Disease Progression in the Contralateral Carotid Artery is Still Common After Endarterectomy

Autor: Carlos Ruiz-Carmona, Albert Clarà, Carles Diaz-Duran, Meritxell Mellado Joan, Lluis Roig, Roberto Elosua
Rok vydání: 2017
Předmět:
Carotid Artery Diseases
Male
medicine.medical_specialty
Time Factors
medicine.medical_treatment
Carotid endarterectomy
Kaplan-Meier Estimate
030204 cardiovascular system & hematology
Gastroenterology
Disease-Free Survival
03 medical and health sciences
0302 clinical medicine
Predictive Value of Tests
Internal medicine
medicine
Humans
Endarterectomy
Aged
Proportional Hazards Models
Retrospective Studies
Endarterectomy
Carotid
Ultrasonography
Doppler
Duplex
Proportional hazards model
business.industry
Anticoagulants
Retrospective cohort study
General Medicine
Middle Aged
medicine.disease
Stenosis
Treatment Outcome
Spain
Predictive value of tests
Disease Progression
Platelet aggregation inhibitor
Surgery
Female
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Cardiology and Cardiovascular Medicine
business
030217 neurology & neurosurgery
Dyslipidemia
Platelet Aggregation Inhibitors
Zdroj: Annals of vascular surgery. 50
ISSN: 1615-5947
Popis: Background Disease progression in the contralateral carotid artery (CA) after a carotid endarterectomy (CEA) was common in the past. Current medication regimens for these patients are better and have probably modified this progression. We evaluated the rate of disease progression in the contralateral CA over the last decade. Methods A retrospective analysis of 291 consecutive patients undergoing a CEA between 2005 and 2014 was performed. Disease progression in the contralateral CA after CEA was determined by a duplex ultrasound. Statistics were calculated by Kaplan-Meier life-tables and Cox regression. Results Of the 291 patients, 246 (84.5%) received at baseline antiplatelet and/or anticoagulant agents, and 223 (77%) received statins. These proportions increased over the second half of the study. Disease progression in the contralateral CA was evaluated in 200 patients during a mean follow-up of 3.5 years. Progression-free survival rates from any disease progression at 1 and 5 years were of 89.3% and 68.6%, respectively. Free survival rates from 50% progression or from 50% to 69% to a higher category at 1 and 5 years were of 89.3% and 75.5%, respectively. Finally progression-free survival rates to a >70% stenosis or occlusion at 1 and 5 years were of 96.8% and 90.1%, respectively. Age (hazard ratio = 1.034, P = 0.048) and dyslipidemia (hazard ratio = 1.93, P = 0.045) were also associated with any disease progression. Conclusions Current rates of disease progression in the contralateral CA after CEA are similar to those reported more than 1 decade ago. Further research will be needed to evaluate the impact of current medical regimens at these stages of disease.
Databáze: OpenAIRE
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