Common carotid intima-media thickness measurement is not a pertinent predictor for secondary cardiovascular events after coronary bypass surgery. A prospective study
| Autor: | Philippe Lacroix, Annabel Postil, Cengiz Yildiz, Jérôme Guilloux, Victor Aboyans, Marc Laskar |
|---|---|
| Rok vydání: | 2005 |
| Předmět: |
Male
Pulmonary and Respiratory Medicine medicine.medical_specialty Carotid Artery Common Coronary Disease Preoperative care Coronary artery bypass surgery Predictive Value of Tests Recurrence Internal medicine medicine Humans Postoperative Period Prospective Studies cardiovascular diseases Coronary Artery Bypass Prospective cohort study Stroke Aged Ultrasonography Univariate analysis business.industry Arrhythmias Cardiac General Medicine Middle Aged Prognosis medicine.disease Intima-media thickness Bypass surgery Predictive value of tests Multivariate Analysis cardiovascular system Cardiology Female Surgery Endothelium Vascular Tunica Intima Cardiology and Cardiovascular Medicine business Follow-Up Studies |
| Zdroj: | European Journal of Cardio-Thoracic Surgery. 28:415-419 |
| ISSN: | 1010-7940 |
| DOI: | 10.1016/j.ejcts.2005.06.006 |
| Popis: | Objective: We aimed to assess the utility of common carotid intima-media thickness (CCA-IMT) to predict secondary cardiovascular events after coronary artery bypass grafting (CABG). In primary prevention, carotid-IMT is known as a valuable cardiovascular risk marker, but its interest in secondary prevention has been less studied. We hypothesized that CCA-IMT could be used for peri-operative and long-term risk stratification in candidates for CABG. Methods: A total of 609 patients (66.8G9.2 years) were prospectively enrolled for preoperative CCA-IMT measurement and follow-up. The primary end-point combined cardiovascular death, non-fatal acute coronary syndromes, stroke, secondary coronary revascularization and peripheral arterial surgery during follow-up. The secondary end-point was the 1-month post-operative death. Univariate and multivariate analysis were performed by usual methods. Results: A subgroup of 150 patients (24.6%) was individualized with a CCA-IMT above 90th percentile (O0.90 mm) or presenting plaques in their CCA. At 1 month, there was no significant difference in the prevalence of elevated CCA-IMT between deceased patients and survivors (16.7 vs. 24.9%, PZns). During a mean follow-up of 41.8G16 months, 121 patients (19.8%) met the primary end-point. High CCA-IMT was predictive (ORZ1.67, 95% CI 1.14–2.46, PZ0.009) in the univariate analysis. In the multivariate analysis, age (ORZ1.03, 95% CI 1.00–1.05, PZ0.029) concomitant valvular surgery (ORZ2.17, PZ0.003) arrhythmia (ORZ2.20, PZ0.021), and peripheral arterial disease (ORZ2.41, P!0.001) were significant independent prognostic factors whereas CCA-IMT failed to remain independently significant. Conclusions: Pre-operative CCA-IMT can provide prognostic information for candidates to CABG. However, clinical data present stronger prognostic values. Q 2005 Elsevier B.V. All rights reserved. |
| Databáze: | OpenAIRE |
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