-time ischemic strokes at 7.8 years of follow-up. Common carotid artery interadventitial diameter was a significant predictor of ischemic stroke (hazard ratio, 1.86; 95% confidence interval, 1.59-2.17 per millimeter) and remained so after adjustment for risk factors and common carotid IMT with a hazard ratio of 1.52/mm (95% confidence interval, 1.22-1.88). Common carotid IMT was not an independent predictor after adjustment (hazard ratio, 0.14; 95% confidence interval, 0.14-1.19). CONCLUSIONS-: Although common carotid IMT is not associated with stroke, interadventitial diameter of the common carotid artery is independently associated with first-time incident ischemic stroke even after adjusting for IMT. Our hypothesis that this is in part attributable to the effects of exposure to blood pressure needs confirmation by other studies.

AB - BACKGROUND AND PURPOSE-: The common carotid artery interadventitial diameter is measured on ultrasound images as the distance between the media-adventitia interfaces of the near and far walls. It is associated with common carotid intima-media thickness (IMT) and left ventricular mass and might therefore also have an association with incident stroke. METHODS-: We studied 6255 individuals free of coronary heart disease and stroke at baseline with mean age of 62.2 years (47.3% men), members of a multiethnic community-based cohort of whites, blacks, Hispanics, and Chinese. Ischemic stroke events were centrally adjudicated. Common carotid artery interadventitial diameter and IMT were measured. Cases with incident atrial fibrillation (n=385) were excluded. Multivariable Cox proportional hazards models were generated with time to ischemic event as outcome, adjusting for risk factors. RESULTS-: There were 115 first-time ischemic strokes at 7.8 years of follow-up. Common carotid artery interadventitial diameter was a significant predictor of ischemic stroke (hazard ratio, 1.86; 95% confidence interval, 1.59-2.17 per millimeter) and remained so after adjustment for risk factors and common carotid IMT with a hazard ratio of 1.52/mm (95% confidence interval, 1.22-1.88). Common carotid IMT was not an independent predictor after adjustment (hazard ratio, 0.14; 95% confidence interval, 0.14-1.19). CONCLUSIONS-: Although common carotid IMT is not associated with stroke, interadventitial diameter of the common carotid artery is independently associated with first-time incident ischemic stroke even after adjusting for IMT. Our hypothesis that this is in part attributable to the effects of exposure to blood pressure needs confirmation by other studies.

KW - Carotid arteries

KW - Risk factors

KW - Stroke

KW - Ultrasonography

UR - http://www.scopus.com/inward/record.url?scp=84899962126&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84899962126&partnerID=8YFLogxK

U2 - 10.1161/STROKEAHA.114.004850

DO - 10.1161/STROKEAHA.114.004850

M3 - Article

VL - 45

SP - 1442

EP - 1446

JO - Stroke

JF - Stroke

SN - 0039-2499

IS - 5

ER -