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Second Congress of Cardiology and Angiology of Bosnia & Herzegovina

 

INCREASED PEAK SYSTOLIC VELOCITY AS AN INDEPENDENT RISK FACTOR FOR CEREBROVASCULAR EVENTS IN SARAJEVO VASCULAR STUDY
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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