Ipsilateral Infarct in Newly Diagnosed Cervical Internal Carotid Artery Atherosclerotic Occlusion.
OBJECTIVE
We aimed to determine factors associated with recent infarct (RI) in patients with newly identified atherosclerotic cervical internal carotid artery occlusion (CICAO).


METHODS
This was a retrospective review of consecutive patients who underwent cervical CT angiography from 2002 to 2006 at a single tertiary center. RI was defined by positive diffusion-weighted imaging/apparent diffusion coefficient magnetic resonance imaging (MRI) in the correspondent CICAO territory. Subjects were dichotomized into those with a RI versus patients with no RI (No-RI).


RESULTS
Of 2,459 patients with cervical CT angiograms in the study period, 108 (4.4%) had complete medical records and brain MRI and were included. The mean age was 64 ± 13 years, 58% were men, and 62 (57%) had a RI. The demographics of the RI and No-RI patients were comparable, with the exception that those with RI had a lower frequency of coronary artery disease (CAD, 13 vs. 54%; p < 0.01) and dyslipidemia (38 vs. 69%; p < 0.01). The use of antiplatelets was not statistically different between the groups (56 vs. 71%; p = 0.1). Subjects with RI were less likely on statins (21 vs. 56%; p < 0.01) and antihypertensives (9 vs. 71%; p < 0.01). Multivariate regression revealed that CAD, the use of statins, and the use of antihypertensives were associated with No-RI CICAO presentation.


CONCLUSIONS
The use of statins and antihypertensives is associated with a decreased risk of RI atherosclerotic CICAO.
Department of Neurology, Neurosurgery and Radiology, Emory University School of Medicine, Atlanta, Ga., USA.
Diogo C
DC
Haussen
Department of Neurology, University of South Florida, Tampa, Fla., USA.
David Z
DZ
Rose
Department of Neurosurgery, Cedars-Sinai Medical Center, Los Angeles, Calif., USA.
Doniel
D
Drazin
Department of Neurology, Johns Hopkins School of Medicine, Baltimore, Md., USA.
Scott D
SD
Newsome
Department of Neurology, University of Miami Miller School of Medicine, Miami, Fla., USA.
Hannah
H
Gardener
Department of Neurology and Psychiatry, St. Louis University, St. Louis, Mo., USA.
Randall C
RC
Edgell
Department of Neurosurgery, Albany Medical Center, Albany, N.Y., USA.
Alan
A
Boulos
Department of Neurology, Albany Medical Center, Albany, N.Y., USA.
Gary
G
Bernardini
Department of Neurology, University of Miami Miller School of Medicine, Miami, Fla., USA.
Tatjana
T
Rundek
Department of Neurology, University of Miami Miller School of Medicine, Miami, Fla., USA.
Dileep R
DR
Yavagal
Antihypertensive agents; Carotid artery diseases; Hydroxymethylglutaryl-CoA reductase inhibitors; Risk factors; Stroke