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Vascular event rates in patients with atherosclerotic cerebrovascular disease

J L Wilterdink1, J D Easton

  • 1Department of Neurology, Rhode Island Hospital, Providence 02903.

Archives of Neurology
|August 1, 1992
PubMed

Insights

Clinical signs of cerebrovascular atherosclerosis can predict stroke risk. This study found increasing stroke probability with worsening symptoms, from asymptomatic carotid stenosis to major stroke.

Area of Science:

  • Neurology
  • Vascular Medicine
  • Epidemiology

Background:

  • Cerebrovascular atherosclerosis poses a significant risk for stroke.
  • Predicting stroke risk is crucial for timely intervention and patient management.
  • Existing risk models primarily focus on atherosclerosis risk factors.

Purpose of the Study:

  • To review published cerebrovascular studies.
  • To determine if clinical manifestations predict annual stroke probability.
  • To analyze methods for calculating and reporting vascular event rates.

Main Methods:

  • Overview analysis of published cerebrovascular studies.
  • Data extraction on clinical manifestations and stroke events.
  • Calculation and comparison of annual stroke rates across different clinical presentations.

Main Results:

  • Annual stroke rates varied by clinical manifestation: asymptomatic carotid stenosis (1.3%), transient monocular blindness (2.2%), transient ischemic attack (3.7%), minor stroke (6.1%), and major stroke (9.0%).
  • A hierarchical progression of increasing stroke risk was observed with worsening clinical characteristics.
  • Confidence intervals (CI) were provided for each stroke rate (e.g., 95% CI for asymptomatic carotid stenosis: 1.0% to 1.6%).

Conclusions:

  • Clinical manifestations of cerebrovascular atherosclerosis can serve as a predictive profile for stroke risk.
  • A clinical risk profile, alongside conventional risk factors, can enhance stroke prediction.
  • The findings support a graded approach to stroke risk assessment based on clinical presentation.

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