The Impact of Biochemical Markers on Major Adverse Cardiovascular Events and Contralateral Carotid Artery Stenosis Progression Following Carotid Interventions

Stone, Patrick A.; Thompson, Stephanie; Khan, Mija; Northfield, Elizabeth; Schillinger, Rachel M.; Skaff, Paulina

doi:10.1016/j.avsg.2016.08.004

Cited by 13 publications

(6 citation statements)

References 13 publications

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“…28 Additionally, CRP and B-type natriuretic peptide have been demonstrated to have a prognostic value in CAS patients undergoing carotid surgery. 29 Both the studies in the literature and our study indicated that malnutrition is associated with mortality. Accordingly, the CONUT score, which is an objective and easily applicable scoring system, can be a useful nutritional indicator in predicting adverse events in CAS patients and, as a novel indicator, can contribute to the prediction of adverse events such as long-term mortality and stroke in the CAS patients, in addition to traditional parameters.…”

Section: F I G U R E 3 Roc Curve Indicating the Ability Of Prognostic Nutritional Index (Pni)supporting

confidence: 64%

Impact of nutritional assessment on long‐term outcomes in patients with carotid artery stenting

Demir

Özbek

2021

Int J Clin Pract

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Stroke is a leading cause of disability and death worldwide.Atherosclerotic narrowing of the extracranial carotid arteries is responsible for approximately one-fifth of all strokes. 1 There are two main interventional treatment methods in symptomatic or asymptomatic high-grade carotid artery stenosis: carotid artery stenting (CAS) and carotid endarterectomy. 2,3 Although there is sufficient evidence on the long-term outcomes of patients after CAS, potential risk factors affecting the long-term course of the disease have not yet been studied sufficiently. 4,5 Comorbid diseases accompanying severe CAS affect the long-term outcomes of the disease. Although risk factors showing long-term consequences such as diffuse proliferative hyperplasia after CAS, low highdensity lipoprotein cholesterol level, diabetes mellitus (DM), low body mass index (BMI), and contralateral carotid artery occlusion have so far been identified, a detailed risk assessment has not yet been performed. [6][7][8][9][10] Malnutrition is associated with adverse outcomes in many diseases. 11,12 The Controlling Nutritional Status (CONUT) score is an objective index widely used for evaluating nutritional status of individuals. The CONUT score is calculated based on serum albumin level, total cholesterol level, and total lymphocyte count and it can assess

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Section: F I G U R E 3 Roc Curve Indicating the Ability Of Prognostic Nutritional Index (Pni)supporting

confidence: 64%

Impact of nutritional assessment on long‐term outcomes in patients with carotid artery stenting

Demir

Özbek

2021

Int J Clin Pract

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“…In patients with hip fractures, Oscarsson et al (2009a) found that the elevation of preoperative NT-proBNP was strongly connected with cardiac complications in perioperative period. Stone et al (2017) had also proven the significant role of BNP in predicting MACE in patients undergoing carotid intervention, however, due to the incomplete data, we haven't included this paper. In consistent with the conclusions of previous studies, our meta-analysis unveils that both BNP and NT-proBNP are valuable predictors for MACE in postoperative period.…”

Section: Discussionmentioning

confidence: 99%

Cardiac Biomarkers Predicting MACE in Patients Undergoing Noncardiac Surgery: A Meta-Analysis

Zhang

et al. 2019

Front. Physiol.

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Objective: The present meta-analysis was aimed to systematically evaluate the effectiveness and accuracy of brain natriuretic peptide (BNP), cardiac troponin (cTn), high sensitive C reactive protein (hs-CRP) and CRP for predicting postoperative major adverse cardiovascular events (MACE) in patients undergoing noncardiac surgery.Methods: A total of 26 relevant studies with 7,877 participants were collected from five databases, namely PubMed, Embase, China National Knowledge Infrastructure (CNKI), CQVIP and the Wanfang Database until August 10, 2018. And the Review Manager Version 5.3 and Stata/SE 12 software were used for data syntheses in the meta-analysis.Results: Strong relationships of BNP/NT-proBNP, cTnI/cTnT and hs-CRP with MACE were detected in patients undergoing noncardiac surgery, and the five biomarkers all increased the risk of MACE. Compared to normal levels, elevated BNP/NT-proBNP could increase the MACE risk by almost 4-fold [RR:3.92, 95%CI: 3.23–4.75, P < 0.001]; elevated BNP corresponded to a 4.5-fold risk [RR:4.57, 95%CI: 3.37–6.20, P < 0.001]; elevated NT-proBNP led to a 3-fold higher risk [RR:3.48, 95%CI: 2.71–4.46, P < 0.001]. Comparing with normal levels of cTnI/cTnT, increased cTnI/cTnT was associated with nearly 5-fold more higher risk of MACE [RR:5.52, 95%CI: 4.62–6.58, P < 0.001]; elevated cTnI faced a 5-fold risk [RR:5.21, 95%CI: 3.96–6.86, P < 0.001]; elevated cTnT resulted in nearly 6-fold higher risk [RR:5.73, 95%CI: 4.55–7.22, P < 0.001]. The elevation of hs-CRP was associated with nearly 4-fold higher risk of MACE in comparison with normal concentration [RR:3.73, 95%CI: 2.63–5.30, P < 0.001].Conclusion: According to the results of our meta-analysis, the elevations of BNP/NT-proBNP, cTnI/cTnT, and hs-CRP, pre-operation or post-operation immediately, can predict much higher risk of postoperative MACE in patients undergoing noncardiac surgery.

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“…This study shows that SII may be superior to CRP in predicting long-term MACCE in patients who underwent CAS. Although CRP has previously been reported as a predictor of outcomes within 1 month after CAS [ 29 ], another previous study did not address the predictive ability of long-term prognosis of other inflammatory markers, such as CRP, compared with SII in patients who underwent CAS [ 30 ]. CRP is the most widely used inflammatory marker, and elevated CRP has also been linked to all-cause and cardiovascular mortality in the general population [ 31 ].…”

Section: Discussionmentioning

confidence: 99%

Systemic immune-inflammation index as a predictor of prognosis after carotid artery stenting compared with C-reactive protein

Morikawa

Okumura²,

Inoue

et al. 2023

PLoS ONE

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Background Immune-inflammatory processes are highly associated with the progression of atherosclerosis. The systemic immune-inflammation index (SII) is a potential predictor for clinical outcomes in patients with stroke and ischemic heart disease. Therefore, this study aimed to investigate whether SII can accurately predict the short- and long-term prognoses in patients who underwent carotid artery stenting (CAS) compared to that with C-reactive protein (CRP). Methods This study was a single-center retrospective investigation. Overall, 129 patients who underwent CAS were categorized into tertiles based on their SII levels. We primarily investigated the long-term major adverse cardiac and cerebrovascular events (MACCE) and secondarily the in-hospital and long-term stroke incidence, as well as all-cause death. Results The in-hospital stroke rate tended to increase with a rise in SII (P = 0.13). Over the 5-year follow-up period, the Kaplan–Meier overall incidence of MACCE was 9.3%, 16.3%, and 39.5% in the lowest to highest tertiles, respectively (log-rank trend test, P<0.001). The rates of stroke and MACCE during the long-term follow-up were significantly higher with increasing SII. Cox regression analysis showed that the highest tertile of SII (>647) was a predictor of the incidence of long-term stroke (hazard ratio (HR), 21.3; 95% confidence interval (CI), 2.41–188; P = 0.006) and MACCE (HR, 3.98; 95% CI, 1.80–8.81; P<0.001). However, after adjusting for both SII and CRP, only SII remained a significant independent predictor, whereas CRP became less relevant. The receiver operating characteristic curve analysis of long-term MACCE showed that the area under the curve (AUC) for SII (AUC, 0.72; 95% CI, 0.60–0.84; P<0.001) was greater than that of CRP (AUC, 0.64; 95% CI, 0.51–0.77; P = 0.040). Conclusion SII was shown to be an independent predictor of long-term prognosis in patients who underwent CAS and was suggested to be superior to CRP as an inflammatory prognosis predictor.

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The Impact of Biochemical Markers on Major Adverse Cardiovascular Events and Contralateral Carotid Artery Stenosis Progression Following Carotid Interventions

Cited by 13 publications

References 13 publications

Impact of nutritional assessment on long‐term outcomes in patients with carotid artery stenting

Impact of nutritional assessment on long‐term outcomes in patients with carotid artery stenting

Cardiac Biomarkers Predicting MACE in Patients Undergoing Noncardiac Surgery: A Meta-Analysis

Systemic immune-inflammation index as a predictor of prognosis after carotid artery stenting compared with C-reactive protein

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