PROGRESSION OF CAROTID ATHEROSCLEROSIS - 3-YEAR FOLLOW-UP AND ANALYSIS OF RISK-FACTORS

Objective. To elicit the risk factors associated with increasing grade s of stenosis in patients with carotid plaque. Study design. Retrospec tive review of serial duplex scans of the carotid bifurcation. Case no te review for documented risk factors. Setting. Irvine Laboratory of t he Academic Department of Surgery, Vascular Section. Patients and resu lts. Review of serial duplex scans of the carotid bifurcation was perf ormed on 200 unselected patients who each had a follow-up of at least three years. Definite progression of carotid atherosclerosis was defin ed as an unequivocal increase in at least one grade by the criteria of Strandness, and was documented in 50 patients (25%). Even if the init ial situation is normal or minimal disease (<15% stenosis), once defin ite plaque progression is observed, the lesion will progress to a hemo dynamically significant one (>50%)in 67% of this patient population. T he only risk factor for plaque progression that we defined is hyperten sion, and this may be spurious. There are no risk factors associated w ith the subgroup of plaques that progress rapidly above those that pro gress at a slower rate. Conclusions. There are no risk factors defined in this population which are associated with advancing carotid athero sclerosis.