Buradasınız

Karotis Aterosklerozu Gelişmesinde Etkili Risk Faktörleri

Effective Risk Factors in Development Of Carotid Atherosclerosis

Journal Name:

Publication Year:

Keywords (Original Language):

Abstract (2. Language): 
Severe carotid stenosis has an importance in ischemic stroke development. In this study, effective risk factors in development of carotid atherosclerosis in acute stroke population are investigated. Patients were divided into three groups according to the degree of carotid stenosis: slight stenosis (<%30), medium stenosis (%30-69), severe stenosis (>%70). In univariate analysis, aging and smoking were found out as significant risk factors in carotid atherosclerosis development (respectively p=0.02, p=0.001). Ischemic heart disease and peripheral vascular disease were determined to have significant association with severe carotid stenosis (respectively p=0.05, p=0.02). When logistic regression analysis was used, smoking and ischemic heart disease were found to be significant independent determinants of severe carotid stenosis. When carotid plaque ultrasonic characterisation were investigated, soft, heterogenous plaques in severe stenosis group were found more than other groups. As a result, smoking and ischemic heart disease were seen to be important, independent risk factors in development of severe carotid atherosclerosis.
Abstract (Original Language): 
İskemik inme gelişiminde karotis stenozu önemli bir etyolojik faktördür. Bu çalışmada akut iskemik inme tanısı ile yatırılan 90 hastada karotis aterosklerozunun gelişiminde etkin risk faktörleri araştırılmıştır. Doppler ultrasonografide saptanan stenoz derecesine göre hastalar hafif stenoz grubu (stenoz derecesi< % 30), orta dereceli stenoz grubu (%30-69 arası), ağır stenoz grubu (> %70) olmak üzere üç gruba ayrılmıştır. Tek yönlü analizde, ağır stenoz grubunda yaş ortalamasının ve sigara kullanım oranının belirgin yüksek olduğu dikkat çekmiş- tir (sırasıyla p=0.02, p=0.001). Bu grubda, iskemik kalp hastalığı ve periferik arter hastalığı yüksek oranda saptanmıştır (sırasıyla p=0.05, p=0.02). Logistik regresyon analizinde ise sigara kullanımı ve iskemik kalp hastalığı ağır karotis stenozu gelişiminde bağımsız risk faktörü olarak belirlenmiştir. Karotis plaklarının ultrasonografik karakterleri araştırıldığı zaman, soft, heterojen plakların, ağır stenoz grubunda diğer grublara oranla daha fazla olduğu gözlenmiştir. Sonuç olarak sigara ve iskemik kalp hastalığı, karotis aterosklerozunun gelişmesinde bağımsız risk faktörü olarak görülmektedir.
19-24

REFERENCES

References: 

1. Jeng JS, Chung MY, Yip PK, Hwang BS, Chang YC.
Extracranial carotid atherosclerosis and vascular risk factors
in different types of ischemic stroke in Taiwan. Stroke
25(10): 1989-1993, 1994..
2. Moore WS, Boren C, Malone JM, Roon AJ, Eisenberg R,
Goldstone J, Mani R. Natural history of nonstenotic,
asymptomatic ulserative lesions of carotid artery. Arch Surg.
113: 1352-1359, 1978.
3. Zhu CZ, Norris JW. Role of carotid stenosis in ischemic
stroke. Stroke 21(8): 1131-1134, 1990.
4. Folsom AR, Eckfeldt JH, Weitzman S, Ma J, Chambless LE,
Barnes RW, Cram KB, Hutchinson RG. Relation of carotid
artery wall thickness to diabetes mellitus, fasting glucose and
insulin, body size, and physical activity. Stroke 25(1): 66-73,
1994.
5. Gomez CR: Carotid plaque morphology and risk for stroke.
Stroke 24: 25-29, 1989.
6. Hougaku H, Matsumoto M, Handa N, Maeda H, Itoh T,
Tsukamoto Y, Kamata T. Asymptomatic carotid lesions and
silent cerebral infarction. Stroke 25: 566-70, 1994.
7. Moore WS, Hall AD, Francisco S. Importance of emboli
from carotid bifurcation in pathogenesis of cerebral ischemic
attacks. Arch Surg. 101(12): 703-16, 1970.
8. O’Holleran LW, Kenelly MM, McClurken M, Johnson JM.
Natural history of asymptomatic carootid plaque. The Am. J.
Surg. 154: 659-62, 1987.
9. Ringelstein EB, Koschorke S, Holling A, Tron A, Lannertz
H, Minale C. Computed tomographic paterns of proven
embolic brain infarctions. Ann Neurol. 26: 759-65, 1989.
10. Kittner SJ, Sharkness CM, Price TR, Plotnick GD,
Dambrosia JM, Wolf PA, Mohr JP, Hier DB, Kase CS,
Tuhrim S. Infarcts with a cardiac source of embolism in the
NINCDS stroke data bank: Historical features. Neurology
40: 281-284, 1990.
11. Fabris F, Zanocchi M, Bo M, Fonte G, Poli L, Bergoglio I,
Ferrario E, Pernigotti L. Carotid plaque, aging, and risk
factors: A study of 457 subjects. Stroke 25(6): 1133-1140,
1994.
12. Handa N, Matsumoto M, Maeda H, Hougaku H, Ogawa S,
Fukunaga R, Yoneda S, Kimura K, Kamada T. Ultrasonic
evaluation of early carotid atherosclerosis. Stroke 21(11):
1567-72, 1990.
13. Lemne C, Jogestrand T, Faire deU. Carotid intima-media
thickness and plaque in borderline hypertension. Stroke
26(1): 34-9, 1995.
14. Palomaki H, Kaste M, Rainin R, Salonen O, Juvela S, Sarna
S. Risk factors for cervical atherosclerosis in patients with
transient ischemic attack or minor ischemic stroke. Stroke
24(7): 970-5, 1993.
15. Weber F. Risk factors for subclinical carotid atherosclerosis
in healthy men. Neurology 59(4): 524-528, 2002.
16. Brown PB, Zwiebel WJ, Call GK. Degree of cervical carotid
artery stenosis and hemispheric stroke: Duplex US findings.
Radiology 32: 541-43, 1989.
17. Heiss G, Sharrett AR, Barnes R, Chambless LE, Szklo M,
Alzola C. Carotid atherosclerosis measured by B-mode
ultrasound in populations: associations with cardiovascular
risk factors in the ARIC study. Am J Epidemiol. 134: 250-6,
1991.
18. Bogousslavsky J, Regli F, Melle GV. Risk factors and
concomitants of internal carotid artery occlusion or stenosis.
Arch Neurol 42: 864-67, 1985.
19. Pines A, Bornstein NM, Shapira I. Menopause and ischaemic
stroke: basic,clinical and epidemiological consideration. The
role of hormone replacement. Hum Reprod Update 8(2):
161-168, 2002.
20. Adams HP, Biller J: Ischemic cerebrovascular disease. In:
Bradley WG, Daroff RB, Fenichel GM, Marsden CD(eds):
Neurology in clinical practice. Vol. 2. ButterworthHeinemann, USA, 1991, pp 907-939.
21. Dempsey RJ, Moore RW. Amount of independently predicts
carotid artery atherosclerosis severity. Stroke 23(5): 693-96,
1992.
22. Homer D, Ingall TJ, O’Fallon WM, Kotte BA, Whisnant JP.
Serum lipids and lipoproteins are less powerful predictors of
extracranial carotid artery atherosclerosis that are cigarette
smoking and hypertension. Mayo Clin Proc. 66(3): 259-67,
1991.
23. Whisnant JP, Homer D, Ingall TJ, Baker HL, O’Fallon WM,
Wiebers DO. Duration of cigarette smoking is the strongest
predictor of severe extracranial carotid artery atherosclerosis.
Stroke 21(5): 707-14, 1990. N.S. Ertan, ark.
24
24. Csanyi A, Egervari A,Nagy Z. Influence of hypertension and
smoking as the single vascular risk factors on the intimamedia thickness. Eur J Epidemiol. 17(9): 855-861, 2001.
25. Caplan L, Babikion V, Helgason C, Hier DB, DaWitt D,
Patel D, Stein R. Occlusive disease of middle cerebral artery.
Neurology 35: 975-82, 1985.
26. Gorelick PB. The status of alcohol as a risk factor for stroke.
Stroke 20: 1607-1610, 1989.
27. Cooper DE, Goff DC, Bell RA, Zaccaro D, Mayer-Davis EJ,
Karter AJ. Is insulin sensitivity a causal intermediate in the
relationship between alcohol consumption and carotid
atherosclerosis?: the insulin resistance and atherosclerosis
study. Diabetes Care 25(8): 1425-1431, 2002.
28. Yasaka M, Ymaguchi T, Shichiri M. Distribution of
atherosclerosis and risk factors in atherothrombotic
occlusion. Stroke 24(2): 206-11, 1993.
29. Crouse JR, Toole JF, McKinney WM, Dignan MB, Howard
G, Kahl FR, McMahan MR, Harpold GH. Risk factors for
extracranial carotid artery atherosclerosis. Stroke 18: 990-96,
1987.
30. Kalogeropoulou K, Mortzos G, Migdalis I, Velentzas C,
Mikhailidis DP, Georgiadis E, Cordopatis P. Carotid
atherosclerosis in type 2 diabetes mellitus: potential role of
endothelin-1, lipoperoxides, and prostocyclin. Angiology
53(3): 279-285, 2002.
31. Naylor AR, Mehta Z, Rothwell PM, Bell PR. Carotid artery
disease and stroke during coronary artery bypass: a critical
review of the literature. Eur J Vasc Endovasc Surg 23(4):
283-294, 2002.
32. Pasquale GD, Andreoli A, Pinelli G, Grazi P, Manini G,
Tognetti F, Testa C. Cerebral ischemia and asymptomatic
coronary artery disease: A prospective study of 83 patients.
Stroke 17(6): 1098-101, 1986.
33. Chimowitz MI, John MG. Asymptomatic coronary artery
disease in patients with stroke prevalence, prognosis
diagnosis, and treatment. Stroke 23(3): 433-6, 1992.
34. Albers GW, Comess KA, De Rook FA, Bracci P, Atwood
JE, Bolger A, Hotson J. Transesophageal echocardiographic
findings in stroke subtypes. Stroke 25: 23-28, 1994.
35. Kumral K, Kumral E. İnme epidemiyolojisi ve risk faktörleri.
Santral sinir sisteminin damarsal hastalıkları. Ege Üniv Tıp
Fak Yay. No: 72, 1993; 9-23.
36. Tell GS. Cigarette smoking, lipids, lipoproteins and
extracranial carotid artery atherosclerosis. Mayo Clin Proc.
66: 327-331, 1991.
37. Handa N, Matsumoto M, Maeda H, Hougaku H, Itoh T,
Okazaki Y, Kimura K, Kamada T. An ultrasonic study of the
relationship between extracranial carotid atherosclerosis and
ischemic cerebrovascular disease in Japanese. Nippon
29(10): 742-7, 1992.
38. Vehier FM, Leys D, Pruva JP. Stroke patterns in unilateral
atherothrombotic occlusion of the internal carotid artery.
Stroke 26(3): 422-5, 1995.

Thank you for copying data from http://www.arastirmax.com