# Predictive value of carotid artery contrast-enhanced ultrasound combined with clinical indicators in ischemic stroke patients

## TL;DR

This study shows that combining carotid artery ultrasound with blood markers improves predicting ischemic stroke risk.

## Contribution

Combining CEUS with TyG index and LDL/HDL ratio improves IS prediction accuracy.

## Key findings

- IS group had higher CEUS classification, TyG index, and LDL/HDL ratio than NIS group.
- CEUS classification, TyG index, and LDL/HDL ratio were independent risk factors for IS.
- Combined indicators achieved an AUC of 0.910, higher than any single indicator.

## Abstract

To assess the predictive significance of carotid artery contrast-enhanced ultrasound (CEUS) combined with the triglyceride glucose index (TyG index) and low-density lipoprotein (LDL) to high-density Lipoprotein (HDL) ratio in patients with ischemic stroke (IS).

This study included 130 patients admitted to the hospital from June 2021 to June 2023. All patients underwent carotid artery CEUS and were divided into two groups: the ischemic stroke group (IS, n = 73) and the non-ischemic stroke group (NIS, n = 57). Baseline characteristics of both groups were analyzed and compared to identify differences. Logistic regression analysis was performed to determine independent risk factors for IS. Receiver operating characteristic (ROC) curves were constructed to assess the predictive performance of CEUS classification, TyG index, LDL/HDL ratio, and their combination.

Among the 130 patients, the IS group consisted of 73 individuals (53 males, 20 females), with an average age of 64.87 ± 10.55 years, while the NIS group included 57 patients (20 males, 37 females) with an average age of 63.12 ± 10.26 years. The IS group exhibited significantly higher CEUS classification, TyG index, and LDL/HDL ratio compared to the NIS group. Logistic regression analysis identified CEUS classification (OR 3.521, 95% CI 1.731–7.161, p = 0.001), TyG index (OR 3.851, 95% CI 1.129–13.142, p = 0.031), and LDL/HDL ratio (OR 2.957, 95% CI 1.321–6.622, p = 0.008) as independent risk factors for IS. The areas under the ROC Curve (AUC) for predicting IS were 0.871 for CEUS classification, 0.766 for TyG index, and 0.735 for LDL/HDL ratio. The combined application of these indicators yielded an AUC of 0.910, which was significantly higher than that of any single indicator.

CEUS classification, TyG index, and LDL/HDL ratio are useful predictors of IS. Their combined use significantly enhances predictive accuracy.