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Screen­ing of asymp­tomatic carotid atherosclerosis in diabetic patients and its association with ankle-brachial index


Authors: Homza M. 1;  Machaczka O. 2;  Porzer M. 1,3;  Kozák M. 4;  Plášek J. 1,2;  Šipula D. 1,2
Authors‘ workplace: Katedra interních oborů, LF OU, Ostrava 1;  Ústav epidemiologie a veřejného zdraví, LF OU, Ostrava 2;  Kardiovaskulární oddělení, FN Ostrava 3;  Interní kardiologická klinika LF MU a FN Brno 4
Published in: Kardiol Rev Int Med 2019, 21(1): 24-28

Overview

Asymp­tomatic carotid atherosclerosis remains a relatively controversial topic with respect to both interventional ther­apy and recommendations for the use of dia­gnostic ultrasound. In our study, a group of high risk diabetic patients attend­ing a cardiovascular clinic was examined us­ing duplex ultrasound for carotid atherosclerosis and the results were compared with lower extremity arterial dis­ease (LEAD) and the ankle-brachial index (ABI) obtained us­ing the lower of ankle pressures. Carotid atherosclerosis was detected in 87.1% of patients, 27.4% of which had a stenosis of more than 50%, and significant stenosis (i.e., greater than 70%) was detected in 9.7% of patients. These numbers were even higher in the group of patients over 60 years of age. We also revealed a strong relationship between LEAD and significant carotid stenosis as well as between the ABI value, calculated us­ing the lower arterial pressure, and significant carotid stenosis. No patient with normal ABI and no patient without LEAD had significant carotid stenosis. Hence, we conclude that it is beneficial to perform ABI measurement us­ing Doppler ultrasound method and lower arterial pressure at the ankle level that can also serve, as well as the LEAD screening, as a useful tool for determin­ing whether or not a duplex examination of carotids should be performed in the particular patient.

Keywords:

atherosclerosis –  carotids –  ankle-brachial index –  ABI –  lower extremity arterial dis­ease –  peripheral arterial dis­ease –  duplex ultrasonography


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