Outcome in Patients with Asymptomatic Neck Bruits

Chambers, Brian R.; Norris, John W.

doi:10.1056/nejm198610023151404

Cited by 533 publications

(191 citation statements)

References 21 publications

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“…25 In addition, patients with carotid artery disease more often die from coronary atherosclerosis than from complications of carotid atherosclerosis. 26 ' 27 Thus, the relation of measurements of carotid atherosclerosis to the extent of disease in the coronary circulation may be more important than its use in measuring local disease.…”

Section: Resultsmentioning

confidence: 99%

Relation of extent of extracranial carotid artery atherosclerosis as measured by B-mode ultrasound to the extent of coronary atherosclerosis.

Wofford

Kahl

Howard

et al. 1991

Arterioscler Thromb

281

142

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The extent of carotid artery atherosclerosis as measured by B-mode ultrasound has been shown to be strongly and independently correlated with the presence or absence of coronary atherosclerotic disease (CAD), but no studies to date have used carotid B-mode ultrasound to compare the extent of atherosclerotic disease in the two arterial circulations. We used data from a registry of patients undergoing cardiac catheterization and B-mode ultrasound of the carotid arteries to compare the extent of CAD (number of major coronary vessels with 50% or greater stenosis as judged by a consensus interpretation) with the extent of extracranial carotid atherosclerosis. Four hundred thirty-four patients (234 men, 200 women) greater than 40 years of age were stratified by gender and then divided into quartiles on the basis of a B-mode score that was derived by summing arterial wall thickness at nine sites in the left and nine sites in the right carotid arteries. Evaluation of extent of CAD for the four B-mode quartiles showed that men in the lowest B-mode quartile were over six times more likely to have normal coronary arteries than three-to four-vessel CAD, while men in the highest B-mode quartile were over 10 times more likely to have three-to four-vessel CAD than normal coronary arteries. The findings were similar for women but not as dramatic Gender-specific discriminant function models using traditional risk factors alone or in combination with B-mode score were developed to predict the extent of CAD. Discriminant models containing traditional risk factors alone performed only slightly better than a model that contained only the B-mode score. The addition of the B-mode score to models of traditional risk factors added little to the predictive ability for CAD extent (/Irteriosclerosis and Thrombosis 1991;11:1786-1794) E pidemiological studies have established certain factors (age, male gender, hypertension, dyslipidemia, diabetes, and smoking) as predictors of clinical manifestations of coronary artery disease (CAD).1 -3 These same risk factors have also

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Section: Resultsmentioning

confidence: 99%

Relation of extent of extracranial carotid artery atherosclerosis as measured by B-mode ultrasound to the extent of coronary atherosclerosis.

Wofford

Kahl

Howard

et al. 1991

Arterioscler Thromb

281

142

View full text Add to dashboard Cite

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“…As with asymptomatic carotid bruit, an asymptomatic stenosis of the carotid artery is an important indicator of concomitant ischemic cardiac disease. 68,69,72 There have been 4 published randomized controlled trials that were designed to address the benefit of carotid endarterectomy in patients with asymptomatic carotid artery stenosis. The CASANOVA (Carotid Artery Stenosis with Asymptomatic Narrowing: Operation Versus Aspirin) study was inconclusive.…”

Section: Asymptomatic Carotid Stenosismentioning

confidence: 99%

Primary Prevention of Ischemic Stroke

Goldstein¹,

Adams²,

Becker³

et al. 2001

Circulation

406

196

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“…46 In the Toronto prospective study of carotid bruit 44 and stenosis, 47 both bruit and degree of stenosis indicated higher cardiovascular risk.…”

Section: Asymptomatic Chd In Patients With Atherosclerotic Carotid Stmentioning

confidence: 99%

Coronary Risk Evaluation in Patients With Transient Ischemic Attack and Ischemic Stroke

Adams¹,

Chimowitz²,

Alpert³

et al. 2003

Circulation

226

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Stroke and myocardial infarction (MI) share common risk factors and pathological mechanisms, and coronary artery disease (CHD) is an important cause of death in patients with cerebrovascular disease. This Scientific Statement addresses issues in management of the relatively healthy patient with brain ischemia (a transient ischemic attack [TIA] or an ischemic stroke) who does not have recognized CHD but often has risk factors in addition to having had a TIA or stroke that indicate an increased likelihood of disability or death from cardiac disease in the future. This Statement should not be confused with the official American College of Cardiology (ACC)/American Heart Association (AHA) practice guidelines. The reader is referred to the ACC/AHA guidelines for management of recognized and symptomatic CHD 1 and the American College of Chest Physicians (ACCP) 2 and American Stroke Association (ASA) 3-5 guidelines for evaluation of cardiac causes of TIA and stroke, which are important related but separate issues.

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Outcome in Patients with Asymptomatic Neck Bruits

Cited by 533 publications

References 21 publications

Relation of extent of extracranial carotid artery atherosclerosis as measured by B-mode ultrasound to the extent of coronary atherosclerosis.

Relation of extent of extracranial carotid artery atherosclerosis as measured by B-mode ultrasound to the extent of coronary atherosclerosis.

Primary Prevention of Ischemic Stroke

Coronary Risk Evaluation in Patients With Transient Ischemic Attack and Ischemic Stroke

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