Prevalence, predictors and outcome of carotid stenosis: a sub study in the Preventive Antibiotics in Stroke Study (PASS)
Abstract Background The prevalence of carotid artery stenosis (CAS) in acute ischaemic stroke (AIS) patients is historically reported at 15–20%, but an up-to-date estimate is lacking. We hypothesise it is lower than historically reported, due to better risk management to date. The study aims to stud...
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| Format: | Article |
| Language: | English |
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BMC
2021-01-01
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| Series: | BMC Neurology |
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| Online Access: | https://doi.org/10.1186/s12883-020-02032-4 |
| _version_ | 1818960670753816576 |
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| author | Twan J van Velzen Laurien S Kuhrij Willeke F Westendorp Diederik van de Beek Paul J Nederkoorn |
| author_facet | Twan J van Velzen Laurien S Kuhrij Willeke F Westendorp Diederik van de Beek Paul J Nederkoorn |
| author_sort | Twan J van Velzen |
| collection | DOAJ |
| description | Abstract Background The prevalence of carotid artery stenosis (CAS) in acute ischaemic stroke (AIS) patients is historically reported at 15–20%, but an up-to-date estimate is lacking. We hypothesise it is lower than historically reported, due to better risk management to date. The study aims to study prevalence, predictors and survival of CAS in AIS patients. Methods We included patients with AIS from the Preventive Antibiotics in Stroke Study (PASS), a large Dutch randomized, multicentre, open-label phase III trial that included 2538 patients with acute stroke and randomised between standard care or preventive ceftriaxone. Patients with stroke in the anterior circulation that underwent diagnostic testing of the internal carotid artery (ICA) were eligible for this sub study and used in these secondary analyses. Logistic regression analyses were performed to identify predictors for CAS ≥ 50%. Additionally, an ordinal regression was performed to assess the association between presence of CAS at baseline and functional outcome at three months on the modified Rankin scale (mRS). Results 1480 patients with AIS were included; 277 had CAS (18.7%; 95%CI:17.7-19.7). Age, hypertension, smoking and male gender were found as best-fit predictors for presence of CAS. Significant shift in mRS score after 90 days for CAS ≥50% towards a higher mRS score with an OR of 1.66 (95% CI 1.30-2.10) was found. Conclusions Current prevalence of CAS is 18.7%, which is higher than we expected. Gender, smoking and hypertension are important factors associated with CAS. Patients with CAS had a significantly higher mRs score after 90 days. Trial registration Unique identifier: ISRCTN66140176 |
| first_indexed | 2024-12-20T12:01:14Z |
| format | Article |
| id | doaj.art-5079105e47ff47fca265fe42b95e8b4d |
| institution | Directory Open Access Journal |
| issn | 1471-2377 |
| language | English |
| last_indexed | 2024-12-20T12:01:14Z |
| publishDate | 2021-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Neurology |
| spelling | doaj.art-5079105e47ff47fca265fe42b95e8b4d2022-12-21T19:41:32ZengBMCBMC Neurology1471-23772021-01-012111610.1186/s12883-020-02032-4Prevalence, predictors and outcome of carotid stenosis: a sub study in the Preventive Antibiotics in Stroke Study (PASS)Twan J van Velzen0Laurien S Kuhrij1Willeke F Westendorp2Diederik van de Beek3Paul J Nederkoorn4Department of Neurology, Amsterdam UMC, location MeibergdreefDepartment of Neurology, Amsterdam UMC, location MeibergdreefDepartment of Neurology, Amsterdam UMC, location MeibergdreefDepartment of Neurology, Amsterdam UMC, location MeibergdreefDepartment of Neurology, Amsterdam UMC, location MeibergdreefAbstract Background The prevalence of carotid artery stenosis (CAS) in acute ischaemic stroke (AIS) patients is historically reported at 15–20%, but an up-to-date estimate is lacking. We hypothesise it is lower than historically reported, due to better risk management to date. The study aims to study prevalence, predictors and survival of CAS in AIS patients. Methods We included patients with AIS from the Preventive Antibiotics in Stroke Study (PASS), a large Dutch randomized, multicentre, open-label phase III trial that included 2538 patients with acute stroke and randomised between standard care or preventive ceftriaxone. Patients with stroke in the anterior circulation that underwent diagnostic testing of the internal carotid artery (ICA) were eligible for this sub study and used in these secondary analyses. Logistic regression analyses were performed to identify predictors for CAS ≥ 50%. Additionally, an ordinal regression was performed to assess the association between presence of CAS at baseline and functional outcome at three months on the modified Rankin scale (mRS). Results 1480 patients with AIS were included; 277 had CAS (18.7%; 95%CI:17.7-19.7). Age, hypertension, smoking and male gender were found as best-fit predictors for presence of CAS. Significant shift in mRS score after 90 days for CAS ≥50% towards a higher mRS score with an OR of 1.66 (95% CI 1.30-2.10) was found. Conclusions Current prevalence of CAS is 18.7%, which is higher than we expected. Gender, smoking and hypertension are important factors associated with CAS. Patients with CAS had a significantly higher mRs score after 90 days. Trial registration Unique identifier: ISRCTN66140176https://doi.org/10.1186/s12883-020-02032-4Carotid stenosisIschaemic strokePrevalencePredictorsSurvival |
| spellingShingle | Twan J van Velzen Laurien S Kuhrij Willeke F Westendorp Diederik van de Beek Paul J Nederkoorn Prevalence, predictors and outcome of carotid stenosis: a sub study in the Preventive Antibiotics in Stroke Study (PASS) BMC Neurology Carotid stenosis Ischaemic stroke Prevalence Predictors Survival |
| title | Prevalence, predictors and outcome of carotid stenosis: a sub study in the Preventive Antibiotics in Stroke Study (PASS) |
| title_full | Prevalence, predictors and outcome of carotid stenosis: a sub study in the Preventive Antibiotics in Stroke Study (PASS) |
| title_fullStr | Prevalence, predictors and outcome of carotid stenosis: a sub study in the Preventive Antibiotics in Stroke Study (PASS) |
| title_full_unstemmed | Prevalence, predictors and outcome of carotid stenosis: a sub study in the Preventive Antibiotics in Stroke Study (PASS) |
| title_short | Prevalence, predictors and outcome of carotid stenosis: a sub study in the Preventive Antibiotics in Stroke Study (PASS) |
| title_sort | prevalence predictors and outcome of carotid stenosis a sub study in the preventive antibiotics in stroke study pass |
| topic | Carotid stenosis Ischaemic stroke Prevalence Predictors Survival |
| url | https://doi.org/10.1186/s12883-020-02032-4 |
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