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Carotid Bruit May Increase Risk of Cardiovascular Death and Heart Attack
NEW YORK -- May 9, 2008 -- According to the May 10, 2008, edition of The Lancet, the presence of a carotid bruit may substantially increase the risk of cardiovascular death and heart attack.
Christopher Pickett, MD, Walter Reed Army Medical Center, Washington, DC, and colleagues performed a meta-analysis of 22 previous studies with 17,295 patients who were followed up for an average of 4 years. They found that patients with carotid bruits were around twice as likely to have a heart attack compared with those without. These patients also were more than 2.5 times as likely to die from cardiovascular causes. In the 4 studies in which direct comparisons of patients with and without bruits were possible, patients with bruits were still more than twice as likely to have a heart attack or die from cardiovascular causes.
The authors concluded that the study showed that "the presence of a carotid bruit significantly increased the likelihood of cardiovascular death or heart attack. Auscultation for carotid bruits in patients at high risk for heart disease could help select those that might benefit the most from an aggressive cardiovascular risk modification strategy."
The prognostic implications of a carotid bruit have been mostly focused on bleeding events in the brain, yet uncertainty about these prognostic implications has led some organisations, including the US Preventive Services Taskforce and the Canadian Task Force, to recommend against routine auscultation for carotid bruits.
SOURCE: The Lancet
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