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In subjects with ACS, cerebral vasomotor reactivity (CVR) was assessed with the breath-holding index (BHI) transcranial Doppler-based method. Cognitive deterioration was defined as a decrease in the MMSE score by \u22652 points after one year. In order to define the threshold of impaired BHI, a ROC curve analysis was performed adopting the binary difference of MMSE score as the outcome and continuous BHI as the testing variable. A total of 548 subjects completed the follow-up. Cognitive deterioration was observed in 119 patients (21.7%). The BHI value ipsilateral to the stenosis was the strongest predictor of cognitive deterioration among the variables tested. The best cut-point to discriminate between normal and abnormal BHI resulted \u22640.89. The post-test probability of cognitive deterioration for an abnormal BHI was 44%, while a normal BHI showed a post-test probability of 9% for the same outcome. The present investigation provides a threshold of reduced CVR that can be useful to identify subjects with ACS at risk of cognitive deterioration.<\/jats:p>","DOI":"10.1177\/0271678x15613526","type":"journal-article","created":{"date-parts":[[2015,12,4]],"date-time":"2015-12-04T13:48:00Z","timestamp":1449236880000},"page":"1804-1812","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":36,"title":["Thresholds of impaired cerebral hemodynamics that predict short-term cognitive decline in asymptomatic carotid stenosis"],"prefix":"10.1177","volume":"36","author":[{"given":"Laura","family":"Buratti","sequence":"first","affiliation":[{"name":"Neurological Clinic, Marche Polytechnic University, Ancona, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giovanna","family":"Viticchi","sequence":"additional","affiliation":[{"name":"Neurological Clinic, Marche Polytechnic University, Ancona, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lorenzo","family":"Falsetti","sequence":"additional","affiliation":[{"name":"Internal and Subintensive Medicine, Ospedali Riuniti Ancona, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Clotilde","family":"Balucani","sequence":"additional","affiliation":[{"name":"Neurological Clinic, Marche Polytechnic University, Ancona, Italy"},{"name":"Department of Neurology, SUNY Downstate Medical Center, Brooklyn, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claudia","family":"Altamura","sequence":"additional","affiliation":[{"name":"Neurology Unit, Campus Bio-Medico University, Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cristina","family":"Petrelli","sequence":"additional","affiliation":[{"name":"Neurological Clinic, Marche Polytechnic University, Ancona, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leandro","family":"Provinciali","sequence":"additional","affiliation":[{"name":"Neurological Clinic, Marche Polytechnic University, Ancona, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fabrizio","family":"Vernieri","sequence":"additional","affiliation":[{"name":"Neurology Unit, Campus Bio-Medico University, Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mauro","family":"Silvestrini","sequence":"additional","affiliation":[{"name":"Neurological Clinic, Marche Polytechnic University, Ancona, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2016,7,22]]},"reference":[{"key":"bibr1-0271678X15613526","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e318270402e"},{"key":"bibr2-0271678X15613526","doi-asserted-by":"publisher","DOI":"10.1016\/j.neubiorev.2013.05.011"},{"key":"bibr3-0271678X15613526","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.114.005645"},{"key":"bibr4-0271678X15613526","doi-asserted-by":"publisher","DOI":"10.1212\/01.WNL.0000113759.80877.1F"},{"key":"bibr5-0271678X15613526","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-140-4-200402170-00005"},{"key":"bibr6-0271678X15613526","doi-asserted-by":"publisher","DOI":"10.1159\/000108112"},{"key":"bibr7-0271678X15613526","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.108.535245"},{"key":"bibr8-0271678X15613526","doi-asserted-by":"publisher","DOI":"10.1016\/j.neurobiolaging.2007.11.008"},{"key":"bibr9-0271678X15613526","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000345015.35520.52"},{"key":"bibr10-0271678X15613526","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e318295d71a"},{"key":"bibr11-0271678X15613526","doi-asserted-by":"publisher","DOI":"10.3233\/JAD-2012-120949"},{"key":"bibr12-0271678X15613526","doi-asserted-by":"publisher","DOI":"10.1016\/j.neurobiolaging.2011.11.027"},{"key":"bibr13-0271678X15613526","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2292030516"},{"key":"bibr14-0271678X15613526","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.32.6.1318"},{"key":"bibr15-0271678X15613526","doi-asserted-by":"publisher","DOI":"10.1097\/00004872-200311000-00002"},{"key":"bibr16-0271678X15613526","volume-title":"Definition, diagnosis and classification of diabetes mellitus and its complications. 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