Author(s): Lacroix P, Aboyans V, Criqui MH, Bertin F, Bouhamed T,
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Abstract The objective of this prospective observational study was to establish the prevalence of carotid atherosclerosis in an asymptomatic diabetic population and to determine predictive factors for a screening optimization. A total of 300 consecutive type-2 diabetic subjects (166 males, 134 females) underwent a physical examination and duplex carotid scanning. Patients with a recent cerebrovascular event (< or = 6 weeks) or previous carotid surgery were excluded. The prevalence of carotid stenosis > or = 60\% or occlusion was 4.7\%; the prevalence of carotid atherosclerosis was 68.3\%. Risk factors for stenosis > or = 60\% or occlusion were the presence of diabetic retinopathy (OR: 3.62; 95\% CI: 1.12-11.73), ankle-brachial index (ABI) <0.85 (OR: 3.94; 95\% CI: 1.21-12.84) and a personal history of neurological disorders (OR: 4.54; 95\% CI: 1.16-17.81). Being female was a protective factor (OR: 0.09; 95\% CI: 0.01-0.78). The two factors in the analysis limited to the male population were an ABI < 0.85 (OR: 3.66; 95\% CI: 1.04-12.84) and a personal history of coronary heart disease (OR: 3.34; 95\% CI: 1.01-11.01). If male diabetics without either of these two factors are excluded, the negative predictive value for carotid stenosis is 96.6\%. In conclusion, the prevalence of atherosclerotic carotid disease in diabetic patients is high. In these patients, the probability of finding >60\% stenosis is highest among men with a history of coronary heart disease or an ABI <0.85.
This article was published in Vasc Med
and referenced in Journal of General Practice