Severity of Asymptomatic Carotid Stenosis and Risk of Ipsilateral Hemispheric Ischaemic Events: Results from the ACSRS Study

6533b835fe1ef96bd12a0027

RESEARCH PRODUCT

Severity of Asymptomatic Carotid Stenosis and Risk of Ipsilateral Hemispheric Ischaemic Events: Results from the ACSRS Study

A Nicolaides S Kakkos M Griffin M Sabetai S Dhanjil T Tegos D Thomas A Giannoukas G Geroulakos N Georgiou S Francis E Ioannidou C DoréR Adovasio B Ziani E AlóC Cicilioni G Ambrosio A Andreev G Andreozzi F Verlato G Camporese E Arosio E Barkauskas A Barros D'sa P Brannigan V Batchvarova A Dramov P Belardi G Novelli G Simoni P Bell N Bornstein D Bouchier Hayes P Fitzgerald M Cairols P Cao P Derango G Carboni C Geoffredo M Catalano B Chambers M Goetzmann A Dickinson D Clement M Bobelyn S Coccheri E Conti E Diamantopolous E Andreadis L Middleton M Pantziaris T Tyllis E Minar A Willfort L Moggi G Nenci S Radicchia L Norgren E Ribbie S Novo R Tantillo D Olinic W Paaske A Pagnan P Pauletto V Pagliara G Pettina C Pratesi S Matticari J Polivka P Sevcik P Poredos A Blinc V Videcnik A Pujia A Raso P Rispoli M Conforti T Robinson M Dennis S Rosfors G Rudofsky T Schroeder M Gronholdt G Simoni C Finocchi G Rodriguez P Dimakakos T Kotsis B Eikelboom L Entz N Ferrari Bardilleas T Aloi M Salerno J. Fernandes Giorgio Maria Biasi Paolo Mingazzini

subject

Risk medicine.medical_specialty medicine.medical_treatment Carotid Stenosi Predictive Value of Test Carotid endarterectomy Severity of Illness Index Asymptomatic Brain Ischemia chemistry.chemical_compound Cerebrovascular Accident medicine.artery Internal medicine Severity of illness NASCET MED/22 - CHIRURGIA VASCOLARE medicine Carotid Stenosis Medicine(all)Ultrasonography Doppler Duplex Creatinine business.industry Risk Factor Incidence (epidemiology)medicine.disease major clinical study Ultrasonography Duplex Doppler Asymptomatic Stenosis chemistry Predictive value of tests Cardiology Surgery ECST Radiology Internal carotid artery medicine.symptom Cardiology and Cardiovascular Medicine business Human

description

Objectives. This study determines the risk of ipsilateral ischaemic neurological events in relation to the degree of asymptomatic carotid stenosis and other risk factors. Methods. Patients (n = 1115) with asymptomatic internal carotid artery (ICA) stenosis greater than 50% in relation to the bulb diameter were followed up for a period of 6-84 (mean 37.1) months. Stenosis was graded using duplex, and clinical and biochemical risk factors were recorded. Results. The relationship between ICA stenosis and event rate is linear when stenosis is expressed by the ECST method, but S-shaped if expressed by the NASCET method. In addition to the ECST grade of stenosis (RR 1.6; 95% CI 1.21-2.15), history of contralateral TIAs (RR 3.0; 95% CI 1.90-4.73) and creatinine in excess of 85 μmol/L (RR 2.1; 95% CI 1.23-3.65) were independent risk predictors. The combination of these three risk factors can identify a high-risk group (7.3% annual event rate and 4.3% annual stroke rate) and a low risk group (2.3% annual event rate and 0.7% annual stroke rate). Conclusions. Linearity between ECST percent stenosis and risk makes this method for grading stenosis more amenable to risk prediction without any transformation not only in clinical practice but also when multivariable analysis is to be used. Identification of additional risk factors provides a new approach to risk stratification and should help refine the indications for carotid endarterectomy. © 2005 Elsevier Ltd. All rights reserved.

year	journal	country	edition	language
2005-09-01	European Journal of Vascular and Endovascular Surgery

https://doi.org/10.1016/j.ejvs.2005.04.031