Carotid IDR, peak systolic velocity tied to neurological severe ischaemic events in Takayasu arteritis

In patients with Takayasu arteritis, calculating the carotid intima-media thickness (IMT)/diameter ratio (IDR) and peak systolic velocity (PSV) may be useful in identifying neurological severe ischaemic events (SIEs), suggests a study.

This study included patients with supra-aortic involvement including brachiocephalic trunk, bilateral common carotid artery and internal carotid artery, and bilateral subclavian and vertebral artery and baseline carotid ultrasound examination.

The researchers measured bilateral carotid diameter, IMT, and PSV using ultrasound. They then calculated the IMT/IDR ratio. Multivariate logistic regression was used to analyse risk factors associated with neurological SIEs.

A total of 295 patients (88.14 percent female) were analysed, of whom 93 (31.53 percent) had neurological SIEs. Involved supra-aortic artery distribution (p=0.04) and number (p<0.01) differed between patients with neurologic and non-neurologic SIEs; this indicated higher prevalence of common carotid and vertebral artery involvement after Bonferroni correction and 56.99 percent of patients with at least four involved arteries in the neurological SIE group.

A substantial difference was observed in the bilateral IDR (p<0.01) between patients with and without neurological SIEs. The carotid IDR (left: cutoff value ≥0.55; odds ratio [OR], 2.75, 95 percent confidence interval [CI], 1.24‒6.07; p=0.01; right: ≥0.58; OR, 2.70, 95 percent CI, 1.21‒6.02; p=0.01), left carotid PSV (≤76.00 cm/s; OR, 3.09, 95 percent CI, 1.53–6.27; p<0.01), and involved supra-aortic artery number (≥4; OR, 2.33, 95 percent CI, 1.15–4.72; p=0.02) each correlated with neurological SIEs.