title: Prevalence and risk factors for cerebral infarction and carotid artery stenosis in peripheral arterial disease.
abstract: OBJECTIVE
  The purpose of the study was to examine the prevalence and risk factors for cerebral infarction (CI) and carotid artery stenosis (CAS) in patients with peripheral arterial disease (PAD) compared with normal controls.
  
  
  METHODS
  A cross-sectional analysis was performed in 857 subjects (PAD: 543, controls: 314). CI and lacunar infarction (LI) were evaluated using brain computed tomography. Intima-media thickening (IMT) and CAS were measured with ultrasound.
  
  
  RESULTS
  The prevalences of CI and LI were higher in patients with PAD than in controls (15.0% vs. 9.8%, 41.0% vs. 13.4%, respectively, p < 0.05). In multiple logistic analysis, CI was associated with diabetes mellitus, low HDL cholesterol and CAS ≥ 70% (p < 0.05). LI was associated with age, PAD, diabetes mellitus, and estimated glomerular filtration rate (p < 0.05). The prevalences of CAS ≥ 70% and CAS ≥ 50% were higher in patients with PAD than in controls (5.2% vs. 0.6%, 17.6% vs. 3.8%, respectively, p < 0.01). Mean and max IMT differed significantly between the two groups (PAD vs. controls: 1.01 ± 0.45 vs. 0.90 ± 0.28, 2.67 ± 2.00 vs. 1.73 ± 1.05 mm, respectively, p < 0.001). CAS ≥ 70% correlated with high LDL cholesterol, and CAS ≥ 50% with age and PAD. IMT was positively correlated with PAD, high LDL cholesterol, age, and hypertension (p < 0.05).
  
  
  CONCLUSIONS
  Prevalences of CI and CAS were markedly higher in patients with PAD than in controls, indicating that PAD is a meaningful risk factor for CI, LI, and CAS. This suggests that screening for CI and CAS is important for managements in PAD, as with screening for PAD in patients with stroke.
authors: Department of Internal Medicine, Cardiovascular Hospital of Central Japan (Kitakanto Cardiovascular Hospital), Shimohakoda 740 Hokkitu-machi, Shibukawa, Gunma, Japan.
authors: Yoshihiro
authors: Y
authors: Araki
authors: Hisao
authors: H
authors: Kumakura
authors: Hiroyoshi
authors: H
authors: Kanai
authors: Shu
authors: S
authors: Kasama
authors: Hiroyuki
authors: H
authors: Sumino
authors: Akiko
authors: A
authors: Ichikawa
authors: Toshio
authors: T
authors: Ito
authors: Toshiya
authors: T
authors: Iwasaki
authors: Yoshiaki
authors: Y
authors: Takayama
authors: Shuichi
authors: S
authors: Ichikawa
authors: Kishu
authors: K
authors: Fujita
authors: Kuniki
authors: K
authors: Nakashima
authors: Kazutomo
authors: K
authors: Minami
authors: Masahiko
authors: M
authors: Kurabayashi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D059168:Carotid Intima-Media Thickness; D016893:Carotid Stenosis / Q000000981:diagnostic imaging / Q000453:epidemiology*; D016022:Case-Control Studies; D002544:Cerebral Infarction / Q000000981:diagnostic imaging / Q000453:epidemiology*; D016009:Chi-Square Distribution; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D058729:Peripheral Arterial Disease / Q000000981:diagnostic imaging / Q000453:epidemiology*; D011237:Predictive Value of Tests; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed