ORIGINAL ARTICLES   

International Angiology 2002 June;21(2):117-22

Copyright © 2003 EDIZIONI MINERVA MEDICA

language: English

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.