Aim – to analyze the effect of carotid stenosis of varying severity in combination with other factors on the risks of primary and recurrent ischemic stroke, using methods of mathematical regression analysis.
Material and methods. The study included 606 patients (examination by a neurologist, contrast-enhanced CT scan of the brain, ultrasound of the vessels of the head and neck, other tests and instrumental studies). The degree of carotid stenosis was assessed using the NASCET method (stenosis 0-49%, 50-69%, 70% or more). For the purpose of mathematical analysis, patients were divided into 3 comparison groups: those without a history of stroke, patients with a single stroke, and a group of patients with two or more ischemic strokes. In the presence of a history of stroke, the size of the ischemic lesion was assessed according to CT data, the severity of neurological deficit according to the NIHSS scale and the degree of its recovery, and the functional outcome of ischemic stroke (Rankine scale, Rivermead index). The study used logistic regression analysis to assess the relationship between the dependent variable (presence of primary or recurrent stroke) and a set of predictors, which were a set of clinical and instrumental indicators.
Results. The presence of carotid stenosis of 50%-69%, when combined with pathology of the cardiovascular system, acts as a factor that significantly increases the risk of developing primary ischemic stroke. Exceeding the size of the stenotic lesion by more than 70% has a high level of significance in the likelihood of recurrent ischemic stroke, this fact must be taken into account for secondary prevention of stroke.
Conclusion. Preliminary assessment and analysis of the degree of carotid stenosis and other comorbid factors, which together influence the risks of developing primary and recurrent ischemic stroke, has an undoubted potential for reducing the risk of recurrent vascular accidents and organizing a personalized approach to surgical treatment of patients.
