Association Between Carotid Bulb Diaphragm and Ischemic Stroke in Young Afro-Caribbean Patients: A Population-Based
Julien Joux1, Marion Boulanger2, Severine Jeannin2
1From the Stroke Unit (J.J., S.J.), Department of Vascular Surgery (J.-L.H.), and Department of Cellular Pathology (V.M.), University Hospital of Martinique, French West Indies; Stroke Unit, Hospital sud francilien, Corbeil Essonnes, France (N.C., D.S.); Stroke Unit, University Hospital Pellegrin, Bordeaux, France (S.O.); and Université de Caen Normandie, Inserm U919, CHU Côte de Nacre, Caen France (M.B., E.T.). julien.joux@gmail.com.
Insights
Carotid bulb diaphragm (CBD) is linked to a higher risk of carotid ischemic stroke (CIS) in young Afro-Caribbean individuals. This study investigated the prevalence and association of CBD with CIS in this population.
Area of Science:
- Neurology
- Vascular Medicine
- Epidemiology
Background:
- Carotid bulb diaphragm (CBD) is observed in young patients with carotid ischemic stroke (CIS), particularly in Black populations.
- The prevalence of CBD in CIS patients and its role as a risk factor for CIS are not well-established.
- Previous research suggests a potential link, necessitating further investigation.
Purpose of the Study:
- To determine the prevalence of CBD in young CIS patients.
- To assess the association between CBD and incident CIS in a population-based cohort.
- To clarify if CBD is an independent risk factor for CIS in the studied demographic.
Main Methods:
- A population-based cohort study was conducted in Martinique (2012) including young (<55 years) CIS patients and age/sex-matched controls.
- Computed tomographic angiography (CTA) was used for comprehensive work-up in all participants.
- Poisson distribution and conditional logistic regression were employed to calculate incidence and adjusted odds ratios.
Main Results:
- The incidence of CIS associated with ipsilateral CBD was 3.8 per 100,000 person-years.
- Prevalence of ipsilateral CBD was 23% in all CIS patients and 37% in those with undetermined CIS.
- CBD was found to be 24 times more prevalent in undetermined CIS patients compared to controls (adjusted OR, 24.1).
Conclusions:
- Carotid bulb diaphragm (CBD) is significantly associated with an increased risk of ipsilateral carotid ischemic stroke (CIS).
- The findings highlight CBD as a potential risk factor for CIS in the young Afro-Caribbean population.
- Further research is warranted to understand the underlying mechanisms and clinical implications of CBD in stroke etiology.
Background And Purpose:
Carotid bulb diaphragm (CBD) has been described in young carotid ischemic stroke (CIS) patients, especially in blacks. However, the prevalence of CBD in CIS patients is unknown, and whether CBD is a risk factor for CIS remains unclear. We assessed the association between CBD and incident CIS in a population-based study.
Methods:
We selected all young (<55 years) CIS patients from a 1-year population-based cohort study in the Afro-Caribbean population of Martinique in 2012. All patients had a comprehensive work-up including a computed tomographic angiography. We calculated CIS associated with ipsilateral CBD incidence with 95% confidence intervals using Poisson distribution. We then selected age- and sex-matched controls among young (<55 years) Afro-Caribbean stroke-free patients admitted for a road crash who routinely had computed tomographic angiography. Odds ratio (ORs) were calculated by conditional logistic regression adjusted for hypertension, dyslipidemia, diabetes and smoking.
Results:
CIS associated with ipsilateral CBD incidence was 3.8 per 100 000 person-years (95% confidence interval, 1.4-6.1). Prevalence of ipsilateral CBD was 23% in all CIS and 37% in undetermined CIS patients. When restricted to undetermined CIS, CBD prevalence was 24 times higher than that in controls (adjusted OR, 24.1; 95% confidence interval, 1.8-325.6).
Conclusions:
CBD is associated with an increased risk of ipsilateral CIS in young Afro-Caribbean population.
More Related Videos
09:36A Magnetic Resonance Imaging-based Computational Protocol for Analysis of Plaque Morphology and Hemodynamics in Patients with Carotid Artery Stenosis
Published on: August 12, 2025
07:46Bilateral Common Carotid Artery Occlusion as an Adequate Preconditioning Stimulus to Induce Early Ischemic Tolerance to Focal Cerebral Ischemia
Published on: May 9, 2013
