[How can determination of the carotid intima-media thickness contribute to the process of diagnosing transient ischaemic attacks?]. / Qué puede aportar la determinación del grosor íntima-media carotídeo al proceso diagnóstico del ataque isquémico transitorio?

PATIENTS AND METHODS: The carotid intima media thickness (IMT) is a new prognostic marker of vascular events. We studied its usefulness in the diagnosis workup of 211 consecutive transient ischemic attack (TIA) patients from the REGITELL registration. GIM was measured according to Mannheim criteria. It was established its relationship to the main prognostic variables described in TIA: ABCD2 scale, symptomatology and etiologic subtypes according to TOAST classification. RESULTS: Men value of carotid IMT was 0.91 ± 0.20 mm. After Bonferroni adjustment, IMT was associated with age of 60 years or older (0.95 ± 0.19 mm; p < 0.001), male sex (0.95 ± 0.20 mm; p = 0.003), ABCD2 scale (p < 0.001), association of risk factors are greater than or equal to 2 (0.94 ± 0.20 mm; p < 0.001), carotid plaque presence (0.98 ± 0.19 mm; p < 0.001), intracranial stenosis (1.09 ± 0.18 mm; p = 0.001), presence of ischemic chronic lesions on head CT (p <0.001) and etiology (p < 0.001). The patients presented with isolated sensory symptoms had significantly lower IMT (0.77 ± 0.18 mm; p = 0.002). Belonging to the third tertile of IMT was only an independent predictor of large-artery atherosclerosis (OR = 3,06; CI 95% = 1.31-7.13; p = 0.01). CONCLUSION: Based on our results, IMT determination seems to not improve the diagnostic accuracy of other ultrasonographic characteristics like the presence of plaques or the degree of stenosis.

¿Qué puede aportar la determinación del grosor íntima-media carotídeo al proceso diagnóstico del ataque isquémico transitorio? / How can determination of the carotid intima-media thickness contribute to the process of diagnosing transient ischaemic attacks?

Pacientes y métodos. El grosor íntima-media (GIM) carotídeo es un nuevo marcador pronóstico de episodios vasculares. Estudiamos su utilidad diagnóstica en 211 pacientes consecutivos con ataque isquémico transitorio del registro REGITELL, determinamos el GIM según criterios Mannheim y establecimos su utilidad en el proceso diagnóstico del ataque isquémico transitorio, concretamente en la determinación del subtipo etiológico según el criterio del estudio ORG 10172 (TOAST). Resultados. El valor del GIM carotídeo fue 0,91 ± 0,20 mm. Tras el ajuste de Bonferroni, el GIM se asoció a una edad igual o superior a 60 años (0,95 ± 0,19 mm; p < 0,001), sexo varón (0,95 ± 0,20 mm; p = 0,003), escala ABCD2 (p < 0,001), asociación de factores de riesgo vascular igual o superior a 2 (0,94 ± 0,20 mm), presencia de placas carotídeas (0,98 ± 0,19 mm; p < 0,001), estenosis intracraneal (1,09 ± 0,18 mm; p = 0,001), presencia de lesiones isquémicas crónicas en tomografía computarizada craneal (p < 0,001) y etiología (p < 0,001). Los pacientes con sintomatología sensitiva aislada presentaron GIM significativamente más bajos (0,77 ± 0,18 mm; p = 0,002). Pertenecer al tercer tercil del GIM sólo fue predictor independiente de etiología ateromatosa (odds ratio = 3,06; intervalo de confianza del 95% = 1,31-7,13; p = 0,01). Los valores inferiores del GIM se asociaron a etiología cardioembólica e indeterminada. Conclusión. A tenor de nuestros resultados, la utilidad diagnóstica directa de la determinación del GIM carotídeo parece en entredicho. Son más importantes otras variables ultrasonográficas, como la presencia de placas ateromatosas o el grado de estenosis (AU)

Patients and methods. The carotid intima media thickness (IMT) is a new prognostic marker of vascular events. We studied its usefulness in the diagnosis workup of 211 consecutive transient ischemic attack (TIA) patients from the REGITELL registration. GIM was measured according to Mannheim criteria. It was established its relationship to the main prognostic variables described in TIA: ABCD2 scale, symptomatology and etiologic subtypes according to TOAST classification. Results. Men value of carotid IMT was 0.91 ± 0.20 mm. After Bonferroni adjustment, IMT was associated with age of 60 years or older (0.95 ± 0.19 mm; p < 0.001), male sex (0.95 ± 0.20 mm; p = 0.003), ABCD2 scale (p < 0.001), association of risk factors are greater than or equal to 2 (0.94 ± 0.20 mm; p < 0.001), carotid plaque presence (0.98 ± 0.19 mm; p < 0.001), intracranial stenosis (1.09 ± 0.18 mm; p = 0.001), presence of ischemic chronic lesions on head CT (p <0.001) and etiology (p < 0.001). The patients presented with isolated sensory symptoms had significantly lower IMT (0.77 ± 0.18 mm; p = 0.002). Belonging to the third tertile of IMT was only an independent predictor of large-artery atherosclerosis (OR = 3,06; CI 95% = 1.31-7.13; p = 0.01). Conclusion. Based on our results, IMT determination seems to not improve the diagnostic accuracy of other ultrasonographic characteristics like the presence of plaques or the degree of stenosis (AU)