Carotid atherosclerosis progression and cerebrovascular events in patients with diabetes
Julien Vouillarmet1, Marjorie Helfre2, Delphine Maucort-Boulch3
1Department of Endocrinology, Diabetes and Nutrition, Hospices Civils de Lyon, Centre Hospitalier Lyon-Sud, Pierre Bénite, France.
Insights
Carotid atherosclerosis progression is common in diabetes patients, but rarely leads to stroke. Regular screening may not be beneficial, as progression did not predict cerebrovascular events in this study.
Area of Science:
- Cardiology
- Neurology
- Diabetology
Background:
- Carotid atherosclerosis increases cerebrovascular event risk.
- Specific data on atherosclerosis progression in diabetes patients is limited.
Purpose of the Study:
- To assess carotid atherosclerosis progression rate in diabetes patients.
- To determine the association between atherosclerosis progression and cerebrovascular events.
Main Methods:
- Retrospective cohort study of 342 diabetes patients.
- Mean follow-up of 6.4 years with 3.4 Doppler ultrasonography examinations per patient.
- Monitoring for cerebrovascular events.
Main Results:
- Carotid atherosclerosis progression occurred in 20.1% of patients.
- No significant factors were associated with progression.
- No cerebrovascular events occurred in patients with atherosclerosis progression.
Conclusions:
- Carotid atherosclerosis progression is frequent in diabetes but surgical intervention and cerebrovascular events are infrequent.
- Systematic follow-up of carotid atherosclerosis in diabetes patients may have limited benefit.
Aim:
Carotid atherosclerosis progression is associated with a higher risk of cerebrovascular events but there is no specific data for diabetes. We assessed in a cohort of patients with diabetes the rate of atherosclerosis progression by Doppler ultrasonography and the association with cerebrovascular events.
Methods:
We analyzed a retrospective cohort of 342 patients with a mean duration of diabetes of 13.6 ± 10.6 years. The mean delay between the first and last Doppler ultrasonography was 6.4 ± 4.6 years, with a mean of 3.4 examinations per person. Cerebrovascular events were noted.
Results:
A progression of carotid atherosclerosis was observed in 20.1% of cases. No factor was significantly associated with progression. A prophylactic carotid endarterectomy was performed on 6 of the 27 patients with a stenosis ≥50%. A cerebrovascular event occurred in 1.2% of patients; none of them had carotid atherosclerosis progression.
Conclusions:
Carotid atherosclerosis progression in patients with diabetes is frequent but surgical treatment and cerebrovascular events are low. The benefit of a systematic follow-up of carotid atherosclerosis seems limited.
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