El soplo carotideo es un predictor de muerte e infarto, según se ha publicado en LAncet

Methods: The authors pooled data from 22 studies to evaluate the impact of carotid bruits on the risk of cardiovascular death and myocardial infarction (MI).Results: The analysis included 17,295 patients with 62,413 patient-years of follow-up. The sample size ranged from 38 to 4,736, and the median follow-up was 4 years. The rate of MI in patients with carotid bruits was 3.69 (95% confidence interval, 2.97-5.40) per 100 patient-years compared with 1.86 (0.24-3.48) per 100 patient-years in those without bruits. Presence of carotid bruits was also associated with a greater mortality hazard (2.85 [2.16-3.54] per 100 patient-years vs. 1.11 [0.45-1.76] per 100 patient-years). In the four trials in which direct comparisons of patients with and without bruits were possible, the odds ratio for MI was 2.15 (1.67-2.78) and for cardiovascular death was 2.27 (1.49-3.49).Conclusions: A carotid bruit is associated with a significantly increased risk of death and MI.Perspective: Recent guidelines advise against routine screening for carotid stenosis using carotid Doppler given lack of cost-effectiveness for preventing stroke. These data suggest that presence of a carotid bruit is associated with a high mortality risk, and the risk of MI exceeds the risk of stroke associated with severe carotid stenosis. Further, the risk associated with a carotid bruit exceeds that associated with a high electron beam computed tomography score (>400). Detection of carotid bruits is easy and inexpensive, and aggressive risk factor modification should be routinely considered in patients with a carotid bruit.  Hitinder S. Gurm, M.B.B.S., F.A.C.C. Lancet 2008;371:1587-1594.