Abstract 16784: Incidence of Cerebral Infarction is Relatively Low in Japanses Patients With Severe Carotid Sclerosis

There have been few reports on prognosis of severe carotid sclerosis(SCS) in association with other cardiovascular disease(CVD).Then we evaluated new development or recurrence of cerebral infarction(CI) (Methods) Severe carotid sclerosis was diagnosed by carotid ultrasonography, and plaque score(PS) was calculated by summation of max thickness of each plaque. The 468 patients with severe carotid sclerosis(SCS: PS >10)were studied and compared those with 262 patients with mild carotid sclerosis(MCS: PS 5). Patients with significant carotid stenosis (’50% in diameter)were excluded. We evaluated hypertension, diabetes mellitus, dyslipidemia and smoking history as risk factors for arteriosclerosis. (Results) In patients with SCS, mean age was 74.7±9.2(mean±SD), and mean PS was13.8. Cerebral infarction(CI) was observed in 114 patients(24.3%). Cardiovascular disease including peripheral artery disease was observed in 158(33.8 %), and coronary artery disease(CAD) only was observed in 124 (26.4 %). In patients with MCS, mean age was 69.5±8.6, and mean PS was 3.82. CI was observed in 28 patients(10.69%)(P 0.0001 vs SCS)Cardiovascular disease was observed in 26 patients(9.92%),and coronary artery disease(CAD) only was observed in 20(7.63%)(P 0001 vs SCS) . In 3 year follow up, CI developed in 13 (2.78%) out of 468 with SCS, and in 4(1.53%) out of 262 patients with MCS. Antiplatelet therapy had been done in 48% of patients with SCS and in 12% of MCS. There was no difference in percentage of antiplatelet therapy between patients with new CI and those without. All patients who developed CI had other cardiovascular disease. Mean number of RF was 2.7±1.0 in patients who developed CI and 2.5±0.9 in those who did not. Conclusions. Incidence of CAD or CI was greater in patients with SCS than in those with MCS. At 3 year follow up of patients with CS, CI did develop more commonly in patients with SCS than in those with MCS, but the difference was not significant. When patient has not severe carotid stenosis, risk of new development or recurrence of CI is very low in Japanese patients with SCS. Presence of poly vascular lesions may be major risk for CI.