Ischemic Stroke in Patients With Asymptomatic Severe Carotid Stenosis Without Surgical Intervention

To the Editor We would like to raise several points about the recent study that estimated stroke outcomes among patients with asymptomatic severe carotid stenosis without surgical intervention. First, the standard-of-care medical treatment of asymptomatic carotid artery stenosis has made great advances recently and includes use of statins, antiplatelet agents, anticoagulants, and antihypertensives. Therefore, we believe that this study would benefit from a subgroup analysis of medication use in these patients. In addition, higher rates of medication adherence have been observed in patients with previous arterial surgical intervention due to regular postoperative follow-up visits and improved insight into their illness. Therefore, we think a sensitivity test that separates patients whose care was managed medically from those who underwent surgery would be informative when examining medication adherence.
Source: JAMA - Category: General Medicine Source Type: research