People with diabetes may be harbouring advanced vascular disease that could increase their risk of stroke, researchers warn.The findings suggest that arterial imaging with 3D MRI could be useful in helping to determine stroke risk among diabetics.
The carotid arteries are vessels on each side of the neck that supply oxygenated blood to the head.
Narrowing of the carotid arteries is associated with risk of stroke but less is known about stroke risk in people with little or no narrowing of these arteries.
For the new study, the team used 3D MRI to study the carotid arteries for evidence of intraplaque hemorrhage (IPH), an indicator of advanced atherosclerotic disease.
“A recent analysis has shown that people with carotid artery narrowing and IPH have a five- to six-times higher risk of stroke in the near future compared to people without,” explained study author Tishan Maraj, imaging analyst at Sunnybrook Research Institute in Toronto.
Dr Maraj and colleagues focused their study on people with diabetes.
Of the 159 patients imaged, 37 (23.3 per cent) had IPH in at least one carotid artery.
Five of the 37 patients had IPH in both carotid arteries.
IPH was found in the absence of carotid artery narrowing and was associated with an increased carotid artery wall volume as measured by 3D MRI.
“It was surprising that so many diabetic patients had this feature. So perhaps IPH is an early indicator of stroke risk that should be followed up,” Dr Maraj added.
Although there is no treatment for IPH at this time, Dr Maraj said identification of it may help with risk stratification and could even have applications in the non-diabetic population.
“Even though you can’t treat IPH, you can monitor patients a lot more closely,” he concluded.
The new research will be presented next week at the annual meeting of the Radiological Society of North America (RSNA).