The correlation study of carotid atherosclerotic plaque and recurrent cerebral infarction

Abstract

Objective To investigate the risk factors of the recurrence of cerebral infarction and the correlation between carotid atherosclerotic plaque and the recurrent cerebral infarction.Methods One hundred and twenty-six patients with cerebral infarction were divided into primary group with 72 cases and recurrent group with 54 cases.The age,habits (smoking,alcohol consumption),past medical history (including history of diabetes,coronary heart disease,atrial fibrillation and hypertension),triglyceride (TG),total cholesterol (TC),high density lipoprotein cholesterol (HDL-C),low density lipoprotein cholesterol (LDL-C) and high blood pressure level of the two groups were compared.The carotid intimamedia thickness (IMT),and the echo intensity,quantity,location of atherosclerotic plaque were observed by neck ultrasound,and then these factors were analyzed by non-conditional Logistic regression analysis.Results Age,history of diabetes,coronary heart disease,atrial fibrillation and hypertension between recurrent group and primary group had significant differences (P＜0.01 or ＜0.05).High blood pressure level of the recurrent group was significantly higher than that of the primarv group (P＜ 0.01 ).While IMT of carotid artery,carotid bifurcation,internal carotid artery of the recurrent group were obviously higher than those of the primary group,respectively (P＜0.01).The number of cases detected having plaques in the primary group was 31,43.1％ (31/72),the total plaque number was 87,and average plaque number was 1.21 ±0.76.These values in the recurrent group were 46,85.2％(46/54),96,1.78 ±0.92.The number of cases detected having plaques and average plaque number of the recurrent group were significantly higher than those in the primary group (P＜0.01).There were more cases with soft plaque in the recurrent group (61.5％,59/96),while more hard plaque in the primary group (60.9％,53/87),and the difference was significant (P ＜0.01).Non-conditional Logistic regression analysis showed that age,high blood pressure level,history of diabetes and atrial fibrillation,IMT of internal carotid artery,the number of soft plaque were the risk factors of the recurrence of cerebral infarction (OR =1.315,2.435,1.072,2.131,3.024,5.162,respectively,P ＜ 0.01 or ＜ 0.05 ).Conclusions Age,high blood pressure level,history of diabetes and atrial fibrillation,IMT of internaI carotid artery,the number of soft plaque are the risk factors of the recurrence of cerebral infarction.Observing the site and degree of carotid atherosclerosis,the characteristics of plaque besides monitoring blood pressure,blood glucose and other conventional indicators can have some predictive effect for the recurrence of cerebral infarction. Key words: Carotid artery diseases; Carotid stenosis; Brain infarction