Association between Carotid Artery Stenosis and Cognitive Impairment in Stroke Patients: A Cross-Sectional Study

PLoS One. 2016 Jan 11;11(1):e0146890. doi: 10.1371/journal.pone.0146890. eCollection 2016.

Abstract

To investigate potential associations between carotid artery stenosis and cognitive impairment among patients with acute ischemic stroke and to provide important clinical implications. We measured the degree of carotid artery stenosis and recorded the Mini-Mental State Examination score (MMSE) at admission in 3116 acute ischemic stroke patients. The association between carotid stenosis and cognitive impairment assessed by MMSE was tested using multivariate regression analysis. Other clinical variables of interest were also studied. After adjusting for age, gender, education level, marriage, alcohol use, tobacco use, physical activity, hypertension, diabetes, hypercholesterolemia, atrial fibrillation, myocardial infarction and NIHSS (National Institutes of Health Stroke Scale) score, we found that participants with high-grade stenosis of the carotid artery had a higher likelihood of cognitive impairment compared to those without carotid artery stenosis (OR = 1.49, 95%CI: 1.05-2.11, p<0.001). Left common carotid artery stenosis was associated with cognitive impairment in the univariate analysis, although this effect did not persist after adjustment for the NIHSS score. Cognitive impairment was associated with high-grade stenosis of the right carotid artery.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Body Mass Index
  • Carotid Artery, Common / physiopathology*
  • Carotid Stenosis / complications*
  • Carotid Stenosis / diagnosis
  • Cognition Disorders / complications*
  • Cognition Disorders / diagnosis
  • Cross-Sectional Studies
  • Female
  • Humans
  • Male
  • Mental Status Schedule
  • Middle Aged
  • Neuropsychological Tests
  • Odds Ratio
  • Oxidative Stress
  • Patient Admission
  • Prospective Studies
  • Registries
  • Severity of Illness Index
  • Stroke / complications*
  • Stroke / diagnosis
  • Young Adult

Grants and funding

The study was sponsored by the Stroke Screening and Prevention Engineering Office of the National Health and Family Planning Commission. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.