| Carotid stenosis in patients with atrial fibrillation. Prevalence, risk factors, and relationship to stroke in the Stroke Prevention in Atrial Fibrillation Study. | |
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MedLine Citation:
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PMID: 8002689 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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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:
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Type: Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S. |
Journal Detail:
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Title: Archives of internal medicine Volume: 154 ISSN: 0003-9926 ISO Abbreviation: Arch. Intern. Med. Publication Date: 1994 Jun |
Date Detail:
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Created Date: 1994-07-12 Completed Date: 1994-07-12 Revised Date: 2007-11-14 |
Medline Journal Info:
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Nlm Unique ID: 0372440 Medline TA: Arch Intern Med Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 1372-7 Citation Subset: AIM; IM |
Affiliation:
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Department of Medicine, University of Texas Health Sciences Center, San Antonio. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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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:
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R01-NS-24224/NS/NINDS NIH HHS |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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