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Preoperative Coronary Stenosis Is a Determinant of Early Vascular Outcome after Carotid Endarterectomy

Title
Preoperative Coronary Stenosis Is a Determinant of Early Vascular Outcome after Carotid Endarterectomy
Author
고성호
Keywords
carotid endarterectomy; coronary artery disease; coronary angiography; risk assessment
Issue Date
2015-10
Publisher
KOREAN NEUROLOGICAL ASSOC
Citation
JOURNAL OF CLINICAL NEUROLOGY, v. 11, NO 4, Page. 364-371
Abstract
Background and Purpose The benefit of carotid endarterectomy (CEA) is directly influenced by the risk of perioperative adverse outcomes. However, patient-level risks and predictors including coronary stenosis are rarely evaluated, especially in Asian patients. The aim of this study was to determine the relationship between the vascular risk factors underlying CEA, including coronary stenosis, and postoperative outcome. Methods One hundred and fifty-three consecutive CEAs from our hospital records were included in this analysis. All patients underwent coronary computed tomography angiography before CEA. Data were analyzed to determine the vascular outcomes in patients with mild-to-moderate vs. severe coronary stenosis and high vs. standard operative risk, based on the criteria for high operative risk defined in the Stenting and Angioplasty with Protection in Patients at High Risk for Endarterectomy (SAPPHIRE) trial. The vascular outcome was defined as the occurrence of postoperative (≤30 days) stroke, myocardial infarction (MI), or death. Results An adverse vascular outcome occurred in 8 of the 153 CEAs, with 6 strokes, 2 MIs, and 3 deaths. The vascular outcome differed significantly between the groups with mild-to-moderate and severe coronary stenosis (p=0.024), but not between the high- and standard-operative-risk groups (stratified according to operative risk as defined in the SAPPHIRE trial). Multivariable analysis adjusting for potent predictors revealed that severe coronary stenosis (odds ratio, 6.87; 95% confidence interval, 1.20-39.22) was a significant predictor of the early vascular outcome. Conclusions Severe coronary stenosis was identified herein as an independent predictor of an adverse early vascular outcome.
URI
https://synapse.koreamed.org/DOIx.php?id=10.3988/jcn.2015.11.4.364http://hdl.handle.net/20.500.11754/28438
ISSN
1738-6586; 2005-5013
DOI
10.3988/jcn.2015.11.4.364
Appears in Collections:
COLLEGE OF MEDICINE[S](의과대학) > MEDICINE(의학과) > Articles
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