Prognostic significance of carotid artery stenosis in anterior circulation ischemic stroke patients

Abstract Background The carotid artery stenosis (CAS) is a notable risk element for ischemic stroke, accounting for 10 to 20% of such cases. There is a deficiency in research studies exploring the prognostic impact of CAS specifically in the anterior circulation acute ischemic stroke (AIS). Therefore, we conducted this study to evaluate the prognostic impact of CAS in individuals with anterior circulation AIS. Patients were categorized into two groups, patients with both anterior circulation AIS and CAS in comparison to patients with anterior circulation AIS without CAS (control group). We compared patient characteristics, neuroimaging, and outcome evaluations using a modified Rankin Scale (mRS) and the National Institute Health Stroke Scale (NIHSS) in both groups. P -value < 0.05 meaning statistical significance. Results Fifty patients were involved in the current study; of them, 25 patients with both anterior circulation AIS and CAS and 25 patients with anterior circulation AIS without CAS. Both groups were comparable concerning age, gender, co-morbidities of diabetes, hypertension, smoking, and dyslipidemia with p -value > 0.05. The mean NIHSS was significantly elevated the CAS group compared to the control group ( p = 0.037). Our results showed that patients with CAS ≥ 70% were associated with an mRS > 2 and a significantly higher NIHSS compared to control. The regression analysis showed that occlusion > 1/3, CAS ≥ 70%, and higher NIHSS score were considered independent predictors of mRS > 2. The mortality rate was significantly elevated in the CAS group versus the control group ( p < 0.05). Both bilateral and unilateral CAS groups were comparable regarding NIHSS and mRS values. Conclusion Patients with anterior circulation AIS who had CAS of 70% or more, whether unilateral or bilateral, showed a higher likelihood of increased mortality and more severe strokes, as evidenced by elevated NIHSS and mRS scores.