title: Carotid atherosclerosis progression and cerebrovascular events in patients with diabetes.
abstract: OBJECTIVE
  Carotid atherosclerosis progression is associated with a higher risk of cerebrovascular events but there is no specific data for diabetes. We assessed in a cohort of patients with diabetes the rate of atherosclerosis progression by Doppler ultrasonography and the association with cerebrovascular events.
  
  
  METHODS
  We analyzed a retrospective cohort of 342 patients with a mean duration of diabetes of 13.6 ± 10.6 years. The mean delay between the first and last Doppler ultrasonography was 6.4 ± 4.6 years, with a mean of 3.4 examinations per person. Cerebrovascular events were noted.
  
  
  RESULTS
  A progression of carotid atherosclerosis was observed in 20.1% of cases. No factor was significantly associated with progression. A prophylactic carotid endarterectomy was performed on 6 of the 27 patients with a stenosis ≥50%. A cerebrovascular event occurred in 1.2% of patients; none of them had carotid atherosclerosis progression.
  
  
  CONCLUSIONS
  Carotid atherosclerosis progression in patients with diabetes is frequent but surgical treatment and cerebrovascular events are low. The benefit of a systematic follow-up of carotid atherosclerosis seems limited.
authors.affiliation: Department of Endocrinology, Diabetes and Nutrition, Hospices Civils de Lyon, Centre Hospitalier Lyon-Sud, Pierre Bénite, France. Electronic address: julien.vouillarmet@chu-lyon.fr.
authors.forename: Julien
authors.initials: J
authors.lastname: Vouillarmet
authors.affiliation: Department of Vascular Medicine, Hospices Civils de Lyon, Centre Hospitalier Lyon-Sud, Pierre Bénite, France.
authors.forename: Marjorie
authors.initials: M
authors.lastname: Helfre
authors.affiliation: Department of Biostatistics, Hospices Civil de Lyon, Lyon, France; Université Lyon I, Villeurbanne, France; CNRS, UMR 5558, Laboratoire Biostatistiques Sante, Pierre-Bénite, France.
authors.forename: Delphine
authors.initials: D
authors.lastname: Maucort-Boulch
authors.affiliation: Department of Biostatistics, Hospices Civil de Lyon, Lyon, France; Université Lyon I, Villeurbanne, France; CNRS, UMR 5558, Laboratoire Biostatistiques Sante, Pierre-Bénite, France.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Riche
authors.affiliation: Department of Endocrinology, Diabetes and Nutrition, Hospices Civils de Lyon, Centre Hospitalier Lyon-Sud, Pierre Bénite, France; Inserm U1060, Faculté de Médecine Lyon sud, Oullins, France.
authors.forename: Charles
authors.initials: C
authors.lastname: Thivolet
authors.affiliation: Department of Vascular Medicine, Hospices Civils de Lyon, Centre Hospitalier Lyon-Sud, Pierre Bénite, France.
authors.forename: Claire
authors.initials: C
authors.lastname: Grange
mesh_terms: D000328:Adult; D000368:Aged; D050197:Atherosclerosis / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery; D002340:Carotid Artery Diseases / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery; D002561:Cerebrovascular Disorders / Q000150:complications / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D015331:Cohort Studies; D003922:Diabetes Mellitus, Type 1 / Q000150:complications*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D003925:Diabetic Angiopathies / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000503:physiopathology* / Q000601:surgery; D018450:Disease Progression; D016894:Endarterectomy, Carotid; D005260:Female; D005500:Follow-Up Studies; D005602:France / Q000453:epidemiology; D006786:Hospitals, Urban; D006801:Humans; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians'; D012189:Retrospective Studies; D012307:Risk Factors; D018616:Ultrasonography, Doppler, Duplex
keywords: Carotid atherosclerosis progression; Cerebrovascular event; Diabetes; Doppler ultrasonography; Prophylactic carotid endarterectomy