Outcomes Improving in Asymptomatic Carotid Stenosis

Intensive medical therapy linked to reductions in microemboli and cardiovascular events

TUESDAY, Feb. 9 (HealthDay News) -- In patients with asymptomatic carotid stenosis (ACS), intensive medical therapy has significantly reduced microemboli on transcranial Doppler as well as cardiovascular events, according to a study in the February issue of the Archives of Neurology.

J. David Spence, M.D., of the Stroke Prevention and Atherosclerosis Research Centre in London, Canada, and colleagues conducted a prospective study of 468 patients, including 199 who were enrolled between Jan. 1, 2000 and Dec. 31, 2002, and 269 who were enrolled between Jan. 1, 2003 and July 30, 2007.

In the periods before and after 2003, the researchers found that the presence of microemboli declined from 12.6 to 3.7 percent, and that the rate of stroke, death, myocardial infarction, and carotid endarterectomy for symptoms declined from 17.6 to 5.6 percent.

"Given our finding that intensive medical therapy has reduced the prevalence of microemboli to only 3.7 percent and markedly reduced cardiovascular events, particularly stroke, we suggest that such intensive medical therapy be regarded as the first line of therapy for patients with ACS," the authors conclude.

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