Abstract 13250: Gender Differences in Asymptomatic Carotid Artery Stenosis; the Association of Age and Smoking With Disease Progression in Males
Background: A direct relationship exists between internal carotid artery (ICA) disease progression and stroke incidence. For asymptomatic patients with known ICA disease, there is no proven surveillance strategy. It remains unclear which individuals are at greater risk for disease progression, and whether there are gender-specific risk factors. We examined clinical characteristics associated with ICA disease progression in men and women undergoing carotid duplex ultrasound (CDU) surveillance.
Methods: We retrospectively studied 289 patients with known ICA stenosis at baseline who underwent CDU from 2008-2014 and had at least one other CDU ≥11 months later. Categories of stenosis included minimal (0-15%), mild (16-49%), moderate (50-79%), and severe (80-99%). Symptomatic patients (stroke or TIA within 6 months), those with severe baseline stenosis, and arteries with prior interventions were excluded. The primary outcome was progression of stenosis to a level of moderate or higher. Baseline clinical data was recorded, and logistic regression analysis was performed.
Results: Twenty-seven (23%) of 116 females and 30 (17%) of 173 males had progression of ICA stenosis (p=0.21). Females with disease progression were more likely to have moderate baseline stenosis (52% vs 26%, p = 0.01) compared to mild or minimal. Males with disease progression were older (74y vs 70y, p < 0.04), more likely to be current or past smokers (66% vs 44%, p = 0.03), and more likely to have moderate baseline stenosis (50% vs 23 %, p<0.003). Multivariate analysis in males showed age, smoking, and moderate baseline stenosis to be independent predictors of disease progression.
Conclusion: There was no significant difference in proportion of disease progression between genders. In addition to relying on baseline stenosis for both genders, our findings suggest a role for age and smoking history to help determine effective surveillance protocols for monitoring ICA disease progression in males.
Author Disclosures: H. Girn: None. H. Tun: None. D. Wee: None. L. Clavijo: None. D. Shavelle: None. P. Garg: None.
- © 2015 by American Heart Association, Inc.