The two authors contribute equally.
Letter to the editor
Prevalence of carotid artery stenosis in southern China: a retrospective, cross-sectional study
Article first published online: 23 JUL 2013
© 2013 The Authors. International Journal of Stroke © 2013 World Stroke Organization
International Journal of Stroke
Volume 8, Issue 6, pages E31–E32, August 2013
How to Cite
Hu, X.-Y., Zhang, M., Wang, D.-M., Feng, X.-Y., Shen, X.-L., Wei, M.-L., Pan, H., Tang, X.-M., Fang, J., Huang, J.-X., Huang, Q., Yan, W.-H., Su, J.-J. and Liu, J.-R. (2013), Prevalence of carotid artery stenosis in southern China: a retrospective, cross-sectional study. International Journal of Stroke, 8: E31–E32. doi: 10.1111/ijs.12078
- Issue published online: 23 JUL 2013
- Article first published online: 23 JUL 2013
- National Natural Science Foundation of China. Grant Numbers: 81070914, 81271302, 81200941
- Shanghai Jiao Tong University School of Medicine
Severe carotid artery stenosis (CAS) increases the risk of cerebrovascular disease and sometimes requires revascularization to prevent the recurrence of stroke or transient ischemic attacks (TIAs) . The Ministry of Health of the People's Republic of China recently initiated a screening and prevention project for stroke including a screening for extracranial CAS in high-risk population. A better understanding of the prevalence of CAS in various regions of China is warranted to ensure an appropriate allocation of medical resources. Previous studies have found a relative high prevalence of CAS among patients with cerebrovascular disease in northern China [2, 3]; however, the prevalence of CAS in southern China is unknown. Thus, we performed a retrospective, cross-sectional study on 862 inpatients that presented with stroke or TIA at a hospital in southern China and underwent computed tomography angiography (CTA) or contrast enhanced-magnetic resonance angiography (CE-MRA) to determine the prevalence of severe CAS of bilateral carotid arteries. Of 862 patients, 3·7% had CAS between 50% and 69%, 3·1% had CAS between 70% and 99%, and 2·6% had complete occlusion (Table 1). Furthermore, 43 (5·0%) patients had 70–99% symptomatic stenosis ipsilateral to the ischemic hemisphere. The side of more severe stenosis was counted for bilateral carotid stenosis patients (n = 56).
|Characteristic||Underwent CTA/MRA (n = 862)|
|Age (years)||64·6 ± 13·4|
|Initial NIHSS||3·0 (2·0, 6·0)|
|MRS ≥ 3||330 (38·3%)|
|Diabetes mellitus||210 (24·4%)|
|History of TIA/ischemic stroke||166 (19·3%)|
|Coronary artery disease||77 (8·9%)|
|Alcohol consumption||222 (25·8%)|
|Family history of TIA/ischemic stroke||108 (12·5%)|
|Family history of hypertension||168 (19·5%)|
|TOAST in CE||85 (9·9%)|
|Severity of carotid artery stenosis*|
|No CAS||673 (78·1%)|
|Complete occlusion||22 (2·6%)|
|Symptomatic stenosis, >70%||43 (5·0%)|
In one study, the prevalence of CAS (>50% stenosis) in Hong Kong Chinese patients with stroke was reported to be 21% . In northern China, specifically Beijing, it was reported that 17·3% of patients with ischemic stroke had CAS >50% , and 39·4% of patients with stroke or TIA had CAS >70% . Thus, the prevalence of severe CAS is very much lower in southern vs. northern China, possibly due to the difference of living and die habit or genetic background. Accordingly, large-scale screening for extracranial CAS in people at low risk in southern China may not be necessary. B ultrasound screening, rather than expensive and contrast-needed screening (i.e., CTA, CE-MRA, or digital substraction angiography (DSA)) that are used extensively in Chinese large hospitals for all stroke patients, could be used for high-risk population in southern China.
This work was supported by grants from the National Natural Science Foundation of China [No. 81070914, 81271302 to J.R. Liu; No. 81200941 to J.J. Su]; and a grant from the “New One Hundred Talents Program” from the Shanghai Jiao Tong University School of Medicine [2012, J.R. Liu].
- 3The distribution of cerebral artery stenosis in patients with ischemic cerebrovascular disease. Chin J Geritar Heart Brain Vessel Dis 2008; 10:680–683 [in Chinese]., , , , , .