Ipsilateral Infarct in Newly Diagnosed Cervical Internal Carotid Artery Atherosclerotic Occlusion
Diogo C Haussen1, David Z Rose2, Doniel Drazin3
1Department of Neurology, Neurosurgery and Radiology, Emory University School of Medicine, Atlanta, Ga., USA.
Insights
Patients with atherosclerotic cervical internal carotid artery occlusion (CICAO) on statins and antihypertensives had a lower risk of recent infarct (RI). These medications may protect against stroke in CICAO patients.
Area of Science:
- Neurology
- Vascular Medicine
- Radiology
Background:
- Atherosclerotic cervical internal carotid artery occlusion (CICAO) is a significant cause of ischemic stroke.
- Identifying factors associated with recent infarct (RI) in CICAO patients is crucial for risk stratification and treatment.
Purpose of the Study:
- To determine factors associated with recent infarct (RI) in patients with newly identified atherosclerotic cervical internal carotid artery occlusion (CICAO).
Main Methods:
- Retrospective review of patients with cervical CT angiography.
- Inclusion criteria: complete medical records and brain MRI.
- Recent infarct (RI) defined by diffusion-weighted imaging/apparent diffusion coefficient MRI in the CICAO territory.
Main Results:
- Of 108 included patients, 57% had a recent infarct (RI).
- RI patients had lower frequencies of coronary artery disease (CAD), dyslipidemia, statin use, and antihypertensive use compared to No-RI patients.
- Multivariate regression identified CAD, statin use, and antihypertensive use as associated with No-RI CICAO presentation.
Conclusions:
- Statin and antihypertensive use are associated with a decreased risk of recent infarct (RI) in atherosclerotic cervical internal carotid artery occlusion (CICAO).
- These findings suggest a protective role for statins and antihypertensives in preventing stroke in CICAO patients.
Objective:
We aimed to determine factors associated with recent infarct (RI) in patients with newly identified atherosclerotic cervical internal carotid artery occlusion (CICAO).
Methods:
This was a retrospective review of consecutive patients who underwent cervical CT angiography from 2002 to 2006 at a single tertiary center. RI was defined by positive diffusion-weighted imaging/apparent diffusion coefficient magnetic resonance imaging (MRI) in the correspondent CICAO territory. Subjects were dichotomized into those with a RI versus patients with no RI (No-RI).
Results:
Of 2,459 patients with cervical CT angiograms in the study period, 108 (4.4%) had complete medical records and brain MRI and were included. The mean age was 64 ± 13 years, 58% were men, and 62 (57%) had a RI. The demographics of the RI and No-RI patients were comparable, with the exception that those with RI had a lower frequency of coronary artery disease (CAD, 13 vs. 54%; p < 0.01) and dyslipidemia (38 vs. 69%; p < 0.01). The use of antiplatelets was not statistically different between the groups (56 vs. 71%; p = 0.1). Subjects with RI were less likely on statins (21 vs. 56%; p < 0.01) and antihypertensives (9 vs. 71%; p < 0.01). Multivariate regression revealed that CAD, the use of statins, and the use of antihypertensives were associated with No-RI CICAO presentation.
Conclusion:
The use of statins and antihypertensives is associated with a decreased risk of RI atherosclerotic CICAO.
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