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| INCREASED
PEAK SYSTOLIC VELOCITY AS AN INDEPENDENT RISK FACTOR FOR CEREBROVASCULAR
EVENTS IN SARAJEVO VASCULAR STUDY |
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M. Dilić, M. Kulić, S. Pehar, O. Terzić and S. Kazić . |
| Institute
of Vascular Diseases, Clinic of Cardiosurgery, Clinical Center
University of Sarajevo, Bosnia and Herzegovina |
Background:
Sarajevo Vascular Study (SVS) with total of 1680 pts. is an ongoing
single center prospective randomised rial to asses a relationship
of Color Doppler parameters with overall outcome of cerebrovascular
and peripheral vascular diseases. There are many studies analysing
systolic blood flow velocity parameters of common carotid arteries
(CCA), obtained with Color Doppler examination, by multivariante
analysis as a predictor in cerebrovascular events (CVE) - transient
ishemic attacks (TIA's), reccurent TIA's (rTIA's), ishemic stroke
(IS), or reccurent IS (rIS). In our everyday clinical practice
there are a number of pts. without carotid stenosis or occlusion
but with increased carotid velocity parameters. Methods: we included
total of 107 patients who had a CVE, 62 females, 45 males, mean
age 61±7,29 had TIA's, 65 had rTIA's, 21 developed IS, and 11
rIS. All pts were without carotid stenosis or occlusion. We collected
the following clinical variables: age, gender, hyperlipidemia,
hypertension, tobacco, obesity, diabetes mellitus, and velocity
parameters: peak systolic velocity (PSV), end-diastolic velocity
(EDV), pulsatility index (PI), resistive index (RI), acceleration
time (AT), decceleration time (DT), lumen diameter (LD), and IMT.
Color Doppler examination was perfomed on distal portion of CCA,
and we took the mean of both Results: we found significance for
the following variables: hypertension, smoking, age, hyperlipidemia,
obesity, diabetes mellitus, PSV, PI, and IMT. Regression logistic
test, with 95%. confidence interval, was perfomed and we get an
independent risk factors for CVE: hypertension (p=0,009), smoking
(p=0,0012), obesity (p=0,003), PSV (p=0,008). Increased PSV (over
95 cm/sec) revealed a significant association with CVE, sensitivity
of 57% and specificity of 89 %. The 105 cm/sec criterion was the
best single predictor of TIAs (sensitivity 65% specificity 91%),
while 130 cm/sec criterion was predictor of rIS (sensitivity 78%
specificity 86%). Conclusion: (a) in our pts. with CVE, hypertension,
smoking, age, hyperlipidemia and PSV were the only indenpendent
risk factors, (b) relative risk for CVE in pts with PSV over 105
cm/sec is 2 times than in pts. with low levels.
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