The aim of our study is to evaluate the cardiovascular risk profile for carotid artery stenosis in patients undergoing carotid surgery.
Design and method:
We studied prospectively 100 patients (75 men and 25 women of mean age 66.1 ± 8.2 years old) with >60% stenosis of the extracranial carotid arteries undergoing carotid endarterectomy (CEA). They were divided into two groups - 32 had symptomatic carotid artery stenosis and 68 were asymptomatic. We did not include patients with bilateral carotid artery thrombosis and those with severe neurological deficit. We analysed the risk factors for atherosclerosis, concomitant atherosclerotic disease and implemented medication. Blood pressure, total cholesterol and C-reactive protein had been measured.
In all 100 patients ultrasonography identified 116 carotid plaques causing >60% stenosis. We performed unilateral CEA of common and internal carotid arteries. 19 of the symptomatic patients had stroke, 9 – transient ischemic attack and 4 – amaurosis fugax. Percentage of hypertension is extremely high - 96%. It was more frequent in asymptomatic patients (97%) compared to the symptomatic patients (94%). 75% of all included patients had dyslipidemia and 73% were smokers. Diabetes was found in one third of the patients and more frequently in the symptomatic group (41%). C-reactive protein was with higher values in symptomatic than in asymptomatic patients but without statistical significance (p = 0.453). In 68% of all patients we found multifocal atherosclerosis - 21% had coronary artery disease and 47% - peripheral arterial disease. 54% of patients were on statin therapy, 88% - on antiplatelet drugs and 92% - on antihypertensive therapy.
Our results show that patients with advanced carotid pathology have high incidence (more than two) of traditional risk factors for atherosclerosis and hypertension was leading among them.