The impact of the carotid plaque type on restenosis and future cardiovascular events: a 12-year prospective study.
OBJECTIVE
to evaluate the impact of the carotid plaque type on recurrent carotid stenosis, future cardiovascular events and patients' survival.


METHODS
open prospective study.


METHODS
three hundred and eight patients who underwent a total of 338 carotid endarterectomies were included in the study. All of the patients were evaluated postoperatively with clinical examination and colour duplex 1 month after the operation and every 6 months thereafter. Mean duration of follow-up was 63 months (range: 12-144). Eight patients (3%) were lost to follow-up. Restenoses, cardiovascular events and deaths were recorded and analysed with regard to the traditional risk factors and the ultrasonographic characteristics of the plaques. Statistical analysis was performed using the Kaplan-Meier method, the log rank test and Cox regression analysis.


RESULTS
cumulative restenosis rate at 10 years of follow-up was 21% and was associated with coronary artery disease (p=0.01) and echolucent plaques (p=0.02). Life-table analysis showed a 10-year survival rate of 64% and a 10-year rate of cardiovascular events of 41%. Hypertension (p=0.003), coronary artery disease (p=0.002) and echolucent plaques (p=0.01) were associated with a higher incidence of cardiovascular events.
Liapis
C D
CD
2nd Department of Propedeutic Surgery, Athens University Medical School, Laiko Hospital, Athens, Greece.
Kakisis
J D
JD
Dimitroulis
D A
DA
Kostakis
A G
AG
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000000981:diagnostic imaging / Q000209:etiology* / Q000401:mortality; D016893:Carotid Stenosis / Q000150:complications* / Q000000981:diagnostic imaging* / Q000401:mortality; D023903:Coronary Restenosis / Q000000981:diagnostic imaging / Q000209:etiology* / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012008:Recurrence; D012307:Risk Factors; D015996:Survival Rate; D013997:Time Factors; D018615:Ultrasonography, Doppler, Color