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Gaceta médica de México
versión On-line ISSN 2696-1288versión impresa ISSN 0016-3813
Resumen
CHIQUETE, Erwin et al. Enfermedad carotídea aterosclerosa y enfermedad de sustancia blanca en sujetos sin historia de infarto cerebral o isquemia cerebral transitoria. Gac. Méd. Méx [online]. 2019, vol.155, n.4, pp.350-356. Epub 01-Jul-2021. ISSN 2696-1288. https://doi.org/10.24875/gmm.19004494.
Introduction:
Atherosclerotic carotid artery disease (CAD) is a major risk factor for cerebrovascular disease.
Objective:
To analyze the association of major vascular risk factors with atherosclerotic CAD and white matter disease (WMD) in patients without a history of ischemic stroke.
Method:
Risk factors were assessed with carotid examination using Doppler duplex ultrasound. Cases with a history cerebral infarction or transient ischemic attack were not included. Subjects had brain magnetic resonance imaging scans available and those with large-artery ischemic lesions were excluded. Multivariate models were constructed for the prediction of atherosclerotic CAD, significant carotid stenosis, atheroma burden and WMD.
Results:
One-hundred and forty-five subjects were assessed (60.7% were females, mean age was 73 years). Atherosclerotic CAD was documented in 54.5%, carotid stenosis ≥ 50% in 9.0%, > 6 atheroma plaques in 7.6%, and periventricular or subcortical WMD in 28.3% (20.6% had atherosclerotic CAD and WMD concurrently). Risk factors independently associated with atherosclerotic CAD were age and hypertension; hypertension was associated with ≥ 50% carotid stenosis; age was associated with > 6 atheroma plaques; and age, diabetes and hypertension were associated with WMD. Obesity was not associated with any of the analyzed independent variables.
Conclusions:
In asymptomatic subjects without a history of ischemic stroke, age and hypertension were the most important risk factors for macrovascular disease. Diabetes mellitus was associated with microvascular disease. Obesity alone was not a major determinant of CAD or WMD.
Palabras llave : Atherosclerosis; Diabetes; Carotid artery disease; Hypertension; White matter disease; Obesity.