Validation of two different grading schemes to identify patients with asymptomatic carotid artery stenosis in general population.

Pubmed ID: 18380694

Journal: Journal of neuroimaging : official journal of the American Society of Neuroimaging

Publication Date: April 1, 2008

Affiliation: Zeenat Qureshi Stroke Research Center, Department of Neurology, University of Minnesota, Minneapolis, Minnesota 55455, USA. suri0027@umn.edu

MeSH Terms: Humans, Male, Female, Aged, Prevalence, ROC Curve, Risk Assessment, Mass Screening, Chi-Square Distribution, Carotid Stenosis, Ultrasonography, Doppler

Authors: Qureshi AI, Suri MF, Divani AA, Ezzeddine MA, Lakshminarayan K

Cite As: Suri MF, Ezzeddine MA, Lakshminarayan K, Divani AA, Qureshi AI. Validation of two different grading schemes to identify patients with asymptomatic carotid artery stenosis in general population. J Neuroimaging 2008 Apr;18(2):142-7.

Studies:

Abstract

BACKGROUND: Identification of significant asymptomatic carotid artery stenosis (ACAS) is important because of potential stroke-risk reduction offered by carotid endarterectomy. We present an external validation of two previously developed scoring schemes designed to identify patients with ACAS. METHODS: We used the data from the Cardiovascular Health Study (CHS)-a cohort study of cardiovascular risk factors, for external validation. Carotid Doppler ultrasound was performed in study participants. Two grading schemes, which used age more than 65 years, current smoking, and history of coronary artery disease and hyperlipidemia as predictors for ACAS, were validated using this dataset. RESULTS: A total of 5,449 persons (mean age 72 +/- 5 years; 42% men; and 84% white) were screened. The overall prevalence of ACAS of > or =50% was 4.2%. The prevalence of ACAS in the highest risk category was 19% in both stratification schemes. The stratification remained effective in the white sub-population (P < .001), but was not significant in the African American population (P > .05). CONCLUSION: Both schemes were effective in identifying persons with ACAS among general population aged 65 years or greater. A subset with a prevalence of ACAS of greater than 20% can be identified using these schemes making screening cost-effective among white population.