Evidence map›Paper›PMID 34607563›Full record

ArticleBMC neurology2021

Prevalence and correlates of carotid artery stenosis in a cohort of Sri Lankan ischaemic stroke patients.

K C D Mettananda, M D P Eshani, L M Wettasinghe, S Somaratne, Y P Nanayakkkara, W Sathkorala, A Upasena, C Sirigampola, P M Y Tilakaratna, A Pathmeswaran and 1 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC neurology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
1.2field-weighted citation impact, top 20% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 10 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 2 institutions in 1 country.

K C D Mettananda *Department of Pharmacology, Faculty of Medicine, University of Kelaniya, Talagolla Road, Ragama, Sri Lanka. chamila@kln.ac.lk.
M D P EshaniDepartment of Pharmacology, Faculty of Medicine, University of Kelaniya, Talagolla Road, Ragama, Sri Lanka.
L M WettasingheDepartment of Pharmacology, Faculty of Medicine, University of Kelaniya, Talagolla Road, Ragama, Sri Lanka.
S SomaratneStroke Unit, Colombo North Teaching Hospital, Ragama, Sri Lanka.
Y P NanayakkkaraStroke Unit, Colombo North Teaching Hospital, Ragama, Sri Lanka.
W SathkoralaRadiology Unit, North Colombo Teaching Hospital, Ragama, Sri Lanka.
A UpasenaRadiology Unit, North Colombo Teaching Hospital, Ragama, Sri Lanka.
C SirigampolaStroke Unit, Colombo North Teaching Hospital, Ragama, Sri Lanka.
P M Y TilakaratnaDepartment of Medicine, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka.
A PathmeswaranDepartment of Public Health, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka.
U K Ranawaka *Stroke Unit, Colombo North Teaching Hospital, Ragama, Sri Lanka.
University of Kelaniya · LKColombo North Teaching Hospital · LK

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundLarge artery atherosclerotic disease is an important cause of stroke, accounting for 15-46% of ischaemic strokes in population-based studies. Therefore, current guidelines from west recommend urgent carotid imaging in all ischaemic strokes or transient ischaemic attacks and referral for carotid endarterectomy. However, the clinical features and epidemiology of stroke in Asians are different from those in Caucasians and therefore the applicability of these recommendations to Asians is controversial. Data on the prevalence of carotid artery stenosis (CAS) among South Asian stroke patients is limited. Therefore, we sought to determine the prevalence and associated factors of significant CAS in a cohort of Sri Lankan patients with ischaemic stroke.

methodsWe prospectively studied all ischaemic stroke patients who underwent carotid doppler ultrasonography admitted to the stroke unit of a Sri Lankan tertiary care hospital over 5 years. We defined carotid stenosis as low (< 50%), moderate (50-69%) or severe (70-99%) or total-occlusion (100%) by North American Symptomatic Trial Collaborators (NASCET) criteria. We identified the factors associated with CAS ≥ 50% and ≥ 70% by stepwise multiple logistic regression analysis.

resultsA total of 550 ischaemic stroke patients (326 (59.3%) male, mean age was 58.9 ± 10.2 years) had carotid doppler ultrasonography. Of them, 528 (96.0%) had low-grade, 12 (2.2%) moderate and 7 (1.3%) severe stenosis and 3 (0.5%) had total occlusion. On multivariate logistic regression, age was associated with CAS ≥ 50% (OR 1.12, p = 0.001) and CAS ≥ 70% (OR 1.14, p = 0.016), but none of the other vascular risk factors studied (sex, hypertension, diabetes mellitus, smoking, past history of TIA, stroke or ischemic heart disease) showed significant associations.

conclusionsCarotid stenosis is a minor cause of ischemic stroke in Sri Lankans compared to western populations with only 4.0% having CAS ≥ 50 and 3.5% eligible for carotid endarterectomy. Our findings have implications for the management of acute strokes in Sri Lanka.

Indexed as

Brain IschemiaCarotid StenosisEndarterectomy, CarotidIschemic StrokeStrokeHumansMaleMiddle AgedPrevalenceProspective StudiesRisk FactorsCarotid stenosisIschemic strokesPrevalenceRisk-factorsSouth AsiansSri Lanka

Identifiers

PMID34607563
PMCPMC8489097
OpenAlexW3203231194

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.