Abstract TMP97: Impact of Intima Media Thickness on Stroke Recurrence in Patients With Transient Ischemic Attack

Introduction: Carotid stenosis lesions are a risk factor for stroke recurrence after transient ischemic attack (TIA) and are taken into consideration when determining the ABCD 3 -I score. However, few reports have examined the impact of the degree of maximum intima media thickness (max IMT) by sonographic examination on stroke recurrence. Hypothesis: We hypothesized that a larger max IMT would be associated with a greater risk of stroke recurrence. Methods: We enrolled 3,100 consecutive acute stroke patients who were hospitalized in our stroke center from June 2007 to February 2016. The clinical characteristics of patients were assessed on admission, and the clinical course of all patients was subsequently followed. Patients were divided into four groups based on the level of max IMT: I (max IMT < 1.1 mm), II (max IMT ≥ 1.1 but < 2.1 mm), III (max IMT ≥ 2.1 but < 3.1 mm), and IV (max IMT ≥ 3.1 mm). We performed multivariate cox proportional hazards analyses to determine the influence of max IMT grade in these groups on stroke recurrence. Results: Of all patients, 468 (295 men, 68 ± 13 years) cases with TIA were investigated in the present study. Thirty-seven patients (9.2%) suffered recurrence of ischemic stroke during the follow-up period of three months. The three-months gross recurrence rate was 7.7% in group I, 8.7% in group II, 11.4% in group III, and 28.6% in group IV. The Kaplan-Meier method revealed significantly different cumulative recurrence rates of ischemic stroke in the four groups of patients, as shown in Figure 1 (I vs. IV, p < 0.01, log-rank test). On Cox proportional analysis with adjustments for multiple confounding factors, group IV (hazard ratio: 6.17, 95% confidence interval: 1.86-8.52, p < 0.05) had a greater risk of stroke recurrence compared with group I (reference). Conclusions: There is a significant relationship between the level of max IMT and recurrence of ischemic stroke. TIA patients with a larger max IMT have a greater risk of stroke recurrence.