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首页> 外文期刊>Archives of Neurology >Long-term risk of stroke and other vascular events in patients with asymptomatic carotid artery stenosis.
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Long-term risk of stroke and other vascular events in patients with asymptomatic carotid artery stenosis.

机译：中风和其他血管事件的长期风险患者无症状的颈动脉狭窄。

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CONTEXT: The annual risk of ischemic stroke in patients with asymptomatic carotid artery stenosis is about 2% during the short-term (2-3 years), but the long-term risks of stroke and other vascular events are unknown, although they may affect surgical decision making. OBJECTIVE: To evaluate the long-term risk of stroke and other vascular events in patients with asymptomatic carotid artery stenosis. DESIGN: Cohort study with a median follow-up of 10 years (range, 5-18 years). SETTING: The teaching hospital of the University of Toronto, Toronto, Ontario. PATIENTS: From the initial cohort of 500 patients, 106 patients with asymptomatic carotid artery stenosis were selected because they had completed at least 5 years of follow-up. MAIN OUTCOME MEASURES: Ipsilateral stroke, myocardial infarction, and nonstroke vascular death. RESULTS: The 10- and 15-year actuarial risks of ipsilateral stroke were 5.7% (95% confidence interval [CI], 0%-12%) and 8.7% (95% CI, 1%-17%), respectively, in patients with 0% to 49% internal carotid artery stenosis, and 9.3% (95% CI, 1%-18%) and 16.6% (95% CI, 1%-32%) in patients with 50% to 99% internal carotid artery stenosis. The 10- and 15-year risks of myocardial infarction and nonstroke vascular death were 10.1% (95% CI, 4%-16%) and 24.0% (95% CI, 14%-34%). Age (P =.02), diabetes mellitus (P =.02), and internal carotid artery stenosis of 50% or more (P =.04) were predictive of increased risks of myocardial infarction and nonstroke vascular death. Internal carotid artery stenosis of 50% or more did predict the risk of ipsilateral stroke (P =.003) when all 181 asymptomatic carotid arteries were included. CONCLUSIONS: The annual stroke risk in patients with asymptomatic carotid artery stenosis was low and remained stable during long-term follow-up. Any benefit from carotid surgery is therefore unlikely to increase significantly with long-term follow-up. The high long-term risks of myocardial infarction and nonstroke vascular death suggest that prevention strategies should concentrate on coronary risk more than stroke risk.
机译：背景:缺血性中风的风险患者无症状的颈动脉在短期内(2 - 3狭窄大约是2%年),但中风和的长期风险其他血管事件是未知的,尽管他们可能会影响手术决策。评估长期患中风的风险其他患者的血管事件无症状的颈动脉狭窄。队列研究的平均随访10年(范围,5日至18日期间召开年)。多伦多,多伦多大学医院安大略省。患者,106例无症状的颈动脉动脉狭窄被选,因为他们有完成至少5年的随访。结果测量:侧中风,心肌梗塞,nonstroke血管性死亡。结果:10年和15年保险精算的风险身体的同侧的中风是5.7%(95%的信心内部患者分别在0%到49%颈动脉狭窄,9.3%(95%可信区间,1% - -18%)和16.6%(95%可信区间,1% - -32%)的患者颈内动脉狭窄50%到99%。心肌的10年和15年的风险梗塞和nonstroke血管性死亡10.1% (95% CI, 4%-16%)和24.0% (95% CI,14% - -34%)。= .02点),和内部的颈动脉狭窄50%或更多(P = .04点)是增加的预测心肌梗死和nonstroke的风险血管性死亡。50%或更多的预测的风险身体的同侧的中风(P = .003)当所有181无症状的颈动脉被包括在内。结论:一年一度的中风风险的病人与无症状的颈动脉狭窄很低和长期随访期间保持稳定。因此,任何受益于颈动脉手术可能与长期显著增加随访。梗死和nonstroke血管性死亡预防战略应该集中精力冠状动脉中风多风险的风险。

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