Document Detail


Carotid stenosis in patients with atrial fibrillation. Prevalence, risk factors, and relationship to stroke in the Stroke Prevention in Atrial Fibrillation Study.
MedLine Citation:
PMID:  8002689     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Several mechanisms contribute to the increased stroke rate of patients with atrial fibrillation (AF). We assessed the frequency of carotid artery stenosis in patients with AF and its relationship to stroke during aspirin or warfarin therapy. METHODS: Carotid ultrasonography was done in 676 patients with AF enrolled in the Stroke Prevention in Atrial Fibrillation Study to detect cervical carotid stenosis of 50% or more of the luminal diameter. The presence of carotid stenosis was correlated with patient features and subsequent stroke during a mean of 2.6 years of follow-up. RESULTS: In patients with AF who were older than 70 years, the frequency of carotid stenosis was 12% in men and 11% in women. Carotid stenosis was independently associated with systolic hypertension (relative risk, 2.4; P = .002), diabetes (relative risk, 1.8; P = .04), and tobacco use (relative risk, 1.8; P = .02). Carotid stenosis did not add significantly to prediction of stroke when analyzed with other clinical risk factors for stroke in patients with AF (relative risk, 1.3; 95% confidence interval, 0.5 to 3.6; P = .55). CONCLUSIONS: Carotid artery stenosis of 50% or more occurs in about 12% of elderly patients with AF, reflecting the substantial prevalence of hypertension and diabetes in these patients. Carotid stenosis was not usefully predictive of stroke in patients with AF who were given aspirin or warfarin. Routine ultrasonography to detect carotid stenosis does not appear warranted in patients with AF without previous symptoms of brain ischemia.
Authors:
M C Kanter; C H Tegeler; L A Pearce; J Weinberger; W M Feinberg; D C Anderson; C R Gomez; J F Rothrock; C M Helgason; R G Hart
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Archives of internal medicine     Volume:  154     ISSN:  0003-9926     ISO Abbreviation:  Arch. Intern. Med.     Publication Date:  1994 Jun 
Date Detail:
Created Date:  1994-07-12     Completed Date:  1994-07-12     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0372440     Medline TA:  Arch Intern Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1372-7     Citation Subset:  AIM; IM    
Affiliation:
Department of Medicine, University of Texas Health Sciences Center, San Antonio.
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MeSH Terms
Descriptor/Qualifier:
Aged
Analysis of Variance
Atrial Fibrillation / complications*
Carotid Stenosis / complications*,  epidemiology,  ultrasonography
Cerebrovascular Disorders / epidemiology,  etiology*
Diabetes Complications
Female
Humans
Hypertension / complications
Male
Prevalence
Proportional Hazards Models
Prospective Studies
Risk Factors
Smoking
Grant Support
ID/Acronym/Agency:
R01-NS-24224/NS/NINDS NIH HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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