Family History as a Risk Factor for Carotid Artery Stenosis

Khaleghi, Mahyar; Isseh, Iyad; Jouni, Hayan; Sohn, Sunghwan; Bailey, Kent R.; Kullo, Iftikhar J.

doi:10.1161/strokeaha.114.006245

Cited by 18 publications

(7 citation statements)

References 26 publications

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“…Subjects with FHS were found to have higher blood levels of factor VII:C [72], homocysteine [73], C-reactive protein, insulin and diagnosed insulin resistance [63], as well as higher brachial-ankle pulse wave velocity, indicating arterial stiffness [74]. According to one study, stroke-free subjects with FHS more often had significant carotid ar-tery stenosis [75], which however was not confirmed by other authors [76].…”

Section: Interaction With Stroke Risk Factorsmentioning

confidence: 90%

Family history of stroke – a useful clue for the primary care physician and stroke neurologist: a narrative review

Błaż¹,

Sarzyńska‐Długosz²

2023

ppn

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Purpose:The heritability of ischemic stroke is a complex mechanism, involving the contribution of genetic traits and environmental factors, which is why in everyday practice clinicians often rely on the broad term "family history of stroke", defined as the case of any first-degree relative who has had a stroke. The aim of this review is to update the available data regarding family history of stroke in primary and secondary stroke prevention by searching the electronic Scopus database for the phrase TITLE-ABS-KEY ("family history" AND "stroke"). Views: A total of 140 articles met the pre-specified criteria and were included in the review. The prevalence of family history of stroke ranged from 37% in stroke-free individuals to 52% in patients with ischemic stroke. In primary prevention, family history of stroke was associated with increased risk of stroke, transient ischemic attack, stroke risk factors and stroke-like symptoms. In patients with ischemic stroke, it was more often associated with small-and large-vessel disease, though not with a cardioembolic etiology. Family history of stroke did not influence long-term functional outcomes after rehabilitation. In young stroke victims, it was related to symptom severity and the risk of a second stroke. Conclusions: Consideration of family history of stroke in everyday practice may carry useful information both for primary care physicians and stroke neurologists.

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Section: Interaction With Stroke Risk Factorsmentioning

confidence: 90%

Family history of stroke – a useful clue for the primary care physician and stroke neurologist: a narrative review

Błaż¹,

Sarzyńska‐Długosz²

2023

ppn

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“…Unfortunately, we did not ask about the family history of strokes of any cause or coronary artery disease. In a study performed by Khaleghi et al [ 14 ], a family history of stroke or congestive heart disease was independently associated with carotid artery disease. In addition, siblings’ history of stroke or congestive heart disease confers greater risk than parental history, and the magnitude of association is greater in those with a greater number of affected relatives [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

Carotid Artery Angioplasty and Stenting for Carotid Stenosis: A Single-Center Experience from Saudi Arabia

et al. 2020

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Purpose: Atherosclerotic stenosis of the extracranial carotid artery accounts for approximately 20% of all strokes. Both carotid artery endarterectomy and carotid artery angioplasty with stenting (CAAS) are recommended for symptomatic patients with 50% or more stenosis or asymptomatic patients with 70% or more stenosis. CAAS is under-reported in Saudi Arabia, as evidenced by a thorough literature search. In this article, we aim to share our experience of CAAS to call for the necessity of conducting more research on stroke and emphasize the local need of utilizing more endovascular treatments like CAAS.Materials and Methods: A retrospective single-center observational study was conducted at King Abdulaziz Medical City in Jeddah, Saudi Arabia. The inclusion criteria consisted of all adult patients (18 years and above) with carotid stenosis who were treated with CAAS.Results: A total of 16 patients were included in the study. The mean age of the participants was 66.9±13.5 years (range 30–87 years). All patients were symptomatic (had a previous stroke or transient ischemic attack). The procedure was successful in 14 patients (87.5%), while it failed in 2 patients (12.5%) due to technical reasons. All patients had no stroke or myocardial infarction within 30 days of the procedure.Conclusion: Despite the advancement in medicine with free healthcare services in Saudi Arabia, the interventional procedures for secondary prevention of strokes are underutilized. Collaboration between different hospitals will be extremely helpful since few centers in each city are providing such treatments by an expert neurointerventionist and/or strokologist. The good selection of candidates, optimal management of comorbid conditions, and multidisciplinary care may improve outcomes and reduce mortality.

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“…Sibling history of stroke or CHD was a stronger risk factor than parental history, and the association was stronger in people with more affected relatives, regardless of the family size. These findings imply that common genetic and environmental factors influence the risk of CAS and that carotid atherosclerosis and CHD share several genetic variations [ 29 ]. Three independent risk variables for restenosis were male sex, smoking, and hyperlipidemia.…”

Section: Reviewmentioning

confidence: 99%

Carotid Artery Stenosis: A Look Into the Diagnostic and Management Strategies, and Related Complications

Ismail¹,

Ravipati²,

Gonzalez‐Hernandez³

et al. 2023

Cureus

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Carotid stenosis (CS) is a buildup of atherosclerotic plaque within the artery leading to a wide range of symptoms, from mild symptoms, including blurred vision and confusion, to much more life-threatening presentations, including paralysis due to stroke. The presentation is insidious, with symptoms exhibiting predominantly at severe stenosis; hence the emphasis is placed on the importance of early diagnosis, treatment, and lifestyle modifications. CS is seen undergoing almost the same pathogenesis of any atherosclerotic plaque formation, from endothelial damage of the artery lumen to the formation of a fibrous cap with a foam cell, lipid-filled core. The findings of our review article were consistent with the recent literature, depicting that comorbid hypertension, diabetes, and chronic kidney disease (CKD), and lifestyle aspects, including smoking and diet, played the most salient role in plaque development. Among several imaging modalities, duplex ultrasound (DUS) imaging is the widely preferred method in clinical practice. Carotid endarterectomy (CEA) and carotid stenting are the primarily advocated procedures for symptomatic severe stenosis, with similar long-term outcomes. Although, earlier clinical trials showed promising results in mitigating the risk of stroke among asymptomatic severe CS with surgical intervention. However, recent advancements have shifted the focus to medical management alone due to comparable results among the asymptomatic population. Both surgical and medical regimens are beneficial in treating patients, but it is still an ongoing debate as to which is predominantly superior. The currently advancing trials and research will help elucidate definitive guidelines. However, the massive impact of lifestyle modifications advocates some degree of individualized multidisciplinary management strategies.

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Family History as a Risk Factor for Carotid Artery Stenosis

Cited by 18 publications

References 26 publications

Family history of stroke – a useful clue for the primary care physician and stroke neurologist: a narrative review

Family history of stroke – a useful clue for the primary care physician and stroke neurologist: a narrative review

Carotid Artery Angioplasty and Stenting for Carotid Stenosis: A Single-Center Experience from Saudi Arabia

Carotid Artery Stenosis: A Look Into the Diagnostic and Management Strategies, and Related Complications

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