Prevalence and Risk Factors Analysis of Carotid Stenosis Among Ischaemic Heart Diseases Patient in Bangladesh: A Cross-Sectional Study

Abstract

Purpose This study aimed to evaluate the prevalence of carotid stenosis among ischaemic heart disease (IHD) patients undergoing coronary artery bypass graft (CABG) surgery and identify risk factors associated with carotid stenosis at a tertiary-level hospital in Bangladesh. Patients and Methods This cross-sectional study examined 200 IHD patients scheduled for isolated and elective CABG surgery, and multivariate regression analysis was used to determine the impact of independent variables on carotid stenosis with coronary artery disease. A vascular surgeon and sonographer assessed carotid stenosis, and the severity of stenosis was classified according to the current Grayscale and Doppler US diagnosis models. Results We observed that the prevalence of carotid artery stenosis was 13.5%, and the male was significantly higher (85.2%) in the carotid stenosis group. A multivariate regression analysis observed that age (OR 1.79), dyslipidaemia (OR 2.19), uncontrolled hypertension (OR 2.38), uncontrolled DM (OR 2.51), multivessel coronary artery disease (OR 3.79), and multiple comorbidities (OR 4.46) are potential predictors of having significant carotid stenosis in a patient undergoing CABG surgery. Conclusion In Bangladesh, multivessel coronary artery disease, especially in elderly patients with multiple comorbidities, are 4 (four) times higher risk to have significant carotid artery stenosis. Preoperative carotid duplex screening should be performed to curtail the risk of postoperative adverse cerebrovascular events, particularly those who have carotid stenosis associated potential risk factors.

Comparison of traditional and upper thoracic epidural analgesia after off‐pump coronary artery bypass graft surgery: A Quasi‐experimental study

“…Following cardiac surgery, pain disrupts the humoral and neuroendocrine systems' equilibrium, increasing stress hormone levels and myocardial oxygen demand. 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 As a result, arrhythmias and myocardial ischemia are increased. Pain also impairs mechanical ventilation and mobility restriction.…”

“…Oxygen supply‐demand mismatch can lead to myocardial ischemia, detrimental to patient outcomes. 7 , 8 Optimal postoperative pain management with a regular and routine assessment of pain will improve postoperative outcomes. The patient's assessment of pain using a visual analog scale (VAS) is the most reliable and should be used when possible.…”

“…International Association for the Study of Pain (IASP) defined pain as “An unpleasant sensory and emotional experience associated with or resembling that associated with, actual, or potential tissue damage.” 6 Postoperative pain stimulates the sympathetic nervous system and increases myocardial oxygen consumption. Oxygen supply‐demand mismatch can lead to myocardial ischemia, detrimental to patient outcomes 7,8 . Optimal postoperative pain management with a regular and routine assessment of pain will improve postoperative outcomes.…”

Prevalence and Risk Factors of Carotid Artery Stenosis (CAS) Among Cardiac Surgery Patients

“…Moreover, there is evidence to suggest that significant CAS is common among patients undergoing cardiac surgery with a high risk of critical neurological events [8][9]. Approximately 30% of annual global mortality is attributable to cardiovascular disease, while an additional 10% is attributable to cerebrovascular events [10][11].…”

“…Therefore, significant CAS is a critical cause of strokes among patients with heart disease, who have undergone cardiac revascularization surgery [13][14]. In Western countries, the prevalence of CAS among heart surgery patients in recent decades has risen from 12.8% to 22% [10][11]. It is believed that the extent of coronary artery illness is directly related to the severity of CAS.…”