Screening for Significant Carotid Artery Disease among a Cohort of 1,000 Egyptian Patients

Abstract

The objective of this study was to determine the prevalence of significant carotid artery disease (SCAD) in a cohort of Egyptian patients to compare it with matched groups of patients in published data of Western populations. One thousand consecutive patients referred for color flow duplex scanning of the carotid arteries were included. SCAD was defined as carotid stenosis > or = 50% or occlusion. There were 567 males (56.7%), and the mean age was 60.4 years. There were 382 (38.2%) patients presenting with and 617 (61.7%) patients without specific carotid territory symptoms. SCAD was significantly more prevalent in patients aged > or = 60 (13.2%, vs 6.25%; p < .001), in symptomatic patients (16.45% vs 6.32%; p < .001), in diabetics (15.96% vs 7.39%; p < .001), in patients with ischemic heart disease (17.65% vs 7.22%; p < .001), in hypertensive patients (12% vs 7.54%; p = .025), and in patients with dyslipidemia (12.53% vs 6.56%; p < .025). The prevalence of SCAD in this cohort of Egyptian patients was similar to that of matched patients of Western populations. Screening for SCAD in patients with specific carotid territory symptoms is recommended. Screening of asymptomatic subjects could be considered if they are > or = 60 years of age and have three or more associated risk factors.

Is Carotid Atherosclerosis Epidemiology Changed among Egyptians?

“…This finding is in contrast with study results by Bishara et al [4] , which show that the prevalence of carotid artery disease in their cohort of 1,000 Egyptian patients was similar to that in matched patients of Western populations, and that significant stenosis was detected in 16% of symptomatic subjects.…”

Society for Vascular Surgery clinical practice guidelines for management of extracranial cerebrovascular disease

“…82 One investigator reported that screening of asymptomatic patients is appropriate if they were aged $60 years and had three or more traditional atherosclerotic risk factors. 83 However, few direct comparative studies have evaluated the efficacy of screening with respect to the actual clinical outcomes of stroke or death. Most reported studies have used the prevalence of significant carotid stenosis in the studied populations as the actual outcome measure.…”