Abstract
Background and Purpose: Carotid atherosclerosis has been recognized as a major cause of stroke. The cur-rent study aimed to describe the effect of multiplicity rather than the type of vascular risk factors on severity of carotid atherosclerosis among a large sample of Egyptian population. Methods: We analyzed the data of 1969 Egyptian subjects, who proved to have extra cranial carotid atherosclerotic disease by duplex scanning at the vascular laboratories of Cairo Uni-versity Hospitals. Demographic, clinical data and causes of referral were recorded and correlated with ultrasound findings. Atherosclerotic indices, namely IMT, plaque number and percentage of stenosis were used for evaluation of severity of carotid atherosclerosis. Furthermore, subjects were classified according to multiplicity of major atherosclerotic risk factors and multivariate regression analysis was performed to detect independent predictors of significant carotid disease. Results: Out of 1969 subjects with proved signs of extracranial carotid atherosclerosis by duplex ultrasonographic scan, 225 (11.4%) showed hemody-namic significant stenosis (≥50%). Multiplicity of risk factors beyond the age of 50 years was the strongest predictor of significant stenosis. Conclusion: Age more than 50 years and multiplicity rather than the type of risk factors were the strongest predictors of significant carotid atherosclerotic disease (CAD).
Highlights
Identification of risk factors in asymptomatic and/or symptomatic patients is the preferred method to improve the quality of clinical practice and patient care
The current study aimed to describe the effect of multiplicity rather than the type of vascular risk factors on severity of carotid atherosclerosis among a large sample of Egyptian population
This study highlights the strong relationship between aggregation of major cerebrovascular risk factors and severity of carotid atherosclerosis among a large sample of Egyptian subjects
Summary
Identification of risk factors in asymptomatic and/or symptomatic patients is the preferred method to improve the quality of clinical practice and patient care. It is well known that multiple risk factors contribute to atherosclerosis that causes cerebrovascular disease (CVD) and these risk factors interact multiplicatively [1,2]. Ultrasound measurements of IMT and plaque in the carotid arteries are important for the assessment of structural alterations and because the extent of atherosclerosis in these vessels reflects the severity of arterial damage in other vascular territories [3]. The significance of multiple risk factors and their relation to atherosclerosis has been mainly examined in European, American and Asian population [9]. It remains to be clarified whether multiple risk factors are related to severity of atherosclerosis and/or are predictive to atherosclerosis of the carotid arteries in the Egyptian population
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