Effects of intensive medical therapy on microemboli and cardiovascular risk in asymptomatic carotid stenosis

Archives of Neurology

Volumn 67, Issue 2, 2010, Pages 180-186

  David Spence, J ^a,b   Coates, Victoria ^a   Li, Hector ^b   Tamayo, Arturo ^a,c   Muñoz, Claudio ^a   Hackam, Daniel G ^a,b   DiCicco, Maria ^a   DesRoches, Janine ^a   Bogiatzi, Chrysi ^a,d   Klein, Jonathan ^a,b   Madrenas, Joaquim ^a,b   Hegele, Robert A ^a,b  

^a ROBARTS RESEARCH INSTITUTE   (Canada)

^b WESTERN UNIVERSITY   (Canada)

^c Brandon Regional Health Centre   (Canada)

^d DEMOCRITUS UNIVERSITY OF THRACE   (Greece)

Author keywords

[No Author keywords available]

Indexed keywords

ACETYLSALICYLIC ACID; ANGIOTENSIN RECEPTOR ANTAGONIST; ANTIHYPERTENSIVE AGENT; ANTILIPEMIC AGENT; ATORVASTATIN; BETA ADRENERGIC RECEPTOR BLOCKING AGENT; CALCIUM CHANNEL BLOCKING AGENT; CLOPIDOGREL; DIPEPTIDYL CARBOXYPEPTIDASE INHIBITOR; EZETIMIBE; FIBRIC ACID DERIVATIVE; HYDROCHLOROTHIAZIDE; HYDROXYMETHYLGLUTARYL COENZYME A REDUCTASE INHIBITOR; LIPID; METFORMIN; NICOTINIC ACID; PIOGLITAZONE; ROSUVASTATIN;

ADULT; AGED; ARTICLE; ATHEROSCLEROSIS; ATHEROSCLEROTIC PLAQUE; CARDIOVASCULAR DISEASE; CARDIOVASCULAR RISK; CAROTID ARTERY OBSTRUCTION; CAROTID ENDARTERECTOMY; DEATH; DOPPLER ECHOGRAPHY; FEMALE; FOLLOW UP; HEART INFARCTION; HUMAN; INSULIN RESISTANCE; LIFESTYLE MODIFICATION; LIPID BLOOD LEVEL; M MODE ECHOCARDIOGRAPHY; MAJOR CLINICAL STUDY; MALE; MEASUREMENT; MEDITERRANEAN DIET; MICROEMBOLISM; PRIORITY JOURNAL; PROSPECTIVE STUDY; REVASCULARIZATION; STROKE; SYMPTOM; TREATMENT OUTCOME;

AGED; CAROTID STENOSIS; CHI-SQUARE DISTRIBUTION; CONFIDENCE INTERVALS; FEMALE; HUMANS; HYDROXYMETHYLGLUTARYL-COA REDUCTASE INHIBITORS; INTENSIVE CARE; INTRACRANIAL EMBOLISM; KAPLAN-MEIERS ESTIMATE; LIPIDS; MALE; MIDDLE AGED; PLAQUE ASSAY; PROSPECTIVE STUDIES; RETROSPECTIVE STUDIES; RISK FACTORS; ULTRASONOGRAPHY, DOPPLER, TRANSCRANIAL;

EID: 76149138463     PISSN: 00039942     EISSN: 15383687     Source Type: Journal    
DOI: 10.1001/archneurol.2009.289     Document Type: Article

References (29)

1. Chimowitz MI, Weiss DG, Cohen SL, Starling MR, Hobson RW II. Cardiac prognosis of patients with carotid stenosis and no history of coronary artery disease: Veterans Affairs Cooperative Study Group 167. Stroke. 1994;25(4):759-765.
2. Endarterectomy for asymptomatic carotid artery stenosis: Executive Committee for the Asymptomatic Carotid Atherosclerosis Study. JAMA. 1995;273(18): 1421-1428.
3. Rothwell PM. ACST: which subgroups will benefit most from carotid endarterectomy? Lancet. 2004;364(9440):1122-1126.
4. Barnett HJ. Carotid endarterectomy. Lancet. 2004;363(9420):1486- 1487.
5. Barnett HJM, Meldrum HE, Eliasziw M; North American Symptomatic Carotid Endarterectomy Trial (NASCET) collaborators. The appropriate use of carotid endarterectomy. CMAJ. 2002;166(9):1169-1179.
6. Kresowik TF, Bratzler D, Karp HR, et al. Multistate utilization, processes, and outcomes of carotid endarterectomy. J Vasc Surg. 2001;33(2):227-235.
7. Chaturvedi S, Bruno A, Feasby T, et al; Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Carotid endarterectomy-an evidence-based review: report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Neurology. 2005;65(6):794-801.
8. Endovascular versus surgical treatment in patients with carotid stenosis in the Carotid and Vertebral Artery Transluminal Angioplasty Study (CAVATAS): a randomised trial. Lancet. 2001;357(9270):1729-1737.
9. Yadav JS, Wholey MH, Kuntz RE, et al; Stenting and Angioplasty with Protection in Patients at High Risk for Endarterectomy Investigators. Protected carotid-artery stenting versus endarterectomy in high-risk patients. N Engl J Med. 2004; 351(15):1493-1501.
10. Mas JL, Trinquart L, Leys D, et al; EVA-3S investigators. Endarterectomy Versus Angioplasty in Patients with Symptomatic Severe Carotid Stenosis (EVA-3S) trial: results up to 4 years from a randomised, multicentre trial. Lancet Neurol. 2008;7(10):885-892.
11. Ringleb PA, Chatellier G, Hacke W, et al. Safety of endovascular treatment of carotid artery stenosis compared with surgical treatment: a meta-analysis. J Vasc Surg. 2008;47(2):350-355.
12. McPhee JT, Schanzer A, Messina LM, Eslami MH. Carotid artery stenting has increased rates of postprocedure stroke, death, and resource utilization than does carotid endarterectomy in the United States J Vasc Surg. 2008;48(6):1442-1450, 1450.e1.
13. Abbott A. Asymptomatic carotid artery stenosis: it's time to stop operating. Nat Clin Pract Neurol. 2008;4(1):4-5.
14. Abbott AL, Bladin CF, Levi CR, Chambers BR. What should we do with asymptomatic carotid stenosis? Int J Stroke. 2007;2(1):27-39.
15. Spence JD. Technology Insight: ultrasound measurement of carotid plaque-patient management, genetic research, and therapy evaluation. Nat Clin Pract Neurol. 2006;2(11):611-619.
16. Spence JD, Eliasziw M, DiCicco M, Hackam DG, Galil R, Lohmann T. Carotid plaque area: a tool for targeting and evaluating vascular preventive therapy. Stroke. 2002; 33(12):2916-2922.
17. Johnsen SH, Mathiesen EB, Joakimsen O, et al. Carotid atherosclerosis is a stronger predictor of myocardial infarction in women than in men: a 6-year follow-up study of 6226 persons: the Tromsø Study. Stroke. 2007;38(11):2873-2880.
18. Markus HS, Mackinnon A. Asymptomatic embolization detected by Doppler ultrasound predicts stroke risk in symptomatic carotid artery stenosis. Stroke. 2005; 36(5):971-975.
19. Molloy J, Markus HS. Asymptomatic embolization predicts stroke and TIA risk in patients with carotid artery stenosis. Stroke. 1999;30(7):1440-1443.
20. Spence JD, Tamayo A, Lownie SP, Ng WP, Ferguson GG. Absence of microemboli on transcranial Doppler identifies low-risk patients with asymptomatic carotid stenosis. Stroke. 2005;36(11):2373-2378.
21. Fayad P; SAPPHIRE Investigators. Stenting and angioplasty with protection in patients at high risk for endarterectomy: The Sapphire Study-the two-year follow-up and results [abstract]. In: Proceedings of the World Stroke Congress; June 23-26, 2004; Vancouver, BC, Canada.
22. Spence JD. Point: uses of carotid plaque measurement as a predictor of cardiovascular events. Prev Cardiol. 2005;8(2):118-121.
23. Ringelstein EB, Droste DW, Babikian VL, et al; International Consensus Group on Microembolus Detection. Consensus on microembolus detection by TCD. Stroke. 1998;29(3):725-729.
24. Spence JD. Intensive management of risk factors for accelerated atherosclerosis: the role of multiple interventions. Curr Neurol Neurosci Rep. 2007;7(1):42-48.
25. Halliday A, Mansfield A, Marro J, et al; MRC Asymptomatic Carotid Surgery Trial (ACST) Collaborative Group. Prevention of disabling and fatal strokes by successful carotid endarterectomy in patients without recent neurological symptoms: randomised controlled trial. Lancet. 2004;363(9420):1491-1502.
26. Hackam DG, Spence JD. Combining multiple approaches for the secondary prevention of vascular events after stroke: a quantitative modeling study. Stroke. 2007;38(6):1881-1885.
27. Rothwell PM, Coull AJ, Giles MF, et al; Oxford Vascular Study. Change in stroke incidence, mortality, case-fatality, severity, and risk factors in Oxfordshire, UK from 1981 to 2004 (Oxford Vascular Study). Lancet. 2004;363(9425):1925-1933.
28. Lewis M, Trypuc J, Lindsay P, O'Callaghan C, Dishaw A. Has Ontario's Stroke System really made a difference? Healthc Q. 2006;9(4):50-59, 2.
29. Rothwell PM, Giles MF, Chandratheva A, et al; Early use of Existing Preventive Strategies for Stroke (EXPRESS) study. Effect of urgent treatment of transient ischaemic attack and minor stroke on early recurrent stroke (EXPRESS study): a prospective population-based sequential comparison. Lancet. 2007;370(9596): 1432-1442.