Preoperative medical therapy prescription rates for carotid endarterectomy increased significantly over 13 years for statins (+60.8%) and ASA (+29.2%), but remained suboptimal in symptomatic patients.
Observational (n=852)
How has chronic medical therapy evolved over a 13-year period in patients undergoing carotid endarterectomy, and how does it differ between symptomatic and asymptomatic patients?
Medical therapy for patients with carotid stenosis has improved over time, but preoperative drug therapy remains suboptimal in symptomatic patients compared to asymptomatic patients.
p-value: p=< .05
We evaluated the evolution of chronic medical therapy in patients admitted for carotid endarterectomy (CEA) over a 13-year period and to analyze the difference in medical treatment between symptomatic and asymptomatic patients. A retrospective study was conducted on patients treated between 2002 and 2015. The use of antiplatelets (acetylsalicylic acid ASA, ticlopidine, and clopidogrel), oral anticoagulant therapy (OAT), statins and antihypertensives (angiotensin-converting enzyme inhibitors ACE-I/angiotensin receptor blockers ARBs, β-blockers BB) administration was evaluated. During the study period, 852 CEAs were performed in 681 (79.9%) asymptomatic patients. Prescription rate increased significantly for ASA (+29.2%), clopidogrel (+10.3%), statins (+60.8%), ACE-I/ARBs (+31.1%), and BB (+19.3%; all P trend < .05). No significant modification was observed for ticlopidine and OAT (ticlopidine use was abandoned in the recent years, but this difference was not significant due to the small numbers). A lower medication intake was recorded for symptomatic patients when compared with asymptomatic patients, except for OAT and clopidogrel. Our analysis suggests that medical therapy has changed over the years for patients with carotid stenosis. Although this is a big step toward best medical therapy, preoperative drug therapy remains suboptimal in symptomatic patients.
Bissacco et al. (Thu,) conducted a observational in Carotid stenosis (n=852). Chronic medical therapy vs. Symptomatic vs asymptomatic patients was evaluated on Prescription rates of chronic medical therapy (p=< .05). Preoperative medical therapy prescription rates for carotid endarterectomy increased significantly over 13 years for statins (+60.8%) and ASA (+29.2%), but remained suboptimal in symptomatic patients.