White matter hyperintensities and their subtypes in patients with carotid artery stenosis: a systematic review and meta-analysis.

ABSTRACT: OBJECTIVE:We aimed to perform a systematic review and meta-analysis to clarify the association between white matter hyperintensities (WMHs) and carotid artery (CA) stenosis. STUDY DESIGN:Systematic review and meta-analysis. PARTICIPANTS:CA stenosis was set at ?50%, and WMHs were assessed by MRI and evaluated quantitatively or semiquantitatively. DATA SOURCES:A comprehensive literature search was performed in PubMed, EMBASE and Cochrane Library for studies evaluating the association between WMHs and CA stenosis ?50% from inception to 13 September 2017. MAIN OUTCOMES AND MEASURES:Standardised mean difference (SMD) with 95%?CI was used to evaluate the association between WMHs and CA stenosis. Results were presented in a forest plot with a fixed-effects model or random-effects model. We assessed the quality of included studies using the Newcastle-Ottawa Scale. Funnel plots and Egger's and Begg's tests were conducted to assess publication bias. Sensitivity analysis was performed to evaluate the influence of each individual study. RESULTS:Eight studies enrolling 677 patients were included. There was a positive relationship between the total WMHs and CA stenosis, with a pooled fixed-effects SMD of 0.326 (95% CI 0.194 to 0.459, p=0.000). Heterogeneity and publication bias were low among these studies. Subgroup analysis of three studies enrolling 225 patients showed an association between periventricular WMHs and CA stenosis, with a pooled fixed-effects SMD of 0.412 (95% CI 0.202 to 0.622, p=0.000). CONCLUSION:This meta-analysis showed that the total WMHs and periventricular WMHs were associated with CA stenosis. WMHs may be considered as an individual risk stratification score when choosing a proper plan for therapy of CA stenosis.

SUBMITTER: Ye H 

PROVIDER: S-EPMC5961568 | biostudies-literature | 2018 May

REPOSITORIES: biostudies-literature