Prevalence and Factors Associated with Carotid Stenosis in Acute Ischemic Stroke Patients with Atrial Fibrillation.

IF 3.2 3区医学 Q2 CLINICAL NEUROLOGY

Neuroepidemiology Pub Date : 2024-07-09 DOI:10.1159/000539693

Dimitrios Sagris, Eleni Korompoki, Davide Strambo, Georgios Mavraganis, Patrik Michel, Ashraf Eskandari, Konstantinos Vemmos, Clara Lastras, Jorge Rodriguez-Pardo, Blanca Fuentes, Exuperio Díez-Tejedor, Paula Tiili, Mika Lehto, Jukka Putaala, Elisa Cuadrado-Godia, Esmirna Farington-Terrero, Antonio Arauz, Hooman Kamel, Julieta Soledad Rosales, Maria Soledad Rodriguez Perez, Maia Gomez Schneider, Miguel Barboza, Alexander Tsiskaridze, George Ntaios

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引用次数: 0

Abstract

Introduction: Among stroke patients with atrial fibrillation (AF), it is not uncommon to identify carotid atherosclerosis. This study aimed to estimate the prevalence of, and factors associated with, carotid atherosclerosis among patients with AF and acute ischemic stroke.

Patients and methods: Prospectively collected data from consecutive patients with anterior ischemic stroke and AF who underwent carotid imaging from 10 stroke registries were categorized retrospectively according to the degree of stenosis in: no atherosclerosis, stenosis <50%, stenosis ≥50%, and occlusion. Logistic regression analysis was used to identify factors associated with ipsilateral carotid atherosclerosis.

Results: Among 2,955 patients with ischemic stroke and AF, carotid atherosclerosis was evident in 1,022 (34.6%) patients, while carotid stenosis ≥50% and occlusion were identified in 204 (6.9%) and 168 (5.7%) patients, respectively. Ipsilateral carotid stenosis ≥50% or occlusion was associated with higher age (OR: 1.15, 95% CI: 1.01-1.32, per decade), previous ischemic stroke or transient ischemic attack (OR: 1.70, 95% CI: 1.29-2.25), peripheral artery disease (OR: 1.85, 95% CI: 1.23-2.78), coronary artery disease (OR: 1.53, 95% CI: 1.16-2.04), and statin treatment on admission (OR: 1.30, 95% CI: 1.01-1.67). Patients with lacunar stroke had a lower likelihood of stenosis ≥50% or occlusion (OR: 0.29, 95% CI: 0.13-0.68). Compared to the absence of atherosclerotic disease, atherosclerosis in one and two arterial beds was associated with the identification of ipsilateral carotid stenosis (OR: 1.49, 95% CI: 1.22-2.98 and OR: 3.18, 95% CI: 1.85-5.49, respectively).

Conclusion: Among acute ischemic stroke patients with AF, 1 out of 3 had ipsilateral carotid atherosclerosis, and 1 out of 8 had ipsilateral carotid stenosis ≥50% or occlusion. Atherosclerosis in two arterial beds was the most important predictor for the identification of ipsilateral carotid stenosis. Among ischemic stroke patients with AF, carotid atherosclerosis is common, while carotid imaging should not be overlooked, especially in those with coronary or/and peripheral artery disease.

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伴有心房颤动的急性缺血性脑卒中患者颈动脉狭窄的患病率及相关因素。

导言：在心房颤动（房颤）脑卒中患者中发现颈动脉粥样硬化并不少见。本研究旨在估算心房颤动和急性缺血性中风患者中颈动脉粥样硬化的患病率及其相关因素：回顾性分析从 10 个卒中登记处收集的前部缺血性卒中和房颤连续患者颈动脉造影数据，根据狭窄程度分为：无动脉粥样硬化、狭窄<50%、狭窄≥50%和闭塞。采用逻辑回归分析确定与同侧颈动脉粥样硬化相关的因素：在2955名缺血性卒中和房颤患者中，1022名（34.6%）患者颈动脉粥样硬化明显，而颈动脉狭窄≥50%和闭塞的患者分别为204名（6.9%）和168名（5.7%）。同侧颈动脉狭窄≥50%或闭塞与较高的年龄（OR:1.15,95%CI:1.01-1.32, 每十年）、既往缺血性中风或短暂性脑缺血发作（OR:1.70,95%CI:1.29-2.25）、外周动脉疾病（OR:1.85,95%CI:1.23-2.78）、冠状动脉疾病（OR:1.53,95%CI:1.16-2.04）和入院时他汀类药物治疗（OR:1.30,95%CI:1.01-1.67）。腔隙性卒中患者血管狭窄≥50%或闭塞的可能性较低（OR:0.29,95%CI:0.13-0.68）。与无动脉粥样硬化疾病相比，一侧和两侧动脉床的动脉粥样硬化与同侧颈动脉狭窄的识别相关（OR：1.49，95%CI：1.22-2.98；OR：3.18，95%CI：1.85-5.49）：结论：在房颤急性缺血性卒中患者中，每3人中就有1人患有同侧颈动脉粥样硬化，每8人中就有1人患有同侧颈动脉狭窄≥50%或闭塞。两个动脉床的动脉粥样硬化是发现同侧颈动脉狭窄最重要的预测因素。在房颤缺血性卒中患者中，颈动脉粥样硬化很常见，而颈动脉成像不应被忽视，尤其是那些患有冠状动脉或/和外周动脉疾病的患者。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Neuroepidemiology 医学-公共卫生、环境卫生与职业卫生

CiteScore

9.90

自引率

1.80%

发文量

审稿时长

6-12 weeks

期刊介绍： ''Neuroepidemiology'' is the only internationally recognised peer-reviewed periodical devoted to descriptive, analytical and experimental studies in the epidemiology of neurologic disease. The scope of the journal expands the boundaries of traditional clinical neurology by providing new insights regarding the etiology, determinants, distribution, management and prevention of diseases of the nervous system.