Asymptomatic 50% to 75% internal carotid artery stenosis in 288 patients: risk factors for disease progression and ipsilateral neurological symptoms.

Introduction: This study identified characteristics of patients with moderate internal carotid artery stenosis that are at increased risk for disease progression.

Methods: Patients with asymptomatic moderate internal carotid disease correlating to 50% to 75% diameter reduction were followed for 3 years. Progression to greater than 75% diameter reduction or presentation with focal neurological symptoms was documented. Descriptive statistics and χ(2) testing provided statistical analysis.

Results: During follow-up, 26 (9%) developed symptoms or had an asymptomatic increase in diameter reduction to >75%. The rate of disease progression and/or development of symptoms was 5.5% at 12 months and increased to 7.2% by 24 months. Comorbidities with the highest associated event incidences were coronary artery disease (8.1%), hyperlipidemia (7.3%), and hypertension (6.7%).

Conclusion: Male patients with coronary artery disease, hyperlipidemia, and hypertension are at increased risk and are candidates for frequent screening and/or early intervention.