Analysis of Risk Factors Related to Carotid Artery in Patients with Acute Ischemic Stroke

Studying independent risk factors for carotid artery-related Acute Ischemic Stroke (AIS) in affected patients can help guide the clinical prevention and prognosis of AIS.

In this retrospective study, 81 patients who were admitted to our center for routine carotid ultrasound and contrast-enhanced ultrasound examinations were enrolled. The patients were assigned to the study and control groups based on whether they had AIS symptoms. Multivariate logistic regression was used to analyze the correlation between risk factors and carotid artery-related AIS.

Significant differences in Intraplaque Neovascularization (IPN) grade, vascular stenosis, different age stages, plaque length and diameter, and hypertension were observed between the two groups (P < 0.05). Two sonographers were satisfactorily consistent in IPN grading diagnosis (Kappa = 0.763). According to the multivariate logistic regression analysis, the IPN grade and hypertension were independent risk factors for carotid artery-associated AIS (P < 0.05). Receiver Operating Characteristic (ROC) analysis showed that IPN grading demonstrated better discriminative performance for AIS than lumen stenosis, with an Area Under the Curve (AUC) of 0.74 versus 0.65.

In the study group, the carotid plaques of AIS patients were mostly of IPN grade III-IV. The number of patients with IPN > II was significantly higher in the study group than in the control group (33.3% (27/81) vs. 7.4% (6/81); P < 0.05). The accuracy, sensitivity, specificity, and positive and negative predictive values of carotid canal cavity stenosis were approximately 65.43%, 64.29%, 66.67%, 67.50%, and 63.41%, respectively. For patients with IPN > II, the values for the aforementioned parameters were 76.54%, 81.81%, 72.92%, 85.36%, and 67.50%, respectively. Statistically significant differences in sensitivity and negative predictive value were observed between the two groups (P < 0.05).

IPN grading demonstrates a stronger association and higher discriminative ability for AIS than for carotid stenosis. It may provide valuable information for early clinical identification, risk stratification, and prevention of carotid artery-related AIS.