Portal de investigação
Why do guidelines recommend screening for abdominal aortic aneurysms, but not for asymptomatic carotid stenosis? A plea for a randomized controlled trial
Data de publicação:
Data Ahead of Print:
Autores da FMUP
Participantes de fora da FMUP
- Paraskevas, KI
- Spence, JD
- Mikhailidis, DP
- Antignani, PL
- Gloviczki, P
- Eckstein, HH
- Spinelli, F
- Stilo, F
- Saba, L
- Poredos, P
- Dardik, A
- Liapis, CD
- Faggioli, G
- Pini, R
- Jezovnik, MK
- Sultan, S
- Musia, P
- Goudot, G
- Lavenson, GS
- Jawien, A
- Blinc, A
- Myrcha, P
- Fernandes, JFE
- Geroulakos, G
- Kakkos, SK
- Knoflach, M
- Proczka, RM
- Capoccia, L
- Rundek, T
- Svetlikov, AS
- Silvestrini, M
- Ricco, JB
- Davies, AH
- Di Lazzaro, V
- Suri, JS
- Lanza, GTN
- Fraedrich, G
- Zeebregts, CJ
- Nicolaides, AN
Unidades de investigação
Abstract
Background: Current guidelines do not recommend screening for asymptomatic carotid artery stenosis (AsxCS). The rationale behind this recommendation is that detection of AsxCS may lead to an unnecessary carotid intervention. In contrast, screening for abdominal aortic aneurysms is strongly recommended.Methods: A critical analysis of the literature was performed to evaluate the implications of detecting AsxCS.Results: Patients with AsxCS are at high risk for future stroke, myocardial infarction and vascular death. Population-wide screening for AsxCS should not be recommended. Additionally, screening of high-risk in-dividuals for AsxCS with the purpose of identifying candidates for a carotid intervention is inappropriate. Instead, selective screening for AsxCS should be considered and should be viewed as an opportunity to identify individuals at high risk for atherosclerotic cardiovascular disease and future cardiovascular events for the timely initiation of intensive medical therapy and risk factor modification.Conclusions: Although mass screening should not be recommended, there are several arguments suggesting that selective screening for AsxCS should be considered. The rationale supporting such selective screening is to optimize risk factor control and to initiate intensive medical therapy for prevention of future cardiovascular events, rather than to identify candidates for an intervention.
Copyright © 2022 Elsevier B.V. All rights reserved.
Dados da publicação
- ISSN/ISSNe:
- 1874-1754, 0167-5273
- Tipo:
- Review
- Páginas:
- 406-412
- Link para outro recurso:
- www.scopus.com
International Journal of Cardiology Elsevier Ireland Ltd
Citações Recebidas na Web of Science: 6
Citações Recebidas na Scopus: 14
Documentos
- Não há documentos
Filiações
Keywords
- Asymptomatic carotid atherosclerosis; Screening; Carotid stenosis; Carotid plaque burden; Stroke; Guidelines
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Citar a publicação
Paraskevas KI,Spence JD,Mikhailidis DP,Antignani PL,Gloviczki P,Eckstein HH,Spinelli F,Stilo F,Saba L,Poredos P,Dardik A,Liapis CD,Mansilha A,Faggioli G,Pini R,Jezovnik MK,Sultan S,Musia P,Goudot G,Lavenson GS,Jawien A,Blinc A,Myrcha P,Fernandes J,Geroulakos G,Kakkos SK,Knoflach M,Proczka RM,Capoccia L,Rundek T,Svetlikov AS,Silvestrini M,Ricco JB,Davies AH,Di V,Suri JS,Lanza GTN,Fraedrich G,Zeebregts CJ,Nicolaides AN. Why do guidelines recommend screening for abdominal aortic aneurysms, but not for asymptomatic carotid stenosis? A plea for a randomized controlled trial. Int. J. Cardiol. 2023. 371p. 406-412. IF:3,500. (2).
