Key result
Combined or staged CABG plus CEA linked to ~250% higher early mortality versus isolated CABG.
Why the study?
Does combined or staged CABG and CEA affect mortality and morbidity compared to CABG alone in advanced age patients?
Cohort (n=120)
No
Does combined or staged CABG and CEA affect mortality and morbidity compared to CABG alone in advanced age patients?
In advanced age patients, combined or staged CABG and CEA is associated with higher mortality compared to CABG alone, likely reflecting the increased baseline risk of concomitant severe carotid and coronary disease.
Answers are grounded in this paper and cite their sources.
May inform risk stratification for combined procedures in severe dual disease; leaves open whether randomized trials would alter management in advanced age patients.
AIM: In present study, we aimed to compare the staged and combined surgery in patients with severe carotid stenosis and coronary atherosclerosis and detect the factors affecting mortality and morbidity. MATERIAL AND METHOD: Between 2004 and 2008, 120 patients with predominant ischemic heart disease were enrolled to study. Patients were divided into three groups on basis surgery procedure. Group 1 (n=40) includeed patients had coronary artery disease without carotid disease underwent coronary artery by-pass graft (CABG) operation. Group 2 (n=40): included patients underwent combined surgery procedure including CABG and carotid endarterectomy (CEA). Patients underwent staged CABG and CEA were enrolled to Group 3 (n=40). All patients were in advanced aged and were had the same risk factors atributable atherosclerosis RESULTS: Mean age of the patients in all groups were 68±6, 69±3, 71±2 respectively, and 83% were male. Eight patients died in all groups at follow-up(seven in group 2 and 3, and one in group 1) and the difference between both groups was statistically significant (p<0.001). The follow-up period in the intensive care unit, and hospitalization period were not statistically different between CABG group and combined CEA plus CABG group. CONCLUSION: We think that the results of staged or combined CABG plus CEA surgery are satisfactory in patients with severe carotid disease and advanced coronary artery disease. However, the mortality and morbidity in both procedures are higher than those of alone.
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İyem et al. (2009) conducted a cohort in Severe carotid stenosis and coronary atherosclerosis (n=120). Combined or staged CABG and CEA vs. Isolated CABG was evaluated on Early mortality (p=<0.001). Combined and staged CABG plus CEA procedures in patients with severe carotid and coronary artery disease were associated with higher early mortality compared to isolated CABG.
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