ASSESSMENT OF CAROTID INTIMAL MEDIAL THICKNESS (CIMT) IN YOUNG PATIENTS WITH ISCHEMIC STROKE: A CASE CONTROL STUDY

Background: Incidence of ischemic stroke in younger patients in increasing leading to higher morbidity and mortality. Data on carotid intimal medial thickness (CIMT) as atherosclerotic marker in young ischemic stroke patients are scarce. Aims and Objective: To evaluate bilateral CIMT thickness and its correlation with various CVD risk factors in young ischemic stroke patients. Methods: Total 40 patients (15 to 45 age group) and age matched 40 controls were taken. Demographic profile and risk factors were evaluated. All subjects were taken for CIMT assessment by B mode ultrasonography scan in multiangle measurements in the common carotid artery (CCA), carotid bifurcation (BIF) and internal carotid artery (ICA). Results: 72.5% of patients were in 35- 45 years age group. Stroke incidence was higher in male. Age specific value of CIMT was higher in all cases as compared to age matched controls in all age group. (p? 0.01) Increasing age, smoking and hypertension were significantly associated with higher bilateral CIMT. Conclusion: Ischemic stroke young population is associated with increased CIMT. Risk factors burden is contributory in speeding up atherosclerotic process leading to higher CIMT with multiple co morbidities. Keywords: carotid intimal medial thickness, carotid bifurcation, ischemic stroke

Potential Factors for Psychological Symptoms at Three Months in Patients with Young Ischemic Stroke

Objective. Psychological status plays a vital role in the recovery in young ischemic stroke patients. However, few reports on the psychological symptoms in Chinese young ischemic stroke patients have been published. In the present study, we aimed to outline the psychological status of young ischemic stroke patients and its risk factors at three months after their stroke. Methods. 364 patients with young ischemic stroke and 384 age-matched healthy controls were consecutively recruited from our study hospitals of the mainland of China between June 2018 and November 2020. Social demographic and clinical data were collected from all enrolled participants in the acute stage of their stroke, and their psychological variables were assessed via the Symptom Checklist 90 Revised (SCL-90-R) at three-month timepoint after their stroke. Multivariable logistic regression analyses were run to identify the independent factors for psychological variables in patients. Results. Compared with healthy controls, patients with young ischemic stroke had significantly higher total score of SCL-90-R and all subscale total scores ( p < 0.01 or 0.05). 22.3% (81/364 cases) in young ischemic stroke patients had psychological abnormalities. Compared with young ischemic stroke patients without psychological symptoms ( n = 283 ), patients with psychological symptoms ( n = 81 ) had higher rate of married status ( p = 0.03 ), rate of hypertension ( p = 0.01 ), infarct size ( p = 0.01 ), and the family dysfunction ( p < 0.01 ). Multivariate logistic regression analyses revealed that the family dysfunction (odds ratio [OR], 2.50, 95% confidence interval [CI]: 1.71 to 3.54, p < 0.01 ), having hypertension (OR, 3.27, 95% CI: 1.92 to 4.27, p = 0.02 ), and ≥20mm3 infarct size (OR, 2.39, 95% CI: 1.53 to 3.45, p < 0.01 ) were independent factors for having psychological abnormalities in patients with young ischemic stroke at three months after their stroke. Single (OR, 1.23, 95% CI: 1.03 to 1.54, p = 0.01 ), poor family function (OR, 1.21, 95% CI: 1.05 to 1.45, p = 0.03 ), and ≥20mm3 infarct size (OR, 1.74, 95% CI: 1.14 to 3.13, p = 0.02 ) were independent factors for having depression in patents with psychological symptoms. The family dysfunction (OR, 2.32, 95% CI: 1.51 to 2.80, p < 0.01 ) and hypertension (OR, 2.41, 95% CI: 1.54 to 3.46, p = 0.03 ) were independent factors for emerging somatization and anxiety in patients with psychological symptoms, respectively. Conclusions. At three months after their stroke, young ischemic stroke patients had psychological problems and risk factors for developing them.