Safety of Carotid Revascularization in Patients With a History of Coronary Heart Disease.
Aged
Carotid Arteries
/ surgery
Carotid Stenosis
/ etiology
Cerebral Revascularization
/ adverse effects
Coronary Disease
/ complications
Disease-Free Survival
Endarterectomy, Carotid
/ adverse effects
Female
Humans
Male
Middle Aged
Postoperative Complications
/ mortality
Risk Factors
Safety
Stroke
/ etiology
Survival Rate
angioplasty
carotid stenosis
coronary artery disease
endarterectomy
risk
Journal
Stroke
ISSN: 1524-4628
Titre abrégé: Stroke
Pays: United States
ID NLM: 0235266
Informations de publication
Date de publication:
02 2019
02 2019
Historique:
pubmed:
10
1
2019
medline:
17
10
2019
entrez:
10
1
2019
Statut:
ppublish
Résumé
Background and Purpose- We investigated whether procedural stroke or death risk of carotid artery stenting (CAS) compared with carotid endarterectomy (CEA) is different in patients with and without history of coronary heart disease (CHD) and whether the treatment-specific impact of age differs. Methods- We combined individual patient data of 4754 patients with symptomatic carotid stenosis from 4 randomized trials (EVA-3S [Endarterectomy Versus Angioplasty in Patients With Symptomatic Severe Carotid Stenosis], SPACE [Stent-Protected Angioplasty Versus Carotid Endarterectomy], ICSS [International Carotid Stenting Study], and CREST [Carotid Revascularization Endarterectomy Versus Stenting Trial]). Procedural risk was defined as any stroke or death ≤30 days after treatment. We compared procedural risk between both treatments with Cox regression analysis, stratified by history of CHD and age (<70, 70-74, ≥75 years). History of CHD included myocardial infarction, angina, or coronary revascularization. Results- One thousand two hundred ninety-three (28%) patients had history of CHD. Procedural stroke or death risk was higher in patients with history of CHD. Procedural risk in patients treated with CAS compared with CEA was consistent in patients with history of CHD (8.3% versus 4.6%; hazard ratio [HR], 1.96; 95% CI, 0.67-5.73) and in those without (6.9% versus 3.6%; HR, 1.93; 95% CI, 1.40-2.65; P
Identifiants
pubmed: 30621529
doi: 10.1161/STROKEAHA.118.023085
pmc: PMC6358179
doi:
Types de publication
Comparative Study
Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
413-418Subventions
Organisme : Medical Research Council
ID : G0300411
Pays : United Kingdom
Organisme : NINDS NIH HHS
ID : U01 NS080168
Pays : United States
Références
Cochrane Database Syst Rev. 2012 Sep 12;(9):CD000515
pubmed: 22972047
Stroke. 2014 Jul;45(7):2160-236
pubmed: 24788967
Stroke. 2015 Oct;46(10):2843-8
pubmed: 26286540
Neuroepidemiology. 2013;40(1):36-41
pubmed: 23075828
Ann Intern Med. 2011 Apr 19;154(8):523-8
pubmed: 21502650
Lancet. 2010 Sep 25;376(9746):1062-73
pubmed: 20832852
Stroke. 1991 Jun;22(6):711-20
pubmed: 2057968
Eur Heart J. 2008 Feb;29(3):394-401
pubmed: 18245121
Lancet. 2016 Mar 26;387(10025):1305-11
pubmed: 26880122
Anesthesiology. 2014 Mar;120(3):564-78
pubmed: 24534856
N Engl J Med. 2006 Oct 19;355(16):1660-71
pubmed: 17050890
Lancet. 2010 Mar 20;375(9719):985-97
pubmed: 20189239
N Engl J Med. 2004 Oct 7;351(15):1493-501
pubmed: 15470212
Lancet. 2006 Oct 7;368(9543):1239-47
pubmed: 17027729
N Engl J Med. 2010 Jul 1;363(1):11-23
pubmed: 20505173