Antiplatelet treatment prolongs survival after carotid bifurcation endarterectomy. Analysis of the clinical series followed by a controlled trial.
To examine the role of antiplatelet drugs in the secondary prevention of arteriosclerotic arterial disease following carotid endarterectomy, a clinical series (n = 252) was analyzed. Based on these results a prospective randomized trial was initiated, comparing the effect of antiplatelet drugs (acetyl-salicylic acid [ASA] 1000 mg/day) versus untreated controls. In both investigations patient survival was the primary end point. A cardiac risk (n = 91) implied a significant reduction in patient survival (p less than 0.019 Breslow, p less than 0.052 Mantel). Antiaggregating drugs prolonged survival in the collective series (p less than 0.0001 Breslow, p less than 0.0002 Mantel) and in the subgroup of patients with cardiac risk (p less than 0.014 Breslow, p less than 0.020 Mantel) as well. In the prospective trial 66 patients were recruited, receiving ASA (n = 32) versus no therapy (n = 34). During follow-up 15 patients died, 4 in the treatment, and 11 in the control group. Between both groups there was a significant difference in the probability of survival (p less than 0.021 Breslow, p less than 0.048 Mantel).
Kretschmer
G
G
First Clinic of Surgery and Angiology Unit, University of Vienna, Austria.
Pratschner
T
T
Prager
M
M
Wenzl
E
E
Polterauer
P
P
Schemper
M
M
Ehringer
H
H
Minar
E
E
D001241:Aspirin / Q000627:therapeutic use*; D002340:Carotid Artery Diseases / Q000601:surgery*; D003327:Coronary Disease / Q000517:prevention & control*; D004691:Endarterectomy / Q000401:mortality*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D002537:Intracranial Arteriosclerosis / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care; D011446:Prospective Studies; D016032:Randomized Controlled Trials as Topic; D015996:Survival Rate
D001241:Aspirin