Carotid bruits are associated with AMI and CV death
Clinical QuestionWhat is the clinical significance of carotid bruits?
Bottom LinePatients with carotid bruits are at an increased risk of myocardial infarction and death from cardiovascular causes. (LOE = 1a-)
ReferencePickett CA, Jackson JL, Hemann BA, Atwood JE. Carotid bruits as a prognostic indicator of cardiovascular death and myocardial infarction: a meta-analysis. Lancet 2008;371:1587-1594. [PMID:18468542]
Study DesignMeta-analysis (other)
FundingSelf-funded or unfunded
SynopsisThese researchers searched MEDLINE and EMBASE to identify studies that prospectively assessed outcomes associated with carotid bruits. They specifically only looked for published studies. Two members of the team independently assessed the quality of the studies and 2 others independently extracted the data from the studies. They included 22 studies with more than 17,000 patients followed up for more than 60,000 patient-years. Most of the studies (14) evaluated patients with asymptomatic bruits. Among patients with bruits the rate of myocardial infarction was 3.69 per 100 patient-years (95% CI, 2.97 - 5.40) compared with 1.86 (0.24 - 3.48) in those without bruits. Among patients with bruits the rate of cardiovascular death was 2.85 per 100 patient-years (2.16 - 3.54) compared with 1.11 (0.45 - 1.76) in those without bruits. In spite of the authors' pronouncement, there are no data to suggest that aggressive evaluation, risk factor modification, or interventions based on the presence or absence of bruits will delay these events.
Barry, Henry, et al., editors. "Carotid Bruits Are Associated With AMI and CV Death." EE+ POEM Archive, John Wiley & Sons, 2019. Evidence Central, evidence.unboundmedicine.com/evidence/view/infoPOEMs/426170/all/Carotid_bruits_are_associated_with_AMI_and_CV_death.
Carotid bruits are associated with AMI and CV death. In: Barry HH, Ebell MHM, Shaughnessy AFA, et al, eds. EE+ POEM Archive. John Wiley & Sons; 2019. https://evidence.unboundmedicine.com/evidence/view/infoPOEMs/426170/all/Carotid_bruits_are_associated_with_AMI_and_CV_death. Accessed June 7, 2023.
Carotid bruits are associated with AMI and CV death. (2019). In Barry, H., Ebell, M. H., Shaughnessy, A. F., & Slawson, D. C. (Eds.), EE+ POEM Archive. John Wiley & Sons. https://evidence.unboundmedicine.com/evidence/view/infoPOEMs/426170/all/Carotid_bruits_are_associated_with_AMI_and_CV_death
Carotid Bruits Are Associated With AMI and CV Death [Internet]. In: Barry HH, Ebell MHM, Shaughnessy AFA, Slawson DCD, editors. EE+ POEM Archive. John Wiley & Sons; 2019. [cited 2023 June 07]. Available from: https://evidence.unboundmedicine.com/evidence/view/infoPOEMs/426170/all/Carotid_bruits_are_associated_with_AMI_and_CV_death.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Carotid bruits are associated with AMI and CV death ID - 426170 ED - Barry,Henry, ED - Ebell,Mark H, ED - Shaughnessy,Allen F, ED - Slawson,David C, BT - EE+ POEM Archive UR - https://evidence.unboundmedicine.com/evidence/view/infoPOEMs/426170/all/Carotid_bruits_are_associated_with_AMI_and_CV_death PB - John Wiley & Sons DB - Evidence Central DP - Unbound Medicine ER -