10.6084/m9.figshare.5182615.v1
Shah Z.
Shah
Z.
Masoomi R.
Masoomi
R.
Thapa R.
Thapa
R.
Wani M.
Wani
M.
Chen J.
Chen
J.
Dawn B.
Dawn
B.
Rymer M.
Rymer
M.
Gupta K.
Gupta
K.
Supplementary Material for: Optimal Medical Management Reduces Risk of Disease Progression and Ischemic Events in Asymptomatic Carotid Stenosis Patients: A Long-Term Follow-Up Study
Karger Publishers
2017
Asymptomatic carotid stenosis
Ischemic stroke
Statins
Optimal medical management
2017-07-07 07:43:10
Journal contribution
https://karger.figshare.com/articles/journal_contribution/Supplementary_Material_for_Optimal_Medical_Management_Reduces_Risk_of_Disease_Progression_and_Ischemic_Events_in_Asymptomatic_Carotid_Stenosis_Patients_A_Long-Term_Follow-Up_Study/5182615
<p><b><i>Background and Purpose:</i></b> To assess the effect of optimal
medical management including atherosclerotic risk factor control on
ischemic stroke (IS), transient ischemic attack (TIA), carotid
revascularization (CRV), and progression of severity of carotid stenosis
(PSCS) in patients with asymptomatic carotid artery stenosis (ACAS). <b><i>Methods:</i></b>
We conducted a retrospective analysis of patients with ACAS (who had at
least 3 serial carotid duplex ultrasounds) for incidence of IS, TIA,
and PSCS. <b><i>Results:</i></b> Eight hundred sixty-four patients with a
mean follow-up duration of 79 ± 36 months were included. IS/TIA and CRV
occurred in 12.2% of the patients and PCSS was observed in 21.5%
vessels. On univariate analysis it was found that low-density
lipoprotein (LDL) levels >100 mg/dL, no statin or low-potency
statins, average systolic blood pressure (SBP) ≥140 mm Hg and/or
diastolic blood pressure (DBP) ≥90 mm Hg and history of smoking were
predictors of the combined endpoint of IS/TIA/CRV and PSCS. On
multivariate analysis, it was found that LDL >100 mg/dL, no statin or
low-potency statin, SBP ≥140 mm Hg and/or DBP ≥90 mm Hg, and Hx of
smoking were independent predictors of PSCS. Similarly no statin or
low-potency statin, SBP ≥140 mm Hg and/or DBP ≥90 mm Hg, Hx of atrial
fibrillation/flutter, Hx of chronic kidney disease, and PSCS were
independent predictors of IS/TIA. No statin or low-potency statin, SBP
≥140 mm Hg and/or DBP ≥90 mm Hg, diabetes mellitus, baseline carotid
artery stenosis ≥70%, and PSCS were found to be independent predictors
of combined endpoint IS/TIA and CRV. <b><i>Conclusion:</i></b> Intensive
medical therapy in the patients with ACAS results in lower incidence of
IS/TIA, CRV, and PSCS with a significant incremental beneficial effect.</p>