engleski

Moderate carotid stenosis-5 year follow up

Patients with moderate carotid artery disease (CAD) are usually not in the high risk stroke group. The aim of this study was to follow up patients with moderate CAD during 5 years. Among 1284 hospitalized stroke patients in 1999, 78 (6 %) patients (48 men and 30 women, mean age 71) had moderate CAD of at least 1 artery. 20 % of patients had bilateral CAD. A total of 58 patients completed the study ; 10 were lost during follow-up and 10 died early during hospitalization. In 1999, 62 (79 %) patients had stroke, 15 (19 %) had TIA and 2 (2%) had subarachnoid hemorrhage. Stroke mortality was 13 %. 39 (50 %) patients had first ever stroke of whom 17 (44%) had ipsilateral stroke to moderate CAD side and 22 (56 %) patients had recurrent stroke. The most common risk factor was hypertension (91 %), while other risk factors prevailed in the range of 35– 40 %. Symptomatic CAD was present in 59 %, asymptomatic in 11%, and ipsilateral amaurosis fugax in 30 %. CEA was performed in 50 % of patients, 12 % of whom had postoperative stroke. At the end of follow up period stroke mortality was 38 %. Ipsilateral recurrent stroke occurred in 39 % of patients, TIA in 18 %, while the control group had stroke incidence of 2 % and TIA incidence of 2%. Moderate CAD in older age groups, especially in men, may represent a higher risk factor for stroke than previously believed.

carotid stenosis; follow up; ultrsound

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