Preoperative Coronary Stenosis Is a Determinant of Early Vascular Outcome afer Carotid Endarterectomy
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Background and Purpose Te beneft of carotid endarterectomy (CEA) is directly infuenced by the risk of perioperative adverse outcomes. However, patient-level risks and predictors including coronary stenosis are rarely evaluated, especially in Asian patients. Te aim of this study was to determine the relationship between the vascular risk factors underlying CEA, including coronary stenosis, and postoperative outcome. Methods One hundred and ffy-three consecutive CEAs from our hospital records were included in this analysis. All patients underwent coronary computed tomography angiography before CEA. Data were analyzed to determine the vascular outcomes in patients with mild-tomoderate vs. severe coronary stenosis and high vs. standard operative risk, based on the criteria for high operative risk defned in the Stenting and Angioplasty with Protection in Patients at High Risk for Endarterectomy (SAPPHIRE) trial. Te vascular outcome was defned as the occurrence of postoperative (≤30 days) stroke, myocardial infarction (MI), or death. Results An adverse vascular outcome occurred in 8 of the 153 CEAs, with 6 strokes, 2 MIs, and 3 deaths. The vascular outcome differed significantly between the groups with mild-tomoderate and severe coronary stenosis (p=0.024), but not between the high- and standard-operative-risk groups (stratifed according to operative risk as defned in the SAPPHIRE trial). Multivariable analysis adjusting for potent predictors revealed that severe coronary stenosis (odds ratio, 6.87; 95% confdence interval, 1.20–39.22) was a signifcant predictor of the early vascular outcome. Conclusions Severe coronary stenosis was identifed herein as an independent predictor of an adverse early vascular outcome.
Abstract
Background and Purpose Te beneft of carotid endarterectomy (CEA) is directly infuenced by the risk of perioperative adverse outcomes. However, patient-level risks and predictors including coronary stenosis are rarely evaluated, especially in Asian patients. Te aim of this study was to determine the relationship between the vascular risk factors underlying CEA, including coronary stenosis, and postoperative outcome. Methods One hundred and ffy-three consecutive CEAs from our hospital records were included in this analysis. All patients underwent coronary computed tomography angiography before CEA. Data were analyzed to determine the vascular outcomes in patients with mild-tomoderate vs. severe coronary stenosis and high vs. standard operative risk, based on the criteria for high operative risk defned in the Stenting and Angioplasty with Protection in Patients at High Risk for Endarterectomy (SAPPHIRE) trial. Te vascular outcome was defned as the occurrence of postoperative (≤30 days) stroke, myocardial infarction (MI), or death. Results An adverse vascular outcome occurred in 8 of the 153 CEAs, with 6 strokes, 2 MIs, and 3 deaths. The vascular outcome differed significantly between the groups with mild-tomoderate and severe coronary stenosis (p=0.024), but not between the high- and standard-operative-risk groups (stratifed according to operative risk as defned in the SAPPHIRE trial). Multivariable analysis adjusting for potent predictors revealed that severe coronary stenosis (odds ratio, 6.87; 95% confdence interval, 1.20–39.22) was a signifcant predictor of the early vascular outcome. Conclusions Severe coronary stenosis was identifed herein as an independent predictor of an adverse early vascular outcome.
참고문헌 (37)
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