Polyvascular Disease Influences Long-Term Cardiovascular Morbidity in Carotid Endarterectomy

Data de publicação: Data Ahead of Print:

Autores da FMUP

  • João Manuel Palmeira Rocha Neves

    Autor

Participantes de fora da FMUP

  • Thierstein, L
  • Pereira-Macedo, J
  • Duarte-Gamas, L
  • Reis, P
  • Myrcha, P
  • Andrade, JP

Unidades de investigação

Abstract

Introduction/Objective: Carotid stenosis (CS) is an important cause of ischemic stroke. Secondary prevention lies in performing a carotid endarterectomy (CEA) procedure, the recommended treatment in most cases. When 2 or more vascular regions are simultaneously affected by atherosclerosis, mainly the carotid arteries, coronary arteries, or limb arteries, a multivessel disease polyvascular disease (PVD) is present. This study aims to assess the potential role of PVD as a long-term predictor of major adverse cardiovascular events (MACE) and all-cause mortality in patients submitted to CEA. Methods: From January 2012 to December 2021, patients submitted to CEA for carotid stenosis in a tertiary care and referral center were eligible from a prospective database. A posthoc survival analysis was performed using the Kaplan-Meier survival curve method. The primary outcome was the incidence of long-term MACE and all-cause mortality. Secondary outcomes included acute myocardial infarction (AMI), major adverse limb events (MALE), stroke, and acute heart failure (AHF). Results: A total of 207 patients were enrolled, with a median follow-up of 63 months. The mean age was 70.4 ? 8.9, and 163 (78.7%) were male. There were 65 (31.4%) patients that had 2 arterial vascular territories affected, and 29 (14.0%) patients had PVD in 3 arterial beds. On multivariable analysis, both MACE and all-cause mortality had as independent risk factors age (aHR 1.039, P = 0.003; aHR 1.041, P = 0.019), chronic kidney disease (aHR 2.524, P = 0.003; aHR 3.377, P < 0.001) and PVD2 (aHR 3.381, P < 0.001; aHR 2.665, P = 0.013). PVD1 was only associated with MACE as a statistically significant risk factor (aHR 2.531, 1.439?4.450, P < 0.001). Conclusions: PVD in patients with cerebrovascular disease (CVD) was revealed to carry a 2-fold increased risk for all-cause mortality and MACE during long-term follow-up. PVD may be a simple yet valuable tool in predicting all-cause mortality, MACE, AMI, and MALE after CEA. ? 2023 The Author(s)

Dados da publicação

ISSN/ISSNe:
1615-5947, 0890-5096

Annals of Vascular Surgery  Elsevier Inc.

Tipo:
Article
Páginas:
236-243
Link para outro recurso:
www.scopus.com

Citações Recebidas na Web of Science: 3

Citações Recebidas na Scopus: 3

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Keywords

  • PERIPHERAL ARTERY-DISEASE; ANKLE-BRACHIAL INDEX; ENDOTHELIAL DYSFUNCTION; EUROPEAN-SOCIETY; RISK-FACTORS; EVENT RATES; OUTPATIENTS; OUTCOMES; EPIDEMIOLOGY; ASSOCIATION

Proyectos asociados

Predictive Factors for Cranioplasty Complications - A Decade Experience (CRANIOPLASTY) - NCT04791904

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Estudo Observacional Académico (CRANIOPLASTY) . 2021

Prognostic Predictors of Cardiovascular and Ophthalmologic Outcomes in Patients With Carotid Artery Stenosis Undergoing Carotid Endarterectomy With Regional Anesthesia - A Prospective Study (STEN) - NCT05625074

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Estudo Observacional Académico (STEN) . 2022

The Portuguese National Health Service Reality in Varicose Vein Surgery - a Transversal Study on the Early Postoperative of Superficial Venous Surgery (VARICOSE) - NCT05625074

Investigador Principal: João Manuel Palmeira Rocha Neves

Estudo Observacional Académico (VARICOSE) . 2022

Implantation of Hydrophobic Tubes for Edema Fluid Drainage in Obstructive Lymphedema of Limbs - a Randomized Clinical Trial (EDEMA) - NCT05970068

Investigador Principal: João Manuel Palmeira Rocha Neves

Ensaio Clínico Académico (EDEMA) . 2023

Polyvascular disease influences long-term cardiovascular morbidity in carotid endarterectomy

Investigador Principal: João Manuel Palmeira Rocha Neves

Estudo Clínico Académico (Polyvascular disease) . 2023

Impacto prognóstico da elevação de troponina em doentes submetidos a endarterectomia carotídea sob anestesia regional - Um estudo prospectivo

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Estudo Clínico Académico (Endarterectomia) . 2020

Management of the carotid artery stenosis in asymptomatic patients

Investigador Principal: João Manuel Palmeira Rocha Neves

Estudo Clínico Académico (Stenosis) . 2020

Myocardial Injury After Aortoiliac Surgery for TASC type D Lesions: a Survival Analysis

Investigador Principal: João Manuel Palmeira Rocha Neves

Estudo Clínico Académico (Myocardial Injury) . 2020

Red cell distribution width (RDW) as a predictor of cardiovascular outcomes in extensive aortoiliac disease

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Estudo Clínico Académico . 2022

IMPACT OF SARCOPENIA IN AORTO-ILIAC OCCLUSIVE DISEASE

Investigador Principal: João Manuel Palmeira Rocha Neves

Estudo Clínico Académico . 2020

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