Risk of Stroke and Cardiac Events in Medically Treated Asymptomatic Carotid Stenosis

Divya, Kalikavil Puthenveedu; Sandeep, Nayani; Sarma, Sankara P.; Sylaja, P N

doi:10.1016/j.jstrokecerebrovasdis.2015.05.030

Cited by 12 publications

(7 citation statements)

References 20 publications

(14 reference statements)

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“…[ 13 ] Among them, AF is especially relevant since it raises the risk for stroke dramatically[ 21 ], with a reported five-fold higher risk[ 22 ]. Another risk factor is CAD, which, especially when symptomatic, magnifies significantly the risk of stroke[ 23 ] and acute coronary events[ 24 ].…”

Section: Discussionmentioning

confidence: 99%

Atrial fibrillation in retinal vascular occlusion disease and non-arteritic anterior ischemic optic neuropathy

et al. 2017

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BackgroundPatients with retinal vascular occlusion disease have an increased risk for ischemic stroke and share some risk factors with cerebrovascular disease. The purpose of this study was to analyze the prevalence of atrial fibrillation (AF) in subjects with retinal vascular occlusive disease and anterior ischemic optic neuropathy and to compare these data to an ischemic stroke group.MethodsProspective, observational single-center trial. Subjects with retinal artery occlusion (RAO), retinal vein occlusion (RVO) and anterior ischemic optic neuropathy (AION) were included. Patients with ischemic stroke (IS) from a previous observational trial were used as control. Investigation included 7-day Holter ECG, echocardiography, duplex ultrasonography of the carotid arteries, and 24-hour blood pressure monitoring. Further vascular risk factors were documented.ResultsDuring the 1-year study period, 101 patients were recruited. The control group with ischemic stroke consisted of 272 subjects. At inclusion, the prevalence of AF was 12% (RAO), 10.2% (RVO), 11.1% (NAION) and 15.8% (IS). The final prevalence after Holter ECG rose to 16% (RAO), 18.4% (RVO), 14.8% (NAION) and 26.5% (IS). No significant difference was measured between groups.ConclusionsWe detected a similar prevalence of AF in all groups. RVO patients tended to exhibit a higher AF detection rate and lower number needed to screen than RAO and NAION. The detection of AF rose considerably via Holter ECG. As a consequence, we recommend prolonged ECG monitoring in patients with acute ophthalmic vascular diseases.

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Section: Discussionmentioning

confidence: 99%

Atrial fibrillation in retinal vascular occlusion disease and non-arteritic anterior ischemic optic neuropathy

et al. 2017

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“…Since each internal carotid artery (ICA) with asymptomatic stenosis has been shown to be a risk factor for a future transient ischemic attack (TIA) or CVA, all carotids were reviewed individually. 4 The CUS were all performed at the Intersocietal Accreditation Commission Vascular Testing-accredited Iowa Heart Center Vascular Laboratory, and all studies were read by either a vascular surgeon or a cardiologist. Equipment utilized by the Iowa Heart Center Vascular Laboratory to perform carotid ultrasounds over the course of the study included the Acuson Sequoia (Mountain View, CA, USA), Toshiba Aplio 80 (Tustin, CA, USA), Toshiba XG, Toshiba Xario, Toshiba A500, Toshiba MX, Philips CX50 (Andover, MA, USA), GE Vivid Q (Chicago, IL, USA), and Esaote MyLab Alpha.…”

Section: Methodsmentioning

confidence: 99%

“…Recent data have shown that the risk of stroke in patients with asymptomatic carotid stenosis on intensive medical therapy is less than 1% per year. [4][5][6] Patients with asymptomatic, mild CAS are generally followed with periodic carotid duplex ultrasounds (CUS), with the intent of identifying those who progress to severe disease. Such patients might be offered carotid endarterectomy or carotid artery stenting in addition to optimal medical therapy.…”

Section: Introductionmentioning

confidence: 99%

Progression of asymptomatic mild carotid artery stenosis: Implications for frequency of surveillance

2017

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We looked retrospectively at the 3- to 5-year progression of mild, asymptomatic carotid artery stenosis (CAS). A random sample of 600 patients who had undergone at least two carotid artery duplex ultrasounds between 31 October 2006 and 1 November 2016 with a second duplex ⩾3 and ⩽5 years following the initial one were screened for inclusion. Internal carotid arteries (ICAs) were included if they had 20-49% stenosis on the initial duplex, with 440 carotid arteries meeting this criteria. Analyses were performed utilizing chi-squared and two-tailed t-tests. Twenty-four (5.45%) of the initial 440 carotid arteries progressed to moderate CAS. There was a statistically significant increase in the prevalence of hypertension (68% vs 47%, p=0.022) and diabetes mellitus (44% vs 22%, p=0.008) in patients with carotids that progressed to moderate CAS. There was a decrease in moderate-intensity statin use (32% vs 58%, p=0.005) and an increase in patients not on statins (36% vs 11%, p=0.001) in the group of carotids that progressed to moderate CAS. One carotid artery (0.2%) progressed from mild CAS to severe CAS. If supported by others, our data may lead to a change in the recommendations regarding appropriate follow-up of asymptomatic CAS.

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“…Carotid artery stenosis (CAS) is a serious disease that is an important cause of strokes particularly in the elderly people [1]. In asymptomatic CAS, the incidence of stroke increases by 0.35-5% and at the same time the incidance and mortality of the heart disease also increase [2].…”

Section: Introductionmentioning

confidence: 99%

Karotis endarterektomili ve şiddetli olmayan karotis arter darlığı olan hastalarda fibrinojen / albümin oranı ve karotis arter hastalığı arasındaki ilişki.

Özsin¹,

Sanrı²,

Toktaş³

et al. 2018

Turkish Journal of Clinics and Laboratory

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Aim: To investigate the relationship between fibrinogen to albumin ratio (FAR) and carotid artery stenosis (CAS). Material and Methods: This study included patients who underwent carotid endarterctomy (CEA) as CEA group and unoperated patients who have CAS less than 50% as non-surgical group. CAS was diagnosed with history and physical examination followed by doppler ultrasonography and carotid angiography. All data retrieved retrospectively from the hospital medical files. Hematologic parameters were measured and recorded. In addition, FAR was calculated. Results: Fifty patients were included in CEA group (70.0 % male, mean age: 71.0 ± 7.7 years) and 60 patients were invluded in non-surgical group (70.0 % male, mean age: 63.9 ± 8.0 years). In logistic regression analysis advanced age, presence of coronary artery disease and FAR were identified as an independent predictor of the development of CAS. In Receiver operating characteristic (ROC) curve analysis, for predicting development of CAS, there were 68.0% sensitivity and 65.0% specificity for FAR (area under the curve [AUC]: 0.669, 95% CI: 0.566-0.771, log rank p = 0.002). Conclusion: We found that FAR were identified as an independent predictor of the development of CAS. FAR could be a potential marker on carotid atherosclerosis in patients. But there is a need large studies including all cardiovascular diseases.

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Risk of Stroke and Cardiac Events in Medically Treated Asymptomatic Carotid Stenosis

Cited by 12 publications

References 20 publications

Atrial fibrillation in retinal vascular occlusion disease and non-arteritic anterior ischemic optic neuropathy

Atrial fibrillation in retinal vascular occlusion disease and non-arteritic anterior ischemic optic neuropathy

Progression of asymptomatic mild carotid artery stenosis: Implications for frequency of surveillance

Karotis endarterektomili ve şiddetli olmayan karotis arter darlığı olan hastalarda fibrinojen / albümin oranı ve karotis arter hastalığı arasındaki ilişki.

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