TY - JOUR T1 - White matter hyperintensities and their subtypes in patients with carotid artery stenosis: a systematic review and meta-analysis JF - BMJ Open JO - BMJ Open DO - 10.1136/bmjopen-2017-020830 VL - 8 IS - 5 SP - e020830 AU - Huirong Ye AU - Yujie Wang AU - Jianting Qiu AU - Qing Wu AU - Mengmeng Xu AU - Jian Wang Y1 - 2018/05/01 UR - http://bmjopen.bmj.com/content/8/5/e020830.abstract N2 - 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. ER -