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DOES CAROTID STENOSIS PREDICT STROKE IN ATRIAL FIBRILLATION?

Factors such as hypertension and diabetes can contribute to the increased risk for stroke in patients with chronic atrial fibrillation. This substudy from the Stroke Prevention in Atrial Fibrillation trial examined the prevalence of carotid stenosis in patients with AF and its effect on stroke risk.

All patients were receiving warfarin or aspirin. Of the 508 patients over age 70, 12 percent had carotid stenosis of at least 50 percent on ultrasonography. Patients with cervical bruits or symptomatic peripheral vascular disease were the most likely to have significant carotid stenosis. Although carotid stenosis was independently related to systolic hypertension, diabetes, and smoking, it did not independently predict stroke.

Comment: This study shows that carotid stenosis is more common in older people with AF (12 percent) than in older people without AF (who have been shown to have a risk of about 8 percent). However, its presence does not predict stroke in patients with AF who have not had previous TIA or stroke.

— CD Mulrow

Published in Journal Watch General Medicine July 19, 1994

Citation(s):

Kanter MC et al. Carotid stenosis in patients with atrial fibrillation: prevalence, risk factors, and relationship to stroke in the Stroke Prevention in Atrial Fibrillation Study. Arch Intern Med 1994 Jun 27 154 1372-1377.

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