Predictive value of carotid atherosclerotic plaques assesment, in combination with glycosylated hemoglobin A1c and C-reactive protein levels, for disease progression in young patients with acute ischemic stroke.

Valor predictivo de la detección de placas ateroscleróticas carotídeas, en combinación con los niveles de hemoglobina glicosilada A1c y proteína C reactiva, para la progresión de la enfermedad en pacientes jóvenes con accidente cerebrovascular isquémico agudo.

• Shuting Jiang Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, Jiangsu Province, China. https://orcid.org/0009-0004-7236-8127
• Hongquan Liu Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, Jiangsu Province, China. https://orcid.org/0009-0003-5246-3939
• Chen Zhong Hepatobiliary Center, The First Affiliated Hospital of Nanjing Medical University, Key Laboratory of Liver Transplantation, Nanjing, Jiangsu Province, China. https://orcid.org/0009-0009-6729-6823
• Jie Yang Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, Jiangsu Province, China. https://orcid.org/0009-0004-8218-9376
• Yue Qin Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, Jiangsu Province, China. https://orcid.org/0009-0006-7083-8679
• Yechen Lu Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, Jiangsu Province, China. https://orcid.org/0009-0005-6100-435X
• Mingming Fang Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, Jiangsu Province, China. https://orcid.org/0009-0007-8211-0789

DOI: https://doi.org/10.54817/IC.v67n2a04

Keywords: Ischemic Stroke, Plaque, Atherosclerotic, Carotid Arteries, C-Reactive Protein, Hemoglobin HA1c

Abstract

This study evaluated the predictive significance of combining carotid atherosclerotic plaques assesment with glycosylated hemoglobin A1c (HbA1c) and C-reactive protein (CRP) levels for disease progression in young acute ischemic stroke (AIS) patients. A total of 130 subjects were evenly recruited, comprising young patients with AIS admitted between January 2015 and March 2025 (case group) and healthy individuals undergoing physical examinations during the same period (control group). Comparisons were conducted on  the incidence rate of carotid  atherosclerotic plaques and serum HbA1c and CRP levels. The case group was categorized into mildmoderate and severe groups according to the National Institute of Health Stroke Scale (NIHSS) score. Significant differences were observed between the severe and mildmoderate groups in NIHSS scores, carotid atherosclerotic plaque incidence, and serum levels of HbA1c and CRP (p<0.05). Increased serum HbA1c levels, elevated CRP levels, and presence of carotid atherosclerotic plaques functioned as risk factors for AIS progression in young patients (odds ratio>1, p<0.05). Serum HbA1c and CRP levels, along with the presence of carotid atherosclerotic plaques, showed a positive correlation with NIHSS scores (r>0, p<0.05). The areas under the ROC curves of serum HbA1c and CRP levels, carotid athero- sclerotic plaques and their combination for assessing AIS progression in young patients were 0.810, 0.823, 0.781, and 0.905, respectively. Elevated HbA1c, CRP, and the presence of carotid plaques are associated with AIS severity in young patients. Combined detection improves predictive accuracy, suggesting clinical utility for risk stratification.

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