Correlation analysis between carotid atherosclerosis and post-stroke cognitive impairment

Abstract Background Post-stroke cognitive impairment (PSCI) significantly impacts the quality of life and recovery of stroke survivors. An indicator capable of identifying the risk of cognitive decline upon admission can facilitate early identification and management of stroke patients. Objective Carotid ultrasound, being a low-cost, widely accessible, and easily measurable diagnostic tool, has drawn the interest of researchers. Consequently, we aimed to investigate the link between carotid atherosclerosis markers and PSCI in patients with mild ischemic stroke (AIS), with the goal of improving early identification and diagnosis of PSCI in patients. Methods We enrolled 181 patients diagnosed with acute ischemic stroke within seven days. Data analysis was conducted using baseline demographics, clinical risk factors, and carotid ultrasound parameters. Binary logistic regression was utilized to analyze the independent factors influencing PSCI. The receiver operating characteristic curve(ROC) was employed to assess the predictive value of carotid atherosclerosis indexes and models combining various independent influencing factors for PSCI. Results A total of 181 participants completed the 6-month follow-up, among whom 75 patients (41.1%) were diagnosed with PSCI. Logistic regression analysis revealed that carotid plaque Crouse score (OR = 1.111, 95% CI = 1.016–1.216) and severe stenosis of the carotid artery (OR = 2.774, 95% CI = 1.148–6.705) were independently associated with PSCI at 6–12 months. The predictive model for post-stroke cognitive impairment included carotid plaque Crouse score (AUC = 0.667) and degree of carotid artery stenosis (AUC = 0.596), along with other covariates, with an overall Area Under the Curve (AUC) of 0.818 (95% CI: 0.758–0.877). There were significant differences in the scores of AVLT-I, AVLT-II, VFT, TMT-B, CDT, and MoCA subdomains between PSCI and post-stroke non-cognitive impairment (PSNCI) patients at 6 months (P < 0.05). Conclusion The carotid atherosclerosis index in the acute phase of AIS is independently correlated with PSCI, and both the carotid plaque Crouse score and severe stenosis of the common carotid artery hold diagnostic value for PSCI.