[Characterisation of factors associated with carotid stenosis in a population at high risk]
Erwin Chiquete1, Benjamín Torres-Octavo, Vanessa Cano-Nigenda
1Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Tlalpan, Mexico.
Insights
Moderate to severe carotid stenosis, though less common, poses a high stroke risk. Advanced age, dyslipidemia, hypertension, and smoking are key associated risk factors in high-risk populations.
Area of Science:
- Vascular Medicine
- Neurology
- Cardiology
Background:
- Moderate to severe carotid stenosis is a less common manifestation of carotid atherosclerotic disease.
- Despite its lower prevalence, it carries a significant risk of ischemic stroke.
Purpose of the Study:
- To identify and characterize factors associated with moderate to severe carotid stenosis.
- Focus on a high-risk population with a history of stroke or multiple risk factors.
Main Methods:
- Analysis of 533 patients undergoing Doppler ultrasound for stroke or risk factors.
- Evaluated traditional risk factors: age, hypertension, dyslipidemia, obesity, diabetes, and smoking.
- Multivariate analysis to determine independent associations.
Main Results:
- Prevalence of carotid stenosis ≥50% was 7.1%, with symptomatic cases at 5.6%.
- Age ≥75 years, dyslipidemia, and smoking were independently associated with stenosis ≥50%.
- Hypertension and smoking were linked to symptomatic stenosis; diabetes and obesity were not significant predictors of stenosis severity.
Conclusions:
- Moderate to severe carotid stenosis is less frequent than a high plaque burden.
- Advanced age, smoking, dyslipidemia, and hypertension are primary traditional risk factors influencing carotid stenosis severity.
Introduction:
Moderate to severe stenosis is the less prevalent among the forms of carotid atherosclerotic disease), but it carries a high risk of ischaemic stroke.
Aim:
To characterise factors associated with moderate to severe carotid stenosis in a high-risk population.
Patients And Methods:
We performed an analysis on traditional risk factors associated with carotid stenosis ≥50% in 533 patients who received Doppler ultrasound due to a history of stroke (34%) or who had = 2 of the risk factors: age ≥55 years (86%), hypertension (65%), dyslipidemia (52%), obesity (42%), diabetes (40%) or smoking (40%).
Results:
The prevalence of carotid stenosis ≥50% was 7.1%, symptomatic (associated with stroke in congruent territory) in 5.6%, bilateral in 2.1% and bilateral symptomatic in 1.5%. A 36.8% of patients had moderate to severe load (≥4) of atherosclerotic plaques (25.9% moderate: 4-6 plaques, and 10.9% severe: ≥7 plaques). By multivariate analysis we identified the age ≥75 years, dyslipidemia, and smoking as factors independently associated with carotid stenosis ≥50%, and hypertension and smoking with symptomatic stenosis. The number of risk factors was strongly associated with the prevalence of carotid stenosis. Notably, neither diabetes nor obesity explained the degree of moderate to severe carotid stenosis.
Conclusions:
As forms of carotid atherosclerotic disease, moderate to severe stenosis is less frequent than a high burden of atherosclerotic plaques. Advanced age, smoking, dyslipidemia and hypertension are the main traditional risk factors associated with the degree of carotid stenosis.
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