This Article Full Text Full Text (PDF) All Versions of this Article: 40/5/1892    most recent STROKEAHA.108.535310v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Brown, H. A. Articles by Crandon, I. Search for Related Content PubMed PubMed Citation Articles by Brown, H. A. Articles by Crandon, I. Related Collections Acute Cerebral Infarction Carotid Stenosis Embolic stroke Doppler ultrasound, Transcranial Doppler etc. Risk Factors for Stroke Carotid endarterectomy

(Stroke. 2009;40:1892.)
© 2009 American Heart Association, Inc.

Research Letters

Prevalence of Carotid Stenosis in a High-Risk Caribbean Population

Hilary A. Brown, MD, FACS; Marilyn B. Lawrence-Wright, MD, MS; Sundeep Shah, MBBS, DM; Sara G. Lawrence, BSc; David Gilbert, MBBS, DM Ivor Crandon, MBBS, FRCS(Ed)

From the Departments of Surgery, Radiology, Anesthesia, and Intensive Care (H.A.B., S.S., S.G.L., I.C.), the Tropical Metabolism Research Unit (M.B.L.-W.), and the Department of Medicine (D.G.), The University of the West Indies, Kingston, Jamaica.

Correspondence to Dr Hilary A. Brown, Department of Surgery, The University of the West Indies, Mona, Kingston 7, Jamaica, West Indies. E-mail hbrown7{at}hotmail.com

Background and Purpose— The purpose of this study was to determine the prevalence of carotid stenosis among patients presenting to the University Hospital of West Indies (UHWI) Accident and Emergency Department (A&E) with an ischemic stroke or transient ischemic attack (TIA).

Methods— Beginning in August 2006, all patients presenting to the UHWI A&E with an acute stroke or TIA were screened for enrollment. Patients were excluded if they had a hemorrhagic stroke or if informed consent could not be obtained. Demographic and clinical information were collected by chart review and interviewer-administered questionnaires. All participants had noncontrast head computed tomography (CT) and bilateral carotid duplex ultrasounds.

Results— 133 patients were enrolled in the study. 90% presented with a stroke and 10% with a TIA. Mean age was 64 years, 52% were male, 96% self-identified as black. 78% had diabetes mellitus or hypertension or both, 27% were current or past smokers. 65.1% had a normal carotid ultrasound, 28.5% had <50% stenosis, 1.6% had 50% to 69% stenosis, 0.8% had 70% stenosis to near occlusion, 1.6% had near occlusion and 1.6% total occlusion.

Conclusions— The prevalence of moderate or high-grade carotid stenosis in this high-risk black Caribbean population presenting with an ischemic stroke or a TIA is 5.6%. This is lower than that described in other populations. Further studies are needed to determine the cost-effectiveness of routine screening for carotid stenosis in this population.

Key Words: cerebrovascular accident • carotid stenosis