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CARPHOLOGY by Rajendra

CAROTID BRUITS

People with a carotid bruit are more likely to die from cardiovascular disease or have a heart attack than those without a bruit. This is the finding of a meta-analysis which included 17 295 patients. The median sample size of the studies was 273 patients (range 38–4736) and the follow-up period was 4 years (range 2–7). The rate of myocardial infarction in patients with carotid bruits was 3.69 (95% CI 2.97 to 5.40) per 100 patient-years compared with 1.86 (0.24 to 3.48) in those without bruits. Yearly rates of cardiovascular death were also higher in patients with bruits than in those without (2.85 (2.16 to 3.54) per 100 patient-years vs 1.11 (0.45 to 1.76)). Auscultation for carotid bruits in patients at risk for heart disease could help select those who might benefit the most from a strategy for modifying cardiovascular risk, say the authors.

Lancet 2008;371:1587–94.

BRAIN HAEMORRHAGE

Haemostatic therapy . . . [Full text of this article]