FACTORS MODIFYING THE PROGNOSIS IN MEN WITH ASYMPTOMATIC CAROTID-ARTERY DISEASE

Objectives. Carotid artery stenosis is associated with an increased pr evalence and incidence of ischaemic heart disease (IHD). The aim of th is study has been to assess whether, in men with carotid artery stenos is, survival and incidence of stroke and myocardial infarction is diff erent in men with and men free from IHD; and to characterize probands with incident cerebrovascular (CBV) event in terms of smoking, hyperte nsion and leg artery disease. Design. Population-based cohort study, ' Men born 1914'. Setting. Malmo, a city in southern Sweden. Subjects. A total of 478 of 621 men born in 1914, who in 1982 participated in ult rasound examination of the carotid arteries. Main outcome measures. Mo rbidity and mortality during 10 years of followup. Results. Asymptomat ic carotid artery stenosis was, in men free from IHD, associated with reduced survival and an increased incidence of serious CBV events that occurred, on average, 3.6 years after the examination. In men with pr evalent IHD, there was no relationship between carotid artery stenosis and incidence of CBV events. The main explanation to the lack of asso ciation seems to be the high vascular mortality rate in that group. Co nclusions. It's our conclusion that in patients with asymptomatic caro tid artery stenosis there is a great heterogeneity with regard to seve rity of disease and prognosis. Survival and incidence of stroke and my ocardial infarction depends on whether patients have concomitant IHD.