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Academia Mexicana de Neurología, A.C.

2010, Number 5

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Rev Mex Neuroci 2010; 11 (5)

Prevalence of carotid stenosis in patients with transient ischemic attack in Mexico

Cantú-Brito C, Ruiz-Sandoval JL, Arauz-Góngora A, Villarreal-Careaga J, Barinagarrementeria F, Murillo-Bonilla LM, Chiquete E, Rangel-Guerra R

Language: Spanish
References: 20
Page: 343-348
PDF size: 54.91 Kb.


ABSTRACT

Background: The importance of transient ischemic attack episodes (TIA) are related with the high risk of ischemic stroke in the following days or weeks. Indeed, around 20% of cerebral infarcts are preceded by a TIA. Objective: To determine the prevalence of carotid artery stenosis in Mexican patients with TIA. Patients and methods: By merging data bases of national registers on cerebrovascular diseases, patients were included in the current study if a carotid Doppler ultrasonography has been performed during their evaluation. Doppler findings were classified as 1) Normal, 2) Mild carotid atherosclerosis, and 3) Severe carotid stenosis ›50%. Results: We studied 185 patients (99 men and 88 women), median age 70 years-old (IQR 60-77 years). Sixty patients (32.4%) had a normal Doppler, without atherosclerosis; 66 (35.7%) had nonstenotic plaques; and 59 (31.9%) had evidence of severe atherosclerosis with carotid stenosis ›50%: 23 (12.4%) with 50-69% carotid stenosis, 23 (12.4%) stenosis of 70-99%, and 13 (7%) had atherothombotic occlusion. Conclusion: The current study allows estimating that in Mexico around 25% of patients with TIA have severe carotid stenosis.


REFERENCES

  1. Hatano S. Experience from a multicentre stroke register: a preliminary report. Bulletin WHO 1976; 54: 541-53.

  2. Johnston SC, Gress DR, Browner WS, Sidney S. Short-term prognosis after emergency department diagnosis of TIA. JAMA 2000; 284(22): 2901-6.

  3. Giles MF, Rothwell PM. Risk of stroke early after transient ischemic attack: a systematic review and meta-analysis. Lancet Neurology 2007; 6: 1063-72.

  4. Kleindorfer D, Panagos P, Pancioli A, Khoury J, Kissela B, et al. Incidence and short-term prognosis of transient ischemic attack in a populationbased study. Stroke 2005; 36: 720-3.

  5. Rothwell PM, Warlow CP. Timing of TIAs preceding stroke: time window for prevention is very short. Neurology 2005; 64: 817-20.

  6. North American Symptomatic Carotid Endarterectomy Trial Collaborators. Benefit of carotid endarterectomy in patients with symptomatic moderate or severe stenosis. N Engl J Med 1998; 339: 1415-25.

  7. European Carotid Surgery Trial lists’ Collaborative Group. Randomized trial of endarterectomy for recently symptomatic carotid stenosis: final result of the MRC European Carotid Surgery Trial. Lancet 1998; 351: 1379-87.

  8. Cantú-Brito C, Ruiz-Sandoval JL, Murillo-Bonilla LM, Chiquete E, León- Jiménez C, Arauz A, Villarreal-Careaga J, et al. Manejo agudo y pronóstico a un año en pacientes mexicanos con un primer infarto cerebral: Resultados del estudio multicéntrico PREMIER.

  9. Arauz A, Cantú C, Ruiz-Sandoval JL, Villarreal-Careaga J, Barinagarrementeria F, Murillo-Bonilla L, Fernández JA, et al., a nombre del Registro Nacional Mexicano de Enfermedad Vascular Cerebral (RENAMEVASC). Pronóstico a corto plazo de la isquemia cerebral transitoria. Registro Multicéntrico de Enfermedad Vascular Cerebral en México. Rev Inv Clin 2006; 58: 530-9.

  10. Cantú-Brito C, Majersik JJ, Sánchez BN, Ruano A, Quiñones G, Arzola J, Morgenstern LB. Hospitalized Stroke Surveillance in the Community of Durango, Mexico. The Brain Attack Surveillance in Durango Study. Stroke 2010; 41: 878-84.

  11. Fisher M, Paganini-Hill A, Martin A, et al. Carotid plaque pathology: thrombosis, ulceration, and stroke pathogenesis. Stroke 2005; 36: 253-7.

  12. Fisher CM. Occlusion of the internal carotid artery. Arch Neurol Psychiatry 1951; 65: 346-77.

  13. Purroy F, Montaner J, Delgado P, Arenillas JF, Molina CA, Santamarina E, et al. Efectividad del estudio ultrasonográfico precoz en el pronóstico a corto plazo de los pacientes con un accidente vascular cerebral isquémico transitorio. Med Clin (Barc) 2006; 6(126): 647-50.

  14. Allendoerfer J, Goertler M, von Reutern G-M, for the Neurosonology in Acute Ischemic Stroke (NAIS) Study Group. Prognostic relevance of ultra-early doppler sonography in acute ischemic stroke: a prospective multicentre study. Lancet Neurol 2006; 5: 835-40.

  15. Wasay M, Azeemuddin M, Masroor I, Sajjad Z, Ahmed R, Khealani BA, et al. Frequency and Outcome of Carotid Atheromatous Disease in Patients With Stroke in Pakistan. Stroke 2009; 40: 708-12.

  16. Mazighi M, Labreuche J, Gongora-Rivera F, Duyckaerts CH, Hauw J-J, Amarenco P. Autopsy Prevalence of Proximal Extracranial Atherosclerosis in Patients With Fatal Stroke. Stroke 2009; 40: 713-8.

  17. Goessens BMB, Visseren FLJ, Kappelle LJ, et al. Asymptomatic carotid artery stenosis and the risk of new vascular events in patients with manifest arterial disease. The SMART Study. Stroke 2007; 38: 1470-5.

  18. Luengo-Fernandez R, Gray AM, Rothwell PM. Effect of urgent treatment for transient ischemic attack and minor stroke on disability and hospital costs (EXPRESS study): a prospective population-based sequential comparison. Lancet Neurol 2009; 8: 235-43.

  19. Lavallée, Meseguer E, Abboud H, Cabrejo L, Olivot J-M, Simon O, etal. A transient ischemic attack clinic with round-the-clock access (SOSTIA): feasibility and effects. Lancet Neurol 2007; 6: 953-60.

  20. Sheehan OC, Kyne L, Kelly LA, Hannon N, Marnane M, Merwick A, et al. Population-based study of ABCD2 score, carotid stenosis, and a trial fibrillation for early stroke prediction after transient ischemic attack: the North Dublin TIA study. Stroke 2010; 41: 844-50.




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