Polyvascular Disease Influences Long-Term Cardiovascular Morbidity in Carotid Endarterectomy
Copyright © 2023 The Author(s). Published by Elsevier Inc. All rights reserved..
INTRODUCTION/OBJECTIVE: Carotid stenosis (CS) is an important cause of ischemic stroke. Secondary prevention lies in performing a carotid endarterectomy (CEA) procedure, the recommended treatment in most cases. When 2 or more vascular regions are simultaneously affected by atherosclerosis, mainly the carotid arteries, coronary arteries, or limb arteries, a multivessel disease polyvascular disease (PVD) is present. This study aims to assess the potential role of PVD as a long-term predictor of major adverse cardiovascular events (MACE) and all-cause mortality in patients submitted to CEA.
METHODS: From January 2012 to December 2021, patients submitted to CEA for carotid stenosis in a tertiary care and referral center were eligible from a prospective database. A posthoc survival analysis was performed using the Kaplan-Meier survival curve method. The primary outcome was the incidence of long-term MACE and all-cause mortality. Secondary outcomes included acute myocardial infarction (AMI), major adverse limb events (MALE), stroke, and acute heart failure (AHF).
RESULTS: A total of 207 patients were enrolled, with a median follow-up of 63 months. The mean age was 70.4 ± 8.9, and 163 (78.7%) were male. There were 65 (31.4%) patients that had 2 arterial vascular territories affected, and 29 (14.0%) patients had PVD in 3 arterial beds. On multivariable analysis, both MACE and all-cause mortality had as independent risk factors age (aHR 1.039, P = 0.003; aHR 1.041, P = 0.019), chronic kidney disease (aHR 2.524, P = 0.003; aHR 3.377, P < 0.001) and PVD2 (aHR 3.381, P < 0.001; aHR 2.665, P = 0.013). PVD1 was only associated with MACE as a statistically significant risk factor (aHR 2.531, 1.439-4.450, P < 0.001).
CONCLUSIONS: PVD in patients with cerebrovascular disease (CVD) was revealed to carry a 2-fold increased risk for all-cause mortality and MACE during long-term follow-up. PVD may be a simple yet valuable tool in predicting all-cause mortality, MACE, AMI, and MALE after CEA.
Medienart: |
E-Artikel |
---|
Erscheinungsjahr: |
2024 |
---|---|
Erschienen: |
2024 |
Enthalten in: |
Zur Gesamtaufnahme - volume:102 |
---|---|
Enthalten in: |
Annals of vascular surgery - 102(2024) vom: 08. Apr., Seite 236-243 |
Sprache: |
Englisch |
---|
Beteiligte Personen: |
Thierstein, Lourenço [VerfasserIn] |
---|
Links: |
---|
Themen: |
---|
Anmerkungen: |
Date Completed 08.04.2024 Date Revised 08.04.2024 published: Print-Electronic Citation Status MEDLINE |
---|
doi: |
10.1016/j.avsg.2023.10.004 |
---|
funding: |
|
---|---|
Förderinstitution / Projekttitel: |
|
PPN (Katalog-ID): |
NLM364366109 |
---|
LEADER | 01000caa a22002652 4500 | ||
---|---|---|---|
001 | NLM364366109 | ||
003 | DE-627 | ||
005 | 20240408232124.0 | ||
007 | cr uuu---uuuuu | ||
008 | 231226s2024 xx |||||o 00| ||eng c | ||
024 | 7 | |a 10.1016/j.avsg.2023.10.004 |2 doi | |
028 | 5 | 2 | |a pubmed24n1369.xml |
035 | |a (DE-627)NLM364366109 | ||
035 | |a (NLM)37944897 | ||
035 | |a (PII)S0890-5096(23)00762-8 | ||
040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
041 | |a eng | ||
100 | 1 | |a Thierstein, Lourenço |e verfasserin |4 aut | |
245 | 1 | 0 | |a Polyvascular Disease Influences Long-Term Cardiovascular Morbidity in Carotid Endarterectomy |
264 | 1 | |c 2024 | |
336 | |a Text |b txt |2 rdacontent | ||
337 | |a ƒaComputermedien |b c |2 rdamedia | ||
338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
500 | |a Date Completed 08.04.2024 | ||
500 | |a Date Revised 08.04.2024 | ||
500 | |a published: Print-Electronic | ||
500 | |a Citation Status MEDLINE | ||
520 | |a Copyright © 2023 The Author(s). Published by Elsevier Inc. All rights reserved. | ||
520 | |a INTRODUCTION/OBJECTIVE: Carotid stenosis (CS) is an important cause of ischemic stroke. Secondary prevention lies in performing a carotid endarterectomy (CEA) procedure, the recommended treatment in most cases. When 2 or more vascular regions are simultaneously affected by atherosclerosis, mainly the carotid arteries, coronary arteries, or limb arteries, a multivessel disease polyvascular disease (PVD) is present. This study aims to assess the potential role of PVD as a long-term predictor of major adverse cardiovascular events (MACE) and all-cause mortality in patients submitted to CEA | ||
520 | |a METHODS: From January 2012 to December 2021, patients submitted to CEA for carotid stenosis in a tertiary care and referral center were eligible from a prospective database. A posthoc survival analysis was performed using the Kaplan-Meier survival curve method. The primary outcome was the incidence of long-term MACE and all-cause mortality. Secondary outcomes included acute myocardial infarction (AMI), major adverse limb events (MALE), stroke, and acute heart failure (AHF) | ||
520 | |a RESULTS: A total of 207 patients were enrolled, with a median follow-up of 63 months. The mean age was 70.4 ± 8.9, and 163 (78.7%) were male. There were 65 (31.4%) patients that had 2 arterial vascular territories affected, and 29 (14.0%) patients had PVD in 3 arterial beds. On multivariable analysis, both MACE and all-cause mortality had as independent risk factors age (aHR 1.039, P = 0.003; aHR 1.041, P = 0.019), chronic kidney disease (aHR 2.524, P = 0.003; aHR 3.377, P < 0.001) and PVD2 (aHR 3.381, P < 0.001; aHR 2.665, P = 0.013). PVD1 was only associated with MACE as a statistically significant risk factor (aHR 2.531, 1.439-4.450, P < 0.001) | ||
520 | |a CONCLUSIONS: PVD in patients with cerebrovascular disease (CVD) was revealed to carry a 2-fold increased risk for all-cause mortality and MACE during long-term follow-up. PVD may be a simple yet valuable tool in predicting all-cause mortality, MACE, AMI, and MALE after CEA | ||
650 | 4 | |a Journal Article | |
700 | 1 | |a Pereira-Macedo, Juliana |e verfasserin |4 aut | |
700 | 1 | |a Duarte-Gamas, Luís |e verfasserin |4 aut | |
700 | 1 | |a Reis, Pedro |e verfasserin |4 aut | |
700 | 1 | |a Myrcha, Piotr |e verfasserin |4 aut | |
700 | 1 | |a Andrade, José P |e verfasserin |4 aut | |
700 | 1 | |a Rocha-Neves, João |e verfasserin |4 aut | |
773 | 0 | 8 | |i Enthalten in |t Annals of vascular surgery |d 1995 |g 102(2024) vom: 08. Apr., Seite 236-243 |w (DE-627)NLM012991953 |x 1615-5947 |7 nnns |
773 | 1 | 8 | |g volume:102 |g year:2024 |g day:08 |g month:04 |g pages:236-243 |
856 | 4 | 0 | |u http://dx.doi.org/10.1016/j.avsg.2023.10.004 |3 Volltext |
912 | |a GBV_USEFLAG_A | ||
912 | |a GBV_NLM | ||
951 | |a AR | ||
952 | |d 102 |j 2024 |b 08 |c 04 |h 236-243 |