Key result
More intensive medical therapy since 2003 was associated with significantly fewer TCD microemboli (3.7% vs 12.6%, P<.001) and cardiovascular events (5.6% vs 17.6%, P<.001) in patients with ACS.
Why the study?
Does intensive medical therapy reduce microemboli and cardiovascular events in patients with asymptomatic carotid stenosis?
Cohort (n=468)
No
Does intensive medical therapy reduce microemboli and cardiovascular events in patients with asymptomatic carotid stenosis?
Absolute Event Rate: 3.7% vs 12.6%
p-value: p=<.001
Intensive medical therapy significantly reduces microemboli and cardiovascular events in asymptomatic carotid stenosis, suggesting that routine revascularization may not be necessary for the vast majority of these patients.
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Supports intensive medical therapy in ACS; leaves open whether revascularization can be safely avoided.
J. David Spence (2009) conducted a cohort in Asymptomatic carotid stenosis (ACS) (n=468). Intensive medical therapy (enrollment since 2003) vs. Baseline medical therapy (enrollment before 2003) was evaluated on Proportion of ACS patients who had microemboli on transcranial Doppler (TCD) (p=<.001). More intensive medical therapy since 2003 was associated with significantly fewer TCD microemboli (3.7% vs 12.6%, P<.001) and cardiovascular events (5.6% vs 17.6%, P<.001) in patients with ACS.
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