The risk of dementia is asymptomatic carotid stenosis is not affected by surgery

Self-report. Ischemic stroke caused by atherosclerosis of the carotid arteries is associated with the development of dementia. The asymptomatic carotid surgical test (ACST-1) was performed in 3,120 asymptomatic dense carotid stenosis patients in 1993-2003 to perform carotid artery bypass grafting (CEA) or to obtain only the best medical treatment. Reduces the risk of stroke by 6-7 percent after surgery 5 and 10 years. [1]The potential effects on the development of dementia are not yet known.

We currently follow ACST-1 patients from Sweden and the United Kingdom (n = 1,601), of whom 796 were asymptomatic for CEA and 805 were nationally averaged 19.4 (quarterly distance 16.9–21.7) with only delayed surgery for symptoms. Databases and records of the potential impact of CEA on the overall incidence of dementia [2]. For the purpose of treatment for analysis, stratification was performed for the home country and adjusted for gender, age and previous cerebral palsy, after which the risk factor (HR) for the development of dementia in the groups was calculated.

Dementia was diagnosed in 107 patients in the CEA group and 115 in the control group; 1,290 patients died, of whom 1,091 (538 and 536) were undiagnosed with dementia. The incidence of dementia increased with age during randomization and was higher in women (men: 8.3 percent <70 years and 15.1 percent ≥70 years; women: 15.1 percent <70 ஆண்டுகள் மற்றும் 22.4 சதவீதம் ≥70 ஆண்டுகள்) மற்றும் நோயாளிகளில் பெருமூளைச் சிதைவின் வரலாறு (20.2 சதவீதம் மற்றும் 13.6 சதவீதம்). இருப்பினும், சீரற்ற குழுக்களில் ஆபத்து ஒரே மாதிரியாக இருந்தது: 10 ஆண்டுகளுக்குப் பிறகு 6.7 சதவிகிதம் மற்றும் 6.6 சதவிகிதம் மற்றும் 14.3 சதவிகிதம் மற்றும் 20 ஆண்டுகளுக்குப் பிறகு 15.5 சதவிகிதம், HR 0.98 (95 சதவிகிதம் நம்பிக்கை இடைவெளி 0.75-1 , 28, P = 0.89) இல்லாமல் வயது, ஸ்டெனோசிஸ் அளவு, இரத்த அழுத்தம், நீரிழிவு, சொந்த நாடு (ஸ்வீடன் அல்லது கிரேட் பிரிட்டன்) அல்லது மருத்துவ சிகிச்சை தொடர்பான பன்முகத்தன்மை (P> 0.05).

In short, asymptomatic carotid stenosis did not affect the risk of developing dementia during 19.4 years of follow-up surgery. Confidence gaps do not preclude a proportional reduction or a 25 percent increase in the risk of dementia, but since no trend is seen, it is not possible to show a larger study difference yet.

Lagardingning 23-24 / 2022

Lakartidningen.se 2022-06-03