Association between Carotid Intima-Media Thickness and Acute Ischaemic Stroke

Background: Stroke is a major public health concern and the second leading cause of death globally. In India, modifiable risk factors like hypertension, smoking, and diabetes mellitus are highly prevalent and significantly contribute to cerebrovascular events. Carotid intima-media thickness (CIMT) is a non-invasive ultrasonographic marker of subclinical atherosclerosis and vascular remodeling. Identifying a link between CIMT and acute ischemic stroke can help predict stroke risk early and guide preventive interventions. Objective: To evaluate the association between common carotid artery intima-media thickness (CCA-IMT), carotid plaque scores, and acute ischemic stroke, and to assess how these ultrasound findings correlate with established vascular risk factors. Methods: This statistically powered, cross-sectional, case-control study included 80 participants (cases and controls) at Bapuji Hospital, Davangere, over a 3-month period (May?July 2024). All subjects underwent carotid Doppler ultrasonography using a 9?15 MHz linear transducer to measure CIMT and detect carotid plaques. Cases were first-time acute ischemic stroke patients confirmed by clinical and radiological criteria, while controls presented with non-stroke neurological complaints. Data on hypertension, diabetes, dyslipidemia, smoking status, and fasting biochemical profiles were collected. CIMT > 0.8 mm was considered abnormal. Results: Patients with acute ischemic stroke demonstrated significantly higher CIMT and plaque scores compared to controls. Abnormal CIMT correlated strongly with elevated fasting blood sugar (mean 130 ? 20 mg/dL), total cholesterol (mean 220 ? 30 mg/dL), male gender, hypertension (p<0.01), dyslipidemia (p<0.01), and diabetes mellitus (p<0.05). The presence and number of carotid plaques also showed a direct association with stroke risk. Conclusion: Increased CIMT and carotid plaque scores are significantly associated with acute ischemic stroke and reflect cumulative exposure to modifiable cerebrovascular risk factors. While CIMT itself may not be a direct cause, it serves as a reliable surrogate marker of atherosclerotic burden. Early detection via carotid ultrasound, along with aggressive management of hypertension, diabetes, dyslipidemia, and smoking, is crucial in reducing stroke risk.