Key result
Angina class II-III is linked to ~284% greater mid-term adverse event risk after carotid endarterectomy.
Why the study?
Identification of unfavorable prognosis factors associated with carotid endarterectomy during mid-term follow-up was emphasized due to limited data on predictors of adverse events.
Cohort (n=222)
No
Odds Ratio: 3.84 (95% CI 1.24–11.9)
Angina pectoris functional class II-III and a SYNTAX Score >22 are significant predictors of mid-term adverse events following carotid endarterectomy.
Aim. Emphasis in the study was placed on the identification of unfavorable prognosis factors associated with carotid endarterectomy (CEE) during mid-term follow-up.Methods. Over a period from 2015 to 2016, 222 CEE operations were performed. Most patients (n = 190; 85.5%) underwent CEE using a patch of xenopericardium, 14.4% (n = 32) received eversion CEE, and a temporary shunt was used in 14.4% (n = 32). Hybrid revascularization in the volume of percutaneous coronary intervention (PCI) + CEE was performed in 9.9% (n = 22) patients. The groups under study were compared by using a chi-square test followed by subsequent analysis of the shares, or if ordinal characters or quantitative traits with a distribution different from the normal one occurred—by using a Mann – Whitney U-test. Correction of multiple comparisons was done by calculating an average fraction of false discoveries of the hypotheses (false discovery rate). The analysis of prognostic factors was done using the odds ratio (OR) by means of the 2 × 2 tables.Results. Among the complications detected in the mid-term follow-up, the most common adverse event was the development of MI in 3.6% (n = 8) of patients. According to color duplex scanning of brachiocephalic arteries, restenosis of the operated ICA was observed in 4.5% of patients. The following risk factors significantly increased the risk of adverse events: angina pectoris II–III functional class (OR = 3.84%, CI = 1.24–11.9), SYNTAX Score >22 (OR = 2.83, CI = 1.137–7.086).Conclusion. Based on the results of a single-center prospective retrospective study, significant risk factors for adverse outcome in the mid-term postoperative period were identified.Received 10 May 2017. Revised 27 September 2017. Accepted 5 October 2017.Funding: The research was done with support of the grant (No. 12090ГУ/2017) awarded by the Fund for Facilitation of Innovations within the framework of the “Umnik-2016” project (Kemerovo).Conflict of interest: The authors declare no conflict of interest.Author contributionsConception and study design: R.S. Tarasov, A.I. Anufriyev Data collection and analysis: A.R. ShabaevDrafting the article: A.N. Kazantsev, N.N. Burkov Critical revision of the article: A.V. MironovFinal approval of the version to be published: L.S. Barbarash
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Тарасов et al. (2017) conducted a cohort in Carotid endarterectomy (n=222). Angina pectoris II-III functional class and SYNTAX Score >22 was evaluated on adverse events (OR 3.84, 95% CI 1.24-11.9). Angina pectoris II-III functional class (OR 3.84; 95% CI 1.24-11.9) and SYNTAX Score >22 (OR 2.83; 95% CI 1.137-7.086) significantly increased the risk of mid-term adverse events after carotid endarterectomy.
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