Julien Joux1, Marion Boulanger2, Severine Jeannin2, Nicolas Chausson2, Jean-Luc Hennequin2, Vincent Molinié2, Didier Smadja2, Emmanuel Touzé2, Stephane Olindo2. 1. From the Stroke Unit (J.J., S.J.), Department of Vascular Surgery (J.-L.H.), and Department of Cellular Pathology (V.M.), University Hospital of Martinique, French West Indies; Stroke Unit, Hospital sud francilien, Corbeil Essonnes, France (N.C., D.S.); Stroke Unit, University Hospital Pellegrin, Bordeaux, France (S.O.); and Université de Caen Normandie, Inserm U919, CHU Côte de Nacre, Caen France (M.B., E.T.). julien.joux@gmail.com. 2. From the Stroke Unit (J.J., S.J.), Department of Vascular Surgery (J.-L.H.), and Department of Cellular Pathology (V.M.), University Hospital of Martinique, French West Indies; Stroke Unit, Hospital sud francilien, Corbeil Essonnes, France (N.C., D.S.); Stroke Unit, University Hospital Pellegrin, Bordeaux, France (S.O.); and Université de Caen Normandie, Inserm U919, CHU Côte de Nacre, Caen France (M.B., E.T.).
Abstract
BACKGROUND AND PURPOSE: Carotid bulb diaphragm (CBD) has been described in young carotid ischemic stroke (CIS) patients, especially in blacks. However, the prevalence of CBD in CIS patients is unknown, and whether CBD is a risk factor for CIS remains unclear. We assessed the association between CBD and incident CIS in a population-based study. METHODS: We selected all young (<55 years) CIS patients from a 1-year population-based cohort study in the Afro-Caribbean population of Martinique in 2012. All patients had a comprehensive work-up including a computed tomographic angiography. We calculated CIS associated with ipsilateral CBD incidence with 95% confidence intervals using Poisson distribution. We then selected age- and sex-matched controls among young (<55 years) Afro-Caribbean stroke-free patients admitted for a road crash who routinely had computed tomographic angiography. Odds ratio (ORs) were calculated by conditional logistic regression adjusted for hypertension, dyslipidemia, diabetes and smoking. RESULTS: CIS associated with ipsilateral CBD incidence was 3.8 per 100 000 person-years (95% confidence interval, 1.4-6.1). Prevalence of ipsilateral CBD was 23% in all CIS and 37% in undetermined CIS patients. When restricted to undetermined CIS, CBD prevalence was 24 times higher than that in controls (adjusted OR, 24.1; 95% confidence interval, 1.8-325.6). CONCLUSIONS: CBD is associated with an increased risk of ipsilateral CIS in young Afro-Caribbean population.
BACKGROUND AND PURPOSE: Carotid bulb diaphragm (CBD) has been described in young carotid ischemic stroke (CIS) patients, especially in blacks. However, the prevalence of CBD in CIS patients is unknown, and whether CBD is a risk factor for CIS remains unclear. We assessed the association between CBD and incident CIS in a population-based study. METHODS: We selected all young (<55 years) CIS patients from a 1-year population-based cohort study in the Afro-Caribbean population of Martinique in 2012. All patients had a comprehensive work-up including a computed tomographic angiography. We calculated CIS associated with ipsilateral CBD incidence with 95% confidence intervals using Poisson distribution. We then selected age- and sex-matched controls among young (<55 years) Afro-Caribbean stroke-freepatients admitted for a road crash who routinely had computed tomographic angiography. Odds ratio (ORs) were calculated by conditional logistic regression adjusted for hypertension, dyslipidemia, diabetes and smoking. RESULTS: CIS associated with ipsilateral CBD incidence was 3.8 per 100 000 person-years (95% confidence interval, 1.4-6.1). Prevalence of ipsilateral CBD was 23% in all CIS and 37% in undetermined CIS patients. When restricted to undetermined CIS, CBD prevalence was 24 times higher than that in controls (adjusted OR, 24.1; 95% confidence interval, 1.8-325.6). CONCLUSIONS:CBD is associated with an increased risk of ipsilateral CIS in young Afro-Caribbean population.
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