Carotid artery disease and the risk of ischaemic stroke and coronary vascular events

Information on the presence and extent of carotid arterial wall disease has significant prognostic value. Carotid artery stiffness, intima-media thick ness, and early plaque formation are potentially useful predictors of the r isk of both ischaemic stroke and coronary heart disease in asymptomatic pop ulations. Early carotid arterial wall disease is also a useful predictor of coronary artery disease on angiography and subsequent coronary vascular ev ents in populations at risk of coronary heart disease. More advanced caroti d wall disease (carotid stenosis and plaque surface morphology) is predicti ve of both ischaemic stroke and coronary heart disease in high-risk populat ions with established cerebrovascular disease. Plaque characteristics on ul trasound, such as echolucency, may also have a prognostic value, However, i n order to identify individuals with high risks of vascular events, this in formation must be combined with other clinical, laboratory, and imaging dat a, Ideally, large prospective cohort studies are required in which all thes e data are recorded and then combined using multivariate statistical modell ing. Future studies should also determine the relationship between the vari ous measures of carotid wall disease and the risk of stroke for the differe nt subtypes of ischaemic stroke. Copyright(C) 2000S.KargerAG.Basel.