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Rivista di Angiologia

Official Journal of the International Union of Angiology, the International Union of Phlebology and the Central European Vascular Forum
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International Angiology 1998 September;17(3):194-200


lingua: Inglese

Prevalence of asymp­to­mat­ic CT ­infarcts in the ongoing asymp­to­mat­ic carot­id sur­gery trial (ACST)

Robless P., BAxter A., Byrd S., Emson M., Halliday A. on ­behalf of the Asymptomatic Carotid Surgery Trial Collaborators

From the Academic Surgical Unit, St. Mary’s Hospital, London, UK


Background. The ACST has ran­dom­ised over 1670 ­patients to deter­mine if carot­id endar­te­rec­to­my (CEA) pro­longs ­stroke free sur­vi­val when com­pared with best med­i­cal treat­ment alone. This study aims to ­assess the prev­a­lence of asymp­to­mat­ic cere­bral ­infarcts in ­patients ­grouped by sex, age, mean blood pres­sure (MBP), total cho­les­te­rol, dia­betes and cor­o­nary ­artery dis­ease (CAD).
Methods. The type of study was ret­ro­spec­tive. Patients with pre­op­er­a­tive CT scans were includ­ed. In those with pre­vi­ous ­stroke, only the con­tra­lat­er­al cere­bral hem­i­sphere was stud­ied for pres­ence of ­infarcts. One thou­sand one hun­dred and forty-two ­patients were stud­ied.
Results. The pro­por­tion of ­patients with CT ­infarcts was 19% (211/1142). Men (155/777) had a high­er inci­dence of CT infarc­tion (20% vs 15%, p=0.01). Mean age was 68 years and mean MBP was 107 mmHg. The inci­dence of CT ­infarcts was not asso­ciat­ed with age or MBP. Diabetics or those with def­i­nite CAD had no dif­fer­ence in the inci­dence of cere­bral infarc­tion. Diabetics with def­i­nite CAD (51/796) had a great­er inci­dence of CT ­infarcts (33% vs 21%, p=0.03) com­pared with those with­out evi­dence of CAD and dia­betes togeth­er (745/796).
Conclusions. In ACST, CT ­infarcts are more prev­a­lent in men com­pared to women, and in dia­bet­ics with CAD. There was no dif­fer­ence in the inci­dence of CT infarc­tion by age, mean BP, or by the pres­ence of dia­betes or CAD alone.

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