scholarly journals An Observational Study Of Risk Factors And Their Association With Carotid Intima- Media Thickness In Cases Of Ischemic Stroke

2020 ◽  
Vol 7 (05) ◽  
pp. 4788-4794
Author(s):  
Dr. Arun Tyagi ◽  
Dr. A.K Shrivastava ◽  
Dr Marcia Waran
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Ischemic Stroke ◽  
Observational Study ◽  
Carotid Stenosis ◽  
Tobacco Use ◽  
Heart Diseases ◽  
Intima Media Thickness ◽  
Stroke Patients ◽  
Media Thickness

INTRODUCTION Currently, ischemic heart diseases and stroke are the leading causes of morbidity and mortality worldwide and more than 80% of deaths occurring in the low and the middle-income countries. There are a number of risk factors associated with ischemic stroke; the important ones being hypertension, diabetes mellitus, tobacco use and hyperlipidemia. All the risk factors also contribute towards atherogenesis. Change in the carotid artery intima–media thickness (CIMT) is an indicator of generalized atherosclerosis. This study was conducted to find out correlation between risk factors and CIMT in the stroke patients of western Maharashtra. AIMS AND OBJECTIVES This observational study was conducted in department of medicine from February 2013 to June 2014 to study the risk factors and their association with CIMT if any, in patients of stroke. Fifty stroke patients admitted in the medical ICU were studied. RESULTS Thirty-five patients out of 50 studied had ischemic stroke. Tobacco use (82%) and hypertension (80%) were the commonest risk factors for stroke followed by, dyslipidemia, obesity, metabolic syndrome and diabetes mellitus. Twenty-four (68.5%) out of 35 ischemic stroke patients had CIMT value more than 1.00 mm. Out of 35 ischemic stroke patients 15 had carotid stenosis; four severe (>70%), five moderate (50% - 70%) and six patients had mild (<50%) stenosis. Out of the patients with carotid stenosis, 13 patients had hypertension, 12 were tobacco user, 8 dyslipidemia and 6 had diabetes mellitus. CONCLUSION Increased CIMT is a marker of generalized atherosclerosis and it correlates directly with other risk factors like age, tobacco use, hypertension, diabetes and dyslipidemia.

scholarly journals Pengaruh Simvastatin Terhadap Ketebalan Intima-Media Karotis Pada Pasien Stroke Iskemik Dengan Diabetes Mellitus Tipe 2

2019 ◽  
Vol 6 (1) ◽  
pp. 20-23
Author(s):  
Aditya Kurnianto ◽  
Dodik Tugaswowo Pramukarso
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Ischemic Stroke ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
T Test ◽  
Stroke Patients ◽  
Media Thickness

BACKGROUND :Ischemic stroke is the most common stroke comprising 70-80% of all cases. Carotid intima-media thickness (CIMT) is associated with the occurrence of stroke in older age and adults. Patients with type 2 diabetes mellitus tend to develop a thickening of intima-media carotid artery. Simvastatins inhibit further atherothrombotic process. OBJECTIVE : To analyze the effect of simvastatin for CIMT in ischemic stroke patient with type 2 diabetes mellitus. METHOD : This study was a Randomized Pretest-Posttest Design and conducted at the Hospital Inpatient Ward Dr. Kariadi and Ketileng Semarang from January to December 2014 for all first ischemic stroke patients with Type 2 Diabetes Mellitus. Subjects were divided into groups of 26 controls and 28 patients treated groups. Treatment group were given simvastatin 20 mg each daily for 24 weeks in 28 subjects with a history of acute ischemic stroke and type 2 Diabetes mellitus. Examine the CIMT at the 1st week and 24th week. The normality of the data were tested using Shapiro Wilk and the differences analyzed by using Paired t-test and independent t test. RESULT : There was a significant differences between delta carotid intima-media thickness on administration of simvastatin for ischemic stroke patients with type 2 diabetes mellitus (p=0,008). CONCLUSION : Simvastatin significantly decreases CIMT on ischemic stroke patients with type 2 diabetes mellitus. Keyword : simvastatin, ischemic stroke, carotid intima-media thickness, type 2 diabetes mellitus   LATAR BELAKANG :Stroke iskemik memiliki angka insidensi terbanyak yaitu 70-80% kasus stroke. Ketebalan Intima-media karotis berhubungan dengan terjadinyastroke pada usia tua.Pasien dengan Diabetes mellitus tipe 2 memiliki kemungkinan yang lebih besar mengalami penebalan intima-media carotis. Simvatatin menghambat proses aterotrombosis. TUJUAN :Untuk menganalisis pengaruh simvastatin terhadap ketebalan intima-media karotis pada pasien stroke iskemik dengan diabetes mellitus tipe 2. METODE :Penelitian ini adalah dengan Randomized Pretest-Posttest Design dan telah dilakukan di Rawat Jalan RSUP dr. Kariadi dan poli saraf rawat jalan RSUD Kota Semarang mulai Januari sampai dengan Desember 2014 untuk semua pasien stroke iskemik pertama kali dengan diabetes mellitus tipe 2. Subjek dibagi menjadi kelompok kontrol 26 pasien dan kelompok perlakuan 28 pasien. Kelompok perlakuan diberi simvastatin 20 mg sehari selama 24 minggu pada 28 subjek stroke iskemik dengan  diabetes mellitus tipe 2. Pemeriksaan ketebalan intima-media karotis dilakukan pada minggu ke-1 dan minggu ke-24. Data kemudian di uji normalitasnya menggunakan Saphiro wilk, lalu di analisis menggunakan uji beda paired t testdan independent t test. HASIL :  Kelompok perlakuan didapatkan penurunan ketebalan tunika intima arteri karotis (0,395 + 0,46; p=0,514), KESIMPULAN : Pemberian simvastatin menurunkan ketebalan intima-media karotis secara bermakna pada pasien stroke iskemik dengan diabetes mellitus tipe 2. Kata Kunci     :simvastatin,stroke iskemik, ketebalan intima-media karotis, diabetes mellitus tipe 2      

scholarly journals Prevalence of Modifiable Risk Factors among Stroke Patients in a Tertiary Care Hospital in Dhaka

1970 ◽  
pp. 18-21 ◽  
Author(s):  
Md Badiuzzaman ◽  
Fazle Rabbi Mohammed ◽  
Fazle Rabbi Chowdhury ◽  
Md Shafiqul Bari ◽  
Md Billal Alam ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Heart Diseases ◽  
Tertiary Care ◽  
Modifiable Risk Factors ◽  
Care Hospital ◽  
Stroke Patients ◽  
Female Ratio ◽  
History Of ◽  
Arachnoid Hemorrhage

Background: An event of stroke can be ignited by a number of risk factors, some of which are nonmodifiable and some are modifiable. Hypertension, diabetes mellitus, different heart diseases, hyperlipidemia and smoking belong to the latter group and their prevalence shows immense diversity worldwide. In this study we tried to identify the most prevalent risk factor for stroke. Categorization of various types of stroke and history of noncompliance in medication has also been evaluated. Methods: This direct observational study was carried out on 400 patients of stroke admitted in different medicine units of Dhaka Medical College Hospital from July to December, 2007. Only patients having clinical diagnosis of stroke, confirmed by CT scan or MRI, were recruited. Patients were grouped into ischemic or hemorrhagic stroke or sub arachnoid hemorrhage. Results: The male, female ratio was found 1.2:1. In the study cerebral infraction, intra cerebral hemorrhages (ICH) and sub arachnoid hemorrhage (SAH) were found in 56.25%, 38.25% and 5.5% patients respectively. In case of Ischemic stroke and ICH males were predominantly affected but in case of SAH females were predominant. Among patients, hypertension was found in 58.62% followed by smoking (53.79%), lipid disorder (48.01%), heart diseases (25.75%), diabetes mellitus (20.01%), and previous history of stroke (10.61%). 40% patients were on irregular use of antihypertensive drug and it was 17.5% in case of anti diabetic drugs. Major groups (42.44%) of patients have two modifiable risk factors. Conclusion: Stroke is better to prevent than to cure. Identification of risk factors is the only way to achieve this goal. Implementation of screening programme in community to identify risk factors and educate people about primary prevention should be initiated in this regard. This way, we can reduce morbidity and mortality among stroke patients and alleviate the burden of stroke.   doi:10.3329/jom.v10i3.2011   J Medicine 2009; 10 (Supplement 1): 18-21

scholarly journals Thicker Carotid Intima Media Thickness in Children with Monocyte Chemoattractant Protein-1: A-2138T and A-2464G Mutation

2014 ◽  
Vol 2014 ◽  
pp. 1-6
Author(s):  
Yuyun Yueniwati ◽  
Valentina Yurina ◽  
Mohammad Rasjad Indra
Keyword(s):  
Ischemic Stroke ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Promoter Polymorphism ◽  
Stroke Patients ◽  
Monocyte Chemoattractant Protein 1 ◽  
Monocyte Chemoattractant ◽  
Monocyte Chemoattractant Protein ◽  
Media Thickness ◽  
Pcr Method

Carotid intima media thickness (CIMT) is clearly associated with atherosclerosis. Studies in ischemic stroke patients reveal that there is a significant association between CIMT with monocyte chemoattractant protein-1 (MCP-1) and osteopontin (OPN) promoter polymorphism. This research aims to explain the effect of MCP-1 and OPN promoter polymorphism toward CIMT changes identified in Javanese Indonesian children. Subjects were 54 children: 27 were from parents with ischemic stroke (cases), and 27 were from healthy parents (controlled). The CIMT was examined by utilizing high resolution B-mode ultrasound. Physical examination and genotyping analysis of MCP-1 promoter were conducted by employing PCR method. Research results indicate that two polymorphisms were obtained, that is, A-2138T and G-2464A, respectively. A-2138T polymorphism was found in 5% of case children and in 14.3% of controlled children. G-2464A polymorphism was found in 5% of case children. CIMT of case children was significantly different from that of controlled children (0.61±0.012 mm versus,0.52±0.015 mm,P=0.021). Subjects with MCP-1 promoter polymorphism have 1.471 times higher tendency to have thicker CIMT than subjects with no polymorphism in MCP1 promoter. OPN promoter T-66G was also studied but it did not indicate occurrence of polymorphism in samples.

Ischemic Stroke and its Association with Risk Factors at Nepalgunj Medical College Teaching Hospital Kohalpur

2021 ◽  
Vol 18 (2) ◽  
pp. 48-50
Author(s):  
Shyam Kumar BK ◽  
Sushil Baral ◽  
Nabin Paudel ◽  
Hitesh Neupane
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Ischemic Stroke ◽  
Carotid Artery ◽  
College Teaching ◽  
Intima Media Thickness ◽  
Cerebrovascular Diseases ◽  
Media Thickness ◽  
Number Of Patients ◽  
Carotid Doppler

Introduction: Incidence of stroke increases with age and growing elderly population worldwide, the number of patients with stroke are likely to increase. It is the third most common cause of death in world in that 85% are ischemic in nature. Atherosclerosis is a major risk factor in cerebrovascular diseases. Carotid Intima Media thickness (CIMT) is a surrogate marker of atherosclerosis and provides a non-invasive method for the risk assessment of cerebrovascular diseases. Aims: To study the atherosclerotic risk profile of patients admitted with ischemic stroke in medical ward with study of the carotid artery intima-media thickness in patients with acute ischemic stroke. Methods:  92 patients with ischemic strokes were studied in this observational study. Carotid Doppler was performed in all patients with emphasis on carotid artery stenosis and intima thickening. Analysis of Association of various risk factors was done in detail. Study period was from June 2019 to May 2020. Results: Higher degree of stenosis was associated with hypoechoic plaques and cortical strokes. Hypertension was the most common and most significant risk factor. Multiple risk factors also appear to have synergistic actions. Conclusion: Various modifiable risk factors provide valuable target for primary and secondary prevention of stroke. Carotid Doppler is a very cheap and highly effective tool for further management of stroke patients. Most of the asymptomatic patients, risk factors may warrant precautionary carotid Doppler, and may result in significant reduction in disease burden on the families and the community and should be encouraged.

Abstract T P338: To Evaluate the Efficacy and Safety of Cilostazol in Ischemic Stroke Patients with Peripheral Arterial Disease (SPAD) Study: Methodology and Baseline Data

Stroke ◽  
2014 ◽  
Vol 45 (suppl_1) ◽  
Author(s):  
Jiann-Shing Jeng ◽  
Li-Ming Lien ◽  
Sien-Tsong Chen ◽  
Chung Y. Hsu ◽  
Keyword(s):  
Diabetes Mellitus ◽  
Ischemic Stroke ◽  
Peripheral Arterial Disease ◽  
Carotid Stenosis ◽  
Smoking Habit ◽  
Arterial Disease ◽  
Stroke Patients ◽  
Vascular Events ◽  
Safety And Efficacy ◽  
Peripheral Arterial

Background and Purpose: Ischemic stroke often co-exists with peripheral arterial disease (PAD). Patients with polyvascular diseases carry higher risks of vascular events and death. We initiated a study to evaluate the safety and efficacy of cilostazol in ischemic Stroke patients with PAD (SPAD) and have been taking aspirin for stroke prevention. Methods: The SPAD study is a prospective, multicenter, national, double-blinded, placebo-controlled, randomized trial. Patients with previous ischemic stroke or TIA who have been taking aspirin (100 mg per day), aged 50 years or older, with PAD in the lower limbs based on ankle-brachial index (ABI) <1.0 were randomized to the treatment group with cilostazol (200 mg/day) or the placebo group with a 1:1 basis. Each patient is periodically followed-up for one year. The primary endpoint of the study is the change in the ABI. The secondary endpoints are the change in the common carotid artery intima-media thickness (IMT); major cardiovascular events, including recurrent stroke, myocardial infarction, unstable angina, other vascular events, and all death; and the safety, including major bleeding events, hemorrhagic stroke, and any death. Results: From September, 2010 to July, 2012, a total of 800 patients (male, 59.9%; female, 40.1%; average age, 70.4±9.3 years) were enrolled in the SPAD study, including 722 (90.2%) with ischemic stroke or 78 (9.8%) with TIA. Several atherosclerotic risk factors were commonly seen in this study population, including hypertension (88%), diabetes mellitus (48%), hypercholesterolemia (54%), smoking habit (41%), and carotid stenosis (15%). The distribution of baseline ABI were 0.90-0.99 (n=294), 0.70-0.89 (n=371), and <0.70 (n=136). Patients with lower ABI were more frequently associated with old age, lower body mass index, smoking habit, diabetes mellitus, carotid stenosis ≥50%, and higher systolic blood pressure. Conclusions: The SPAD trial is the first study to evaluate the safety and efficacy of dual antiplatelets, aspirin plus cilostazol, in ischemic stroke patients with PAD. The trial findings are expected to help in choosing better strategy for prevention of vascular events in this polyvascular disease.

scholarly journals Study On Stroke In Young Patient Due To Cardiac Disease in Tertiary Care Hospital in Dhaka City

2016 ◽  
Vol 17 (2) ◽  
pp. 95-99
Author(s):  
Sanjoy Kumar Saha ◽  
Prodip Kumar Biswas ◽  
Meherunessa Mukta ◽  
Mohammed Shahadat Hossain ◽  
Mimal Kumar Basu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Ischemic Stroke ◽  
Cardiac Disease ◽  
Heart Diseases ◽  
Tertiary Care ◽  
Care Hospital ◽  
Stroke Patients ◽  
Female Ratio ◽  
Valvular Heart Diseases

Objectives: Study of the risk factors associated with stoke due to cardiac disease in age group between 18 to 45 years of age,evaluate the risk factor of hospitalized stroke patients & to search for cardiac disease associated with stroke also appropriate preventive measure applicable for our country.Materials & Methods: Non randomized prospective observational study was carried out in the department of Neurology, Medicine & Cardiology unit of Dhaka Medical College Hospital between the periods of July 2009 to December 2009. Fifty (50) consecutive indoor patients more than 18 years of both sex admitted with suspicion of stroke. Diagnosis of stroke will be made from details clinical history clinical examination and confirmed by CT scan or MRI.Result: Fifty patients were randomly chosen for this study, of which 26 (52%) patients were male, 24 (48%) patients were female & male: female ratio was 1.08:1. Highest incidence of stroke was in between 3rd & 4th decade. The incidence of ischemic stroke 46 (92%) & hemorrhagic stroke 4(8%).Cardio embolism is the major (92%) risk factor for ischemic stroke. Among the cardiac risk factors, valvular disease (64%), MI (16%), &IHD (10%), Atrial fibrillation 8%, Patent foramen ovale 2%.Among the patients 33.33% of women with cerebral infarction were using OCP. Majority of the patients in this study were sedentary worker (45%). Among the stroke patients 8% & 10% had previous H/O stroke & TIA respectively.Conclusion: In this study a number of modifiable risk factors were identified, of which valvular heart disease & HTN are important risk factor next are DM & IHD smoking. Most of the valvular heart diseases are rheumatic in origin, which can be prevented through primary & secondary prevention of rheumatic fever.J MEDICINE July 2016; 17 (2) : 95-99

scholarly journals Carotid artery intima-media thickness in patients with acute ischemic stroke and its correlation with risk factors for atherosclerosis and/or stroke

2014 ◽  
Vol 6 (1) ◽  
pp. 22-27
Author(s):  
Shovan Kumar Das ◽  
Amit Sarkar ◽  
Subhraprakash Pramanik ◽  
Mitabha Bandyopadhyay ◽  
Koushik Mondal ◽  
...  
Keyword(s):  
Risk Factors ◽  
Ischemic Stroke ◽  
Carotid Artery ◽  
Acute Ischemic Stroke ◽  
Intima Media Thickness ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Media Thickness ◽  
Matched Study ◽  
Atherosclerotic Risk Factors

Introduction: Stroke is the second leading cause of mortality worldwide. Ischemic stroke is  more prevalent than hemorrhagic stroke and atherosclerosis is the major cause of ischemic stroke. The increased carotid artery intima-media thickness (CIMT) is considered to be useful indicator of early atherosclerosis. So, this study was aimed to correlate the relationship between atherosclerotic risk factors and intima-media thickness of carotid artery in patients with acute ischemic stroke. Material and Methods: In this cross-sectional study, 100 consecutive patients of acute ischemic stroke and 50 healthy relatives of patients as control were studied for presence of atherosclerotic risk factors and carotid artery intima?media thickness by B-mode Doppler ultrasonography.Results: In this age and sex matched study, higher CIMT measurement was found among patients of acute ischemic stroke than healthy controls (0.849 ± 0.196 vs 0.602 ± 0.092; p < 0.001). The CIMT was well correlated with smoking (Beta = 0.295; t = 5.728; 95% CI 0.088 to 0.181; p < 0.001); hypertension (Beta = 0.387; t = 6.518; CI 0.112 to 0.209; p < 0.001); di abetes (Beta = 0.237; t = 4.848; CI 0.074 to 0.175; p < 0.001); hypercholesterolemia (Beta = 0.292; t = 5.840; CI 0.096 to 0.195; p < 0.001), but not with age (p = 0.153). The CIMT was also found to be higher among acute ischemic stroke patients who were smoker, hypertensive, diabetic and hypercholesterolemic than non?smoker, normotensive, non-diabetic and normo-cholesterolemic respectively. Conclusion: The CIMT being indicator of atherosclerosis can be used as future predictor of ischemic stroke. DOI: http://dx.doi.org/10.3126/ajms.v6i1.10301 Asian Journal of Medical Sciences Vol.6(1) 2015 22-27

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