What is the clinical evidence from this study?

Study design: Observational. Population: Cardiovascular clinic outpatients (n=1777). Intervention: Carotid bruits vs. Absence of carotid bruits. Primary outcome: History of cerebral bleeding or infarction (stroke) (p=<0.01).

What question did this study set out to answer?

To assess the prevalence of carotid bruits in cardiovascular outpatients and evaluate their relationship with carotid artery calcification and stroke history.

January 1, 1984Japanese Heart JournalOpen Access

Carotid bruits and their clinical significance.

Q: What are the key findings of this study?

Patients with carotid bruits had a significantly higher prevalence of prior stroke (23.2%) compared to those without bruits (3.8%, p<0.01), indicating they are a sign of severe cerebrovascular disease.

Q: What question did this study set out to answer?

To assess the prevalence of carotid bruits in cardiovascular outpatients and evaluate their relationship with carotid artery calcification and stroke history.

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Key result

Patients with carotid bruits had a significantly higher prevalence of prior stroke (23.2%) compared to those without bruits (3.8%, p<0.01), indicating they are a sign of severe cerebrovascular disease.

Why the study?

Is the presence of carotid bruits associated with an increased risk of stroke and carotid calcification in adult outpatients?

Population

1,777 outpatients aged 40 years or older attending a cardiovascular clinic in Japan. Excluded: patients with…

Comparison

Presence of carotid bruits on routine auscultation vs Absence of carotid bruits

Design

Cross-sectional

Authors

KIKouji ImatakaYukioka Hospital ASAkira SekiNippon Steel (Japan)NTNobuo TakahashiJapan Atomic Energy Agency

Discussion

Member takes

Implication

Carotid bruits were associated with prior stroke in outpatients; leaves open their value for prospective risk stratification.

Key Points

To assess the prevalence of carotid bruits in cardiovascular outpatients and evaluate their relationship with carotid artery calcification and stroke history.
Auscultation for carotid bruits was routinely performed in 1,777 outpatients aged 40 years or older attending a cardiovascular clinic.
Carotid artery calcification was evaluated using posteroanterior cervical spine radiographs in a subset of 447 patients aged 60 years or older.
Carotid bruits were detected in 4.6% (82/1,777) of outpatients, with prevalence increasing from 1.1% (5/467) in patients aged 40–49 to 17.3% (26/150) in those aged 70–79.
Carotid calcification was present in 42.6% (20/47) of patients with bruits compared to 12.5% (50/400) without bruits, representing a 3.4-fold higher incidence (p < 0.01).
A history of cerebral infarction or bleeding occurred in 23.2% (19/82) of patients with bruits versus 3.8% (64/1,695) without bruits (p < 0.01), though bruit laterality did not correlate with lesion location.

Study Design

Type

Observational (n=1,777)

Multicenter

Structured PICO

Is the presence of carotid bruits associated with an increased risk of stroke and carotid calcification in adult outpatients?

Population

1,777 outpatients aged 40 years or older attending a cardiovascular clinic in Japan, assessed retrospectively for the presence of carotid bruits and their association with stroke and arterial calcification.

Exposure

Presence of carotid bruits on routine auscultation

Comparator

Absence of carotid bruits

Outcome

History of stroke (persistent neurological deficits caused by cerebral infarction or bleeding)hard clinical

Main Result

Absolute Event Rate: 23.2% vs 3.8%

p-value: p=<0.01

Carotid bruits are a significant clinical indicator of severe atherosclerotic cerebrovascular disease and are associated with a markedly increased risk of stroke.

Limitations

Retrospective study design.
Lack of angiographic confirmation of the detailed morphologic configuration of carotid stenosis.
Carotid bruits may disappear as stenosis progresses to complete occlusion, potentially missing severe cases.
Bruit intensity can change according to patient position, exercise, and blood pressure level.

Cite This Study

Imataka et al. (1984) conducted an observational in Cardiovascular clinic outpatients (n=1,777). Carotid bruits vs. Absence of carotid bruits was evaluated on History of cerebral bleeding or infarction (stroke) (p=<0.01). Patients with carotid bruits had a significantly higher prevalence of prior stroke (23.2%) compared to those without bruits (3.8%, p<0.01), indicating they are a sign of severe cerebrovascular disease.

synapsesocial.com/papers/6a9dfecb8dd5fc7fdbd6f0f8 https://doi.org/10.1536/ihj.25.725

Topics

Hypertension management

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Carotid bruits and their clinical significance.

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Topics

Carotid bruits and their clinical significance.

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Also Consider

Topics

Also Consider