Clinical Relevance of Carotid Atherosclerosis among Egyptians: A 5-Year Retrospective Analysis of 4,733 Subjects

Abstract

Background and Purpose: The prevalence of carotid artery stenosis has been studied in several cohorts and groups of populations. Prevalence estimates were mostly based on ultrasound studies, because duplex ultrasound is accurate, reproducible and inexpensive to diagnose and follow up patients with arterial disorders. The purpose of our study was to describe the pattern of carotid artery disease in a large sample of Egyptians. Methods: We analyzed the data of 4,733 Egyptian subjects, who underwent extracranial carotid duplex scanning at the vascular laboratories of Cairo University Hospitals from January 1, 2003, to January 1, 2008. Demographic, clinical data and causes of referral were correlated with ultrasound findings. Results: Atherosclerotic carotid artery disease was present in 41% of the study population in the form of intimal thickening in 835 (17.6%), <50% stenosis in 983 (20.8%), 50–69% stenosis in 81 (1.7%), ≧70% stenosis in 38 (0.8%) and occlusion of internal carotid artery in 3 (0.06%) patients. Nonatherosclerotic disease was detected in 9 (0.2%) patients only. Significant and clinically relevant stenosis ≧50% was detected in 19 (2.5%) of the atherosclerotic symptomatic subjects. Multivariate stepwise logistic regression analysis selected age, diabetes mellitus, hypertension, smoking and dyslipidemia as independent predictors of the presence of carotid atherosclerotic disease. Conclusion: Hemodynamically significant and clinically relevant extracranial atherosclerotic carotid disease is rare among Egyptians. Risk factors for carotid atherosclerosis are the same as in societies where carotid disease is more prevalent.