Diogo C Haussen1, David Z Rose2, Doniel Drazin3, Scott D Newsome4, Hannah Gardener5, Randall C Edgell6, Alan Boulos7, Gary Bernardini8, Tatjana Rundek5, Dileep R Yavagal5. 1. Department of Neurology, Neurosurgery and Radiology, Emory University School of Medicine, Atlanta, Ga., USA. 2. Department of Neurology, University of South Florida, Tampa, Fla., USA. 3. Department of Neurosurgery, Cedars-Sinai Medical Center, Los Angeles, Calif., USA. 4. Department of Neurology, Johns Hopkins School of Medicine, Baltimore, Md., USA. 5. Department of Neurology, University of Miami Miller School of Medicine, Miami, Fla., USA. 6. Department of Neurology and Psychiatry, St. Louis University, St. Louis, Mo., USA. 7. Department of Neurosurgery, Albany Medical Center, Albany, N.Y., USA. 8. Department of Neurology, Albany Medical Center, Albany, N.Y., USA.
Abstract
OBJECTIVE: We aimed to determine factors associated with recent infarct (RI) in patients with newly identified atherosclerotic cervical internal carotid artery occlusion (CICAO). METHODS: This was a retrospective review of consecutive patients who underwent cervical CT angiography from 2002 to 2006 at a single tertiary center. RI was defined by positive diffusion-weighted imaging/apparent diffusion coefficient magnetic resonance imaging (MRI) in the correspondent CICAO territory. Subjects were dichotomized into those with a RI versus patients with no RI (No-RI). RESULTS: Of 2,459 patients with cervical CT angiograms in the study period, 108 (4.4%) had complete medical records and brain MRI and were included. The mean age was 64 ± 13 years, 58% were men, and 62 (57%) had a RI. The demographics of the RI and No-RI patients were comparable, with the exception that those with RI had a lower frequency of coronary artery disease (CAD, 13 vs. 54%; p < 0.01) and dyslipidemia (38 vs. 69%; p < 0.01). The use of antiplatelets was not statistically different between the groups (56 vs. 71%; p = 0.1). Subjects with RI were less likely on statins (21 vs. 56%; p < 0.01) and antihypertensives (9 vs. 71%; p < 0.01). Multivariate regression revealed that CAD, the use of statins, and the use of antihypertensives were associated with No-RI CICAO presentation. CONCLUSION: The use of statins and antihypertensives is associated with a decreased risk of RI atherosclerotic CICAO.
OBJECTIVE: We aimed to determine factors associated with recent infarct (RI) in patients with newly identified atherosclerotic cervical internal carotid artery occlusion (CICAO). METHODS: This was a retrospective review of consecutive patients who underwent cervical CT angiography from 2002 to 2006 at a single tertiary center. RI was defined by positive diffusion-weighted imaging/apparent diffusion coefficient magnetic resonance imaging (MRI) in the correspondent CICAO territory. Subjects were dichotomized into those with a RI versus patients with no RI (No-RI). RESULTS: Of 2,459 patients with cervical CT angiograms in the study period, 108 (4.4%) had complete medical records and brain MRI and were included. The mean age was 64 ± 13 years, 58% were men, and 62 (57%) had a RI. The demographics of the RI and No-RI patients were comparable, with the exception that those with RI had a lower frequency of coronary artery disease (CAD, 13 vs. 54%; p < 0.01) and dyslipidemia (38 vs. 69%; p < 0.01). The use of antiplatelets was not statistically different between the groups (56 vs. 71%; p = 0.1). Subjects with RI were less likely on statins (21 vs. 56%; p < 0.01) and antihypertensives (9 vs. 71%; p < 0.01). Multivariate regression revealed that CAD, the use of statins, and the use of antihypertensives were associated with No-RI CICAO presentation. CONCLUSION: The use of statins and antihypertensives is associated with a decreased risk of RI atherosclerotic CICAO.
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