Progression of moderate stenosis of carotid atherosclerosis:an analysis of influencing factors / 中国脑血管病杂志

ABSTRACT

Objective To assess the influencing factors of the progression of carotid atherosclerotic stenosis using color Doppler flow imaging (CDFI). Methods From January 2009 to December 2014, a total of data 279 consecutive patients first assessed by CDFI as moderate stenosis of carotid atherosclerosis (stenosis rate 50 -69%)and regularly reexamined with CDFI at 12,24 and 36 months after initial examination were enrolled retrospectively. The residual diameter of vascular lesions and the changes of hemodynamic parameters were documented,and they were divided into either a progression group (n = 40)or a non-progression group (n = 239,and the non-progression group was divided into steady group[n = 210]and improved group [n = 29])according to whether the degree of stenosis progressed into severe stenosis (stenosis rate 70 -99%)or occlusion. The effects of the risk factors for common cerebrovascular disease and taking lipid lowering drugs (atorvastatin 20 mg/ d)on stenosis progression were compared in patients between the 2 groups. There were significant differences in hypertension,smoking and the regular use of atorvastatin . The effects of those factors on the progression of carotid stenosis were compared further through Logistic regression analysis. Results The residual vascular diameters of stenosis at 24,and 36 months were reduced obviously in the progression group compared with those of the non-progression group. There was significant difference (all P < 0. 05),and both the stenotic sites and distal peak systolic flow velocity ratio were significantly higher than those of the steady group and improved group (all P < 0. 05). Among the risk factors for cerebrovascular disease,hypertension (OR,2. 686,95% CI 1. 120 -6. 442,P = 0. 027)and smoking (OR,2. 265,95% CI 1. 081 -4. 746,P = 0. 030)were the major risk factors for affecting the progression of carotid stenosis. Regularly taking atorvastatin was a protective factor of delaying the progression of carotid stenosis (OR,0. 383,95% CI 0. 178 -0. 827,P = 0. 015). Conclusions CDFI may objectively evaluate the progression of carotid stenosis. Smoking and hypertension are the independent risk factors for affecting the progression of carotid stenosis,and regularly taking atorvastatin contributes to delay the progression of carotid stenosis.