title: [Natural history of moderate-degree carotid stenosis in patients with peripheral artery disease].
abstract: OBJECTIVE
  To understand the evolution of moderate asymptomatic carotid stenosis, the factors that influence its progression and the related morbimortality.
  
  
  METHODS
  Retrospective observational study of 133 patients with asymptomatic carotid stenosis between 50-69% in one or both carotids between 2002 and 2009. Included patients were subjected to screening for peripheral arterial disease (PAD), aneurysmal disease or carotid bruit. The monitoring was carried out using an annual duplex scan. The rate of progression, the variables related to this, the appearance of neurological events, and global and cardiovascular mortality were evaluated. Descriptive studies, univariate analysis (chi-squared test and Student's t-test), multivariate analysis (logistic regression), and survival curves (Log-Rank test) were carried out.
  
  
  RESULTS
  With an average time of monitoring: 30.8 ± 1.7 months, stenosis progression was observed in 33% of the patients, with an average progression time of 31.3 ± 2.7 months. Greater progression was observed in the subgroup of patients with PAD and ischemic heart disease (odds ratio [OR] 2.84, confidence interval [CI] 95% 1.14-7.03). In the multivariate analysis only the PAD was identified as a risk factor for progression (P=.043). The group of patients with progression showed greater rates of neurological events: 15 vs. 1.6% (P=.01), greater global mortality: 15 vs. 3% (P=.04), and greater cardiovascular mortality: 12.1 vs. 1.5% (P=.03).
  
  
  CONCLUSIONS
  The progression of asymptomatic carotid stenosis between 50-69% is common in patients subjected to screening, especially in those with a history of ischaemic heart disease and/or PAD. This progression is associated with an increased rate of cardiovascular complications. For this reason, we recommend clinical and echographic follow-up of these patients.
authors: Servicio de Angiología, Cirugía Vascular y Endovascular, Hospital Universitario Doctor Peset, Valencia, España. sara_mgisbert@hotmail.com
authors: Sara Mercedes
authors: SM
authors: Morales-Gisbert
authors: Ángel
authors: Á
authors: Plaza-Martínez
authors: Vicente Andrés
authors: VA
authors: Sala-Almonacil
authors: David
authors: D
authors: Olmos-Sánchez
authors: Francisco Julián
authors: FJ
authors: Gomez-Palonés
authors: Eduardo
authors: E
authors: Ortiz-Monzón
mesh_terms: D000368:Aged; D055109:Ankle Brachial Index; D017544:Aortic Aneurysm, Abdominal / Q000453:epidemiology; D058070:Asymptomatic Diseases; D002318:Cardiovascular Diseases / Q000401:mortality; D016893:Carotid Stenosis / Q000150:complications / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000503:physiopathology; D015897:Comorbidity; D018450:Disease Progression; D050171:Dyslipidemias / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006337:Heart Murmurs; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D017543:Iliac Aneurysm / Q000453:epidemiology; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D058729:Peripheral Arterial Disease / Q000453:epidemiology*; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D012189:Retrospective Studies; D012720:Severity of Illness Index; D012907:Smoking / Q000453:epidemiology; D013030:Spain / Q000453:epidemiology; D020521:Stroke / Q000453:epidemiology / Q000209:etiology; D014463:Ultrasonography
chemical_list: D010975:Platelet Aggregation Inhibitors