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[In Process Citation]

Stapf1, Hartmann, Hofmeister

  • 1Stroke Unit/Neurologische Klinik, Universitatsklinikum Benjamin Franklin, Freie Universitat Berlin. cs585@columbia.edu

Fortschritte Der Neurologie-Psychiatrie
|December 22, 1999
PubMed
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Cigarette smoking is a significant independent risk factor for severe carotid artery stenosis in patients experiencing ischemic stroke or transient ischemic attacks. The risk increases with the degree of stenosis.

Area of Science:

  • Neurology
  • Vascular Medicine
  • Cardiology

Background:

  • Cigarette smoking is a prevalent risk factor for cardiovascular diseases.
  • High-grade carotid artery stenosis is a major cause of ischemic stroke.
  • The association between smoking and carotid stenosis requires further investigation.

Purpose of the Study:

  • To investigate the association between cigarette smoking and high-grade carotid artery stenosis.
  • To identify independent risk factors for carotid stenosis in patients with focal cerebral ischemia.

Main Methods:

  • Cross-sectional study of 404 patients with focal brain ischemia.
  • Carotid artery stenosis diagnosed using Doppler-ultrasound (>= 70% luminal narrowing).
  • Multivariate logistic regression analysis adjusted for age, gender, hypertension, diabetes, hypercholesterolemia, and heart disease.

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Main Results:

  • High-grade carotid stenoses (> or = 70%) were present in 25% of patients.
  • Smokers had a significantly higher odds ratio (3.6) for high-grade carotid stenosis.
  • Smoking's association strengthened with increasing stenosis severity (OR 4.3 for >= 80%).

Conclusions:

  • Cigarette smoking is an independent determinant of severe carotid artery stenosis.
  • Hypercholesterolemia and pre-existing heart disease were also associated with stenosis.
  • Hypertension and diabetes mellitus were not significantly associated with high-grade carotid stenosis in this cohort.