Risk score for peri-interventional complications of carotid artery stenting.
| Autor: | Hofmann R; Cardiovascular Division, City Hospital Linz, Austria, A-4020 Linz, Krankenhausstr. 9. robert.hofmann@akh.linz.at, Niessner A, Kypta A, Steinwender C, Kammler J, Kerschner K, Grund M, Leisch F, Huber K |
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| Jazyk: | angličtina |
| Zdroj: | Stroke [Stroke] 2006 Oct; Vol. 37 (10), pp. 2557-61. Date of Electronic Publication: 2006 Sep 21. |
| DOI: | 10.1161/01.STR.0000240688.81918.32 |
| Abstrakt: | Background and Purpose: Routinely available independent risk factors for the peri-interventional outcome of patients undergoing elective carotid artery stenting (CAS) are lacking. The rationale of the study was to create a risk score identifying high-risk patients. Methods: We prospectively enrolled 606 consecutive patients assigned to CAS at a secondary care hospital. Various biochemical, clinical, and lesion-related risk factors were prospectively defined. The primary end point reflecting periprocedural complications encompassed minor and major stroke, nonfatal myocardial infarction and all-cause mortality within 30 days. Results: Three percent of patients (n=18) experienced a nonfatal minor (n=13) or major (n=5) stroke. 1.3% of patients (n=8) died from fatal stroke (n=4) or other causes (n=4). No myocardial infarction was observed within 30 days after stenting. Multivariable analysis revealed diabetes mellitus with inadequate glycemic control (HbA1c > 7%), age > or = 80 years, ulceration of the carotid artery stenosis, and a contralateral stenosis > or = 50% as independent risk factors. A risk score formed with these variables showed a superior predictive value (C-statistic = 0.73) compared with single risk factors. The presence of 2 or more of these risk factors identified patients with a risk of 11% for a periprocedural complication compared with 2% in patients with a score of 0 or 1. Conclusions: In patients undergoing elective CAS, a risk score based on routinely accessible variables was able to identify patients at high-risk for atherothrombotic events and all-cause death within 30 days after the intervention. |
| Databáze: | MEDLINE |
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