Carotid Artery Stenosis Associated with Increased Mortality in Patients who Underwent Coronary Artery Bypass Grafting: A Single Center Experience

Rosa, Marcelo Pereira da; Schwendler, Ricardo; Lopes, Rodrigo; Portal, Vera Lúcia

doi:10.2174/1874192401307010076

Cited by 10 publications

(5 citation statements)

References 29 publications

(29 reference statements)

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“…15 The 2011 European peripheral artery disease (PAD) strategies extended their recommendation for preoperative duplex scan for CAS in CABG patients to include patients more than 70 years of age or those with evidence of carotid bruit, multi-vessel CAD, cerebrovascular disease, or PAD class I evidence. 16 DaRosa et al 17 noted that the perioperative risk of stroke after cardiac surgery was 3.8%–7.4% among the patients with more than 50% CAS; moreover, they reported increasing prevalence with more than 70% carotid lesion, which is similar to our study results. In a retrospective cohort of 1558 Chinese patients who underwent CABG, the prevalence of CAS with ⩾50% and ⩾70% stenosis were 21.2% and 6.7%, respectively.…”

Section: Discussionsupporting

confidence: 91%

Prevalence of carotid artery stenosis in ischaemic heart disease patients in Bangladesh

et al. 2019

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Background:Concurrent carotid artery stenosis and ischaemic heart disease rates are increasing day by day in Bangladesh. Moreover, carotid artery stenosis has been identified as a high-risk factor for postoperative ischaemic cerebral inconvenience following coronary artery bypass graft surgery.Methods:This observational cross-sectional study was performed to evaluate 200 study patients from July 2017 to June 2018. Patients with coronary artery disease scheduled for isolated elective coronary artery bypass graft surgery were included in the study, excluding those with coexisting valvular or congenital heart disease and emergency coronary artery bypass graft surgery.Results:About two-thirds of the study patients were 50–59 years old, with a mean age of 57.7 ± 3.06 years. Approximately 70% patients were male; the male:female ratio was 2.1:1. Most of the patients (74.5%) were Muslim. The majority of patients (59.0%) were overweight, and severe carotid artery stenosis was significantly higher in obese patients (p ⩽ 0.05). Furthermore, hypertension and diabetes mellitus were significantly associated with moderate to severe carotid artery stenosis (p ⩽ 0.05). Multi-vessel coronary artery disease was significantly associated with the severity of carotid artery stenosis. Bilateral carotid artery stenosis was significantly associated with the severity of carotid artery stenosis (p ⩽ 0.05).Conclusion:Routine duplex screening will identify significant carotid artery disease and will subsequently reduce the risk of perioperative stroke in ischaemic heart disease patients undergoing coronary artery bypass graft surgery.

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Section: Discussionsupporting

confidence: 91%

Prevalence of carotid artery stenosis in ischaemic heart disease patients in Bangladesh

et al. 2019

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“…Extracranial carotid artery stenosis (CAS) is a risk factor for perioperative stroke in patients undergoing CABG surgery [34]. In patients with 50% to 80% stenosis of the carotid arteries, the incidence of stroke after CABG ranged from 3% to 10%, and approached 22% in patients with >80% stenosis [35].…”

Section: Extra-cardiac Arteriopathymentioning

confidence: 99%

Traditional predictors of in-hospital mortality after coronary artery bypass grafting: Current status

Kamal¹,

Al-Elwany²,

Ghoneim³

et al. 2017

Cardiothorac Vasc Sci

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The most serious early adverse events after coronary artery bypass grafting (CABG) include in-hospital mortality, low cardiac output, perioperative myocardial infarction, renal dysfunction, stroke, atrial fibrillation and sternal wound infection. Prediction of outcome after CABG has a considerable importance which constitutes guidance for proper perioperative care and improved postoperative outcome. Advances in anesthesia and surgical techniques play a role in enrollment of patients with higher risk for CABG which indicates periodic updating of the traditional predictors of outcome. This review tries to highlight the current status of the important preoperative predictors of early mortality and morbidity after CABG.

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“… 4 In previous studies of CABG patients with 50% to 80% stenosis of the carotid arteries, the incidence of stroke ranged from 3% to 10%, and approached 22% in patients with >80% stenosis. 5 , 6 A recent meta-analysis of American and European studies of CAS found that the risk of perioperative stroke following cardiac surgery ranged from 3.8% to 7.4% in patients with ≥50% stenosis, increasing to 2% to 9.1% in those with ≥70% stenosis. 7 Mortality rates of 3.6% to 15.8% have also been reported in CABG patients with CAS.…”

Section: Introductionmentioning

confidence: 99%

Risk Factors for Carotid Artery Stenosis in Chinese Patients Undergoing Coronary Artery Bypass Graft Interventions

Cheng¹,

Gao²,

Wang³

et al. 2015

Medicine

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Current guidelines established in the USA and Europe for coronary artery bypass graft (CABG) suggest that patients ≥65 and ≥70 years of age, or with certain atherosclerotic-risk factors, should be screened preoperatively for extracranial carotid artery stenosis (CAS) to assess their risk of perioperative stoke. We sought factors that should be taken into consideration when treating Chinese CABG patients using CABG guidelines based on an analysis of CAS in a large cohort of Chinese CABG patients.We analyzed data for 1558 Chinese CABG patients who were screened preoperatively for CAS using duplex ultrasonography at a single institution. We defined significant and severe CAS as ≥50% and ≥70% stenosis, respectively, in one or more common or internal carotid arteries. We investigated the prevalence of CAS, the incidence of perioperative stroke, and the risk factors for CAS in the CABG cohort.The prevalence of CAS in the CABG cohort was 21.2%. Multivariate stepwise logistic regression analysis showed that an age ≥50 years and a history of smoking (odds ratios = 8.36 and 1.83, respectively) were independent risk factors for CAS (P < 0.05 for both). The incidence of perioperative stroke among CABG patients with significant or severe CAS was significantly higher (2.4% and 2.9%, respectively) than in CABG patients with <50% stenosis (0.5%; P = 0.004 and 0.029, respectively).Chinese CABG patients with a history of smoking or ≥50 years of age should undergo preoperative screening for CAS to assess their risk of perioperative stroke.

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Carotid Artery Stenosis Associated with Increased Mortality in Patients who Underwent Coronary Artery Bypass Grafting: A Single Center Experience

Cited by 10 publications

References 29 publications

Prevalence of carotid artery stenosis in ischaemic heart disease patients in Bangladesh

Prevalence of carotid artery stenosis in ischaemic heart disease patients in Bangladesh

Traditional predictors of in-hospital mortality after coronary artery bypass grafting: Current status

Risk Factors for Carotid Artery Stenosis in Chinese Patients Undergoing Coronary Artery Bypass Graft Interventions

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