Hypertension (OR 8.73), history of stroke/TIA (OR 4.05), and CAD (OR 3.38) were significant independent predictors of persistent hemodynamic depression after carotid artery stenting.
Cohort (n=162)
No
What are the clinical predictors and outcomes of persistent hemodynamic depression after carotid artery stenting in patients with carotid arteriosclerotic stenosis?
Hypertension, prior stroke/TIA, CAD, and lesion location predict persistent hemodynamic depression after carotid artery stenting, which is associated with increased stroke risk and longer ICU stays.
Odds Ratio: 8.73 (95% CI 1.05–72.9)
p-value: p=0.045
Hemodynamic depression (HD) is a complication after carotid artery stenting (CAS). However, there are existing controversies in predicting postoperative risk factors and subsequent clinical outcomes, especially in high-risk patients. Therefore, the present study aimed to investigate the rate of incidence, clinical predictors, and clinical significance associated with persistent HD (p-HD) pathology, as well as obstinate persistent HD (op-HD) after CAS in our center. We retrospectively analyzed 162 consecutively recruited carotid arteriosclerotic stenosis (CASS) patients who received interventional therapy in our hospital between September 2020 and September 2022. The acute/subacute effects of proximal internal CAS on p-HD and op-HD were studied to explore the relationship between CAS and perioperative adverse events. Logistic regression analysis was performed to identify independent predictors of p-HD after CAS. Pathological associations between p-HD/op-HD and clinical events at the 30-day time point were analyzed. Of 162 patients, 18.5 % (n = 30) patients had p-HD, while op-HD was observed in 5.6 % (n = 9) of patients. Hypertension (OR: 8.73; 95 % CI: 1.05-72.90; P = 0.045), history of stroke/transient ischemic attack (TIA) (OR: 4.05; 95 % CI: 1.55-10.59; P = 0.004), coronary artery disease (CAD) (OR: 3.38; 95 % CI: 1.29-8.89; P = 0.013), and distance from the carotid bifurcation to the lesion with maximum stenosis (OR: 2.467; 95 % CI: 1.02-5.93; P = 0.044) were significantly associated with p-HD onset. Patients with either p-HD or op-HD suffered from longer intensive care unit (ICU) stays (all P < 0.001) and were associated with a higher risk of stroke (P = 0.003; P < 0.001). Our data suggest that hypertension, previous stroke/TIA, CAD, and distance from the carotid bifurcation to the lesion with maximum stenosis may play roles in the development of p-HD after CAS. Moreover, this study indicates that either p-HD/op-HD can be associated with the risk of clinical adverse events, especially stroke.
Wei et al. (Thu,) conducted a cohort in Carotid arteriosclerotic stenosis (CASS) (n=162). Hypertension vs. Absence of hypertension was evaluated on Persistent hemodynamic depression (p-HD) onset (OR 8.73, 95% CI 1.05-72.90, p=0.045). Hypertension (OR 8.73), history of stroke/TIA (OR 4.05), and CAD (OR 3.38) were significant independent predictors of persistent hemodynamic depression after carotid artery stenting.
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