# An Evaluation of Common Carotid Artery Intima-Media Thickness in Patients With Acute Ischemic Stroke: A Case-Control Study

## TL;DR

This study compares carotid artery thickness in stroke patients and healthy individuals to assess stroke risk in India.

## Contribution

The study establishes a novel association between increased CIMT and acute ischemic stroke in the Indian population.

## Key findings

- AIS patients had significantly higher CIMT (1.11 mm) compared to controls (0.91 mm).
- Lipid profile differences showed borderline significance with CIMT, particularly in low-density lipoproteins.
- Hemoglobin levels were significantly higher in AIS patients compared to controls.

## Abstract

Introduction: Stroke has major clinical and economic ramifications and is one of the world's top causes of morbidity and mortality. Over the past years, there has been an increasing trend in the occurrence of stroke in India. The association between increased common carotid artery intima-media thickness (CIMT) and stroke risk in India's general population has not been well studied. Thus, the purpose of this study is to evaluate, compare, and establish a relationship between the CIMT in acute ischemic stroke (AIS) patients and healthy individuals.

Methods: This prospective, observational, cross-sectional, and case-control study was conducted among patients admitted to the Departments of General Medicine and Neurology at a tertiary-care teaching hospital in Bengaluru, India. The study was conducted between March 2023 and March 2025 and included 50 patients. A total of 25 patients with AIS were included as cases, and 25 healthy individuals were included as controls. The carotid artery Doppler test was used to measure the CIMT. The hematological and biochemical parameters of all the study participants were measured using standard laboratory techniques.

Results: In both groups, the majority of individuals were aged 50 years or older. The control group's mean age was 56.64 ± 10.03 years, compared to 54.40 ± 12.36 years in the case group (t = 0.70, p = 0.48). In contrast to the control group, which had 92% (23) male and 8% (two) female participants (chi-square (𝜒2) = 0.50, p = 0.22), 80% (20) of the cases were male and 20% (five) were female participants. AIS patients had a considerably higher mean CMIT (1.11 ± 0.22 mm), which was significantly (t = -3.612, p = 0.0007) greater than controls (0.91 ± 0.19 mm). The comparison of hematological and biochemical parameters, including the lipid profile, between the case and control groups revealed statistically significant differences in total leucocyte count (TLC) and hemoglobin (Hb) levels. The mean TLC was significantly lower (t = 5.51 and p < 0.0001) in cases (8.89 ± 2.58 cells/mm3) than in controls (12.78 ± 2.41 cells/mm3). Similarly, Hb was significantly higher (t = -6.51 and p < 0.0001) in cases (13.17 ± 2.47 g/dL) than in controls (8.49 ± 2.61 g/dL). Among the lipid parameters, only low-density lipoproteins demonstrated borderline significance (p = 0.05) with CIMT.

Conclusions: Patients with AIS have considerably higher CIMT, which supports its application as a noninvasive and affordable diagnostic modality for identifying people who are more likely to experience cerebrovascular episodes.