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Rivista di Angiologia

Official Journal of the International Union of Angiology, the International Union of Phlebology and the Central European Vascular Forum
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International Angiology 2002 June;21(2):117-22

lingua: Inglese

Carotid atherosclerosis and ischemic stroke in young patients

Oliviero U., Orefice G. *, Coppola G. *, Scherillo G., Ascione S. *, Casaburi C., Barbieri F. *, Saccà L.

Department of Clinical Medicine and Cardiovascular Sciences, and * Department of Neurology, University Federico II Medical School, Naples, Italy


Background. Epidemiological stud­ies indi­cate a high prev­a­lence of carot­id ath­ero­scler­o­sis in eld­er­ly ­patients with ischem­ic ­stroke. The aim of this study was to inves­ti­gate the pres­ence of early carot­id ath­e­ros­cle­rot­ic ­lesions in young sub­jects with ischem­ic ­stroke, in the ­absence of the com­mon ath­e­ros­cle­rot­ic risk fac­tors.
Methods. We stud­ied 98 young ­patients with first ischem­ic ­stroke (54 males and 44 ­females; mean age 41.2 years; range 32-50) and 96 ­healthy con­trols. All sub­jects under­went ultra­son­o­graph­ic scan­ning of the carot­id arter­ies accord­ing to a stan­dard­ized pro­to­col.
Results. The carot­id inti­ma-media thick­ness was sig­nif­i­cant­ly ­increased in the ­patient group (p<0.001) com­pared with con­trols. In addi­tion, the prev­a­lence of carot­id ath­e­ros­cle­rot­ic ­plaques was great­er in the ­patients than in the con­trols (p<0.001). In par­tic­u­lar, we detect­ed 18 non-occlu­sive carot­id ­plaques and 16 throm­bot­ic occlu­sions. In 8 ­patients, the ­lesions were bilat­er­al. The ech­o­graph­ic pat­tern of the ­plaques was hard in 8 cases, soft in 5 cases, and mixed in the remain­ing 5 cases.
Conclusions. We detect­ed an ­increased wall thick­ness of the carot­id arter­ies and an ­increased prev­a­lence of carot­id ath­e­ros­cle­rot­ic ­lesions and carot­id throm­bot­ic occlu­sions in young ­patients with ischem­ic ­stroke, with a rel­a­tive low inci­dence of car­di­o­vas­cu­lar risk fac­tors. This find­ing sug­gests that arte­ri­al inti­ma-media thick­ness per se is an impor­tant deter­mi­nant of vas­cu­lar dis­ease in young ­patients. The data also pro­vide indi­rect sup­port for the poten­tial role of genet­ic fac­tors in the gen­e­sis of ath­ero­scler­o­sis in young ­patients.

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