Treatment-Related Cardiovascular Outcomes in Patients with Symptomatic Subclavian Artery Stenosis.

Autor:	Epperla N; Hematology and Oncology, Medical College of Wisconsin., Ye F; GME Internal Medicine Residency Program, North Florida Regional Medical Center., Idris A; GME Internal Medicine Residency Program, North Florida Regional Medical Center., Sakkalaek A; GME Internal Medicine Residency Program, North Florida Regional Medical Center., Liang H; GME Internal Medicine Residency Program, North Florida Regional Medical Center., Chyou PH; Biomedical Informatics Research Center, Marshfield Clinic Research Foundation., Dart RA; Center for Human Genetics, Marshfield Clinic Research Foundation., Mazza J; Department of Clinical Research, Marshfield Clinic Research Foundation., Yale S; Internal Medicine, University of Central Florida College of Medicine.
Jazyk:	angličtina
Zdroj:	Cureus [Cureus] 2017 May 19; Vol. 9 (5), pp. e1262. Date of Electronic Publication: 2017 May 19.
DOI:	10.7759/cureus.1262
Abstrakt:	Background: Subclavian artery stenosis (SAS) is narrowing of the subclavian artery most commonly caused by atherosclerosis. It serves as a marker for cerebrovascular and myocardial ischemic events. Methods: A retrospective cohort study was conducted to determine the association of treatment via combination therapy (antiplatelet drug plus either by-pass surgery or percutaneous transluminal angioplasty (PTA) with or without stent implantation) versus antiplatelet drug therapy alone on cardiovascular events and all-cause mortality in Marshfield Clinic patients diagnosed with symptomatic SAS from January 1, 1995 to December 31, 2009. Results: Of the total 2153 cases, 100 patients were identified as eligible to be included in the study. Of these 100 patients that met inclusion criteria, 30 underwent combination therapy while 70 were managed only with drug treatment. A median length of follow-up was 8.45 years. Adverse cardiovascular events occurred in 5/30 (17%) of combination therapy patients compared to 28/70 (40%) of antiplatelet drug therapy only patients (p = 0.0355). Accordingly, all-cause mortality was higher (47%) in the antiplatelet drug therapy only group than the combination therapy group (13%) [hazard ratio = 3.45, p = 0.0218]. Conclusions: Preliminary findings in this pilot data set suggest that combination therapy (medications plus either surgical or interventional repair) of subclavian artery stenosis is associated with less cardiovascular adverse events and higher survival rates. However, prospective randomized studies with larger number of patients are needed to validate these findings. Competing Interests: The authors have declared that no competing interests exist.
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu