Identifying Patients With Symptomatic Carotid Artery Disease at High and Low Risk of Severe Myocardial Infarction and Cardiac Death
| Autor: | Ramsay W. Gunton, Ale Algra, Henry J.M. Barnett, Michael Eliasziw, Peter C. Gates |
|---|---|
| Rok vydání: | 2002 |
| Předmět: |
Carotid Artery Diseases
Male medicine.medical_specialty Heart disease medicine.medical_treatment Myocardial Infarction Myocardial Ischemia Comorbidity Carotid endarterectomy Risk Assessment Disease-Free Survival Electrocardiography Risk Factors Internal medicine Carotid artery disease Odds Ratio medicine Humans cardiovascular diseases Myocardial infarction Risk factor Aged Advanced and Specialized Nursing Endarterectomy Carotid medicine.diagnostic_test business.industry Vascular disease medicine.disease Death Sudden Cardiac Treatment Outcome cardiovascular system Cardiology Female Controlled Clinical Trials as Topic Neurology (clinical) Cardiology and Cardiovascular Medicine Risk assessment business Follow-Up Studies |
| Zdroj: | Stroke. 33:2413-2416 |
| ISSN: | 1524-4628 0039-2499 |
| DOI: | 10.1161/01.str.0000030110.05246.2c |
| Popis: | Background and Purpose— The extent of cardiac investigation required in patients with coexistent symptomatic carotid and cardiac disease is unsettled. This study compared the outlook for patients symptomatic from carotid stenosis with and without a history of symptomatic ischemic heart disease (IHD). Methods— The risk of combined outcome of severe myocardial infarction and cardiac death was evaluated in patients from the North American Symptomatic Carotid Endarterectomy Trial. Results— A total of 1124 patients had a history of symptomatic IHD and 1691 did not. The median age was 66 years; 70% were male. With history of IHD at entry, the 5-year risk of combined outcome of severe myocardial infarction and cardiac death was 16.5% (95% CI, 13.9 to 19.0). Without history at entry, risk was 6.7% (95% CI, 5.1 to 8.3). Risk of unheralded severe MI and cardiac death was only 3.3%. One hundred ninety-four patients had ≥4 of the following risk factors: age ≥75 years, history of diabetes, history of hypertension, smoking in past year, left ventricular hypertrophy on ECG, myocardial infarction on ECG, or creatinine >115 μmol/L. The 5-year risk of severe myocardial infarction or cardiac death increased to 33.9% for patients with ≥4 risk factors and a history of IHD and to 23.5% for those without history of IHD. Conclusions— Most patients with symptomatic carotid stenosis without symptomatic IHD had a low risk of severe myocardial infarction and cardiac death. With many risk factors, these patients had a risk high enough to warrant cardiac investigations. |
| Databáze: | OpenAIRE |
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