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  2. Do carotid artery calcifications seen on radiographs predict stenosis in asymptomatic adults?

Do carotid artery calcifications seen on radiographs predict stenosis in asymptomatic adults?

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Author/s: 
Cowdrey, D., Hahn, T. W., Vellardita, L.
Date Added: 
September 23, 2021
Journal/Publication: 
The Journal of Family Practice
Publication Date: 
September 1, 2021
Issue: 
7
Volume: 
70
Pages: 
357-358
Type: 
Meta-analyses, Reviews, and Guidelines
MeSH 
Humans
Adult
Carotid Stenosis
Predictive Value of Tests
Cross-Sectional Studies
Constriction, Pathologic
retrospective studies
Carotid Artery Diseases
atherosclerosis
Radiography
Carotid Arteries
risk factors
cohort studies

RPR Commentary

Carotid artery calcifications are not a good indicator of stenosis.

Abstract

EVIDENCE-BASED ANSWER:
NOT VERY WELL. IN ASYMPTOMATIC PATIENTS, CAROTID ARTERY CALCIFICATION SEEN ON RADIOGRAPH HAS A POSITIVE PREDICTIVE VALUE OF 70% AND A NEGATIVE PREDICTIVE VALUE OF 75% FOR CAROTID ARTERY STENOSIS (STRENGTH OF RECOMMENDATION [SOR]: B, SYSTEMATIC REVIEW OF OBSERVATIONAL STUDIES WITH HETEROGENEOUS RESULTS AND A RETROSPECTIVE COHORT STUDY). CAROTID CALCIFICATIONS ON RADIOGRAPHS MAY BE MORE PREDICTIVE OF CAROTID STENOSIS IN PEOPLE WITH ATHEROSCLEROTIC RISK FACTORS (SOR: C, CROSS-SECTIONAL STUDY). HARMS OUTWEIGH BENEFITS IN SCREENING FOR CAROTID ARTERY STENOSIS IN ASYMPTOMATIC ADULTS (SOR: B, MULTIPLE COHORT STUDIES); THEREFORE, INCIDENTAL RADIOGRAPHIC CAROTID ARTERY CALCIFICATIONS IN ASYMPTOMATIC PATIENTS SHOULD NOT PROMPT FURTHER TESTING.