Long-term results of carotid stenting and risk factors in patients with severe carotid artery stenosis undergoing subsequent cardiac surgery
| Autor: | Selma C. Tromp, Johannes C. Kelder, Jan Van der Heyden, Maarten J. Suttorp, Uday Sonker, Bakhtawar K. Mahmoodi, Najibullah Habib |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Time Factors medicine.medical_treatment Myocardial Infarction 030204 cardiovascular system & hematology Risk Assessment Severity of Illness Index 03 medical and health sciences 0302 clinical medicine Risk Factors Carotid artery disease Internal medicine medicine Humans Carotid Stenosis Radiology Nuclear Medicine and imaging Prospective Studies 030212 general & internal medicine Myocardial infarction Cardiac Surgical Procedures Stroke Aged business.industry Endovascular Procedures Hazard ratio General Medicine Middle Aged medicine.disease Progression-Free Survival Cardiac surgery Stenosis Cardiology Female Stents Carotid stenting Cardiology and Cardiovascular Medicine business Kidney disease |
| Zdroj: | Catheterization and Cardiovascular Interventions. 93:E134-E139 |
| ISSN: | 1522-1946 |
| DOI: | 10.1002/ccd.27947 |
| Popis: | Aims To identify risk factors for composite outcome of mortality, stroke or myocardial infarction in patients with severe carotid stenosis undergoing staged carotid artery stenting (CAS) with subsequent cardiac surgery. Methods and results In this prospective observational study, we enrolled 643 consecutive patients with both symptomatic (i.e., with history of stroke) and asymptomatic severe carotid artery disease, who required cardiac surgery. Generally, cardiac surgery was planned 30 days after the CAS procedure. The composite outcome consisted of death, stroke and myocardial infarction. The composite outcome rate was 26.3% at 5 years and 47% at 8 years after CAS. Age ≥ 80 years (hazard ratio [HR] = 1.89; 95%CI, 1.18-3.03; P = 0.008), history of stroke (HR = 1.66, 1.16-2.37; P = 0.006), chronic obstructive pulmonary disease (HR = 1.86; 1.07-3.24; P = 0.03) and kidney disease (HR = 1.83, 1.11-3.04; P = 0.02) were independent risk factors for the composite outcome during long-term follow-up. Conclusions In this study with staged CAS followed by cardiac surgery, we confirm previously reported event-free survival rates and identify several risk factors for the composite outcome. Future studies are needed to confirm the importance of the identified risk factors and to assess their predictive ability. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Plný text