title: Risk factors for perioperative myocardial ischemia in carotid artery endarterectomy.
abstract: OBJECTIVE
  To identify variables associated with perioperative myocardial ischemia in patients undergoing carotid artery endarterectomy (CEA).
  
  
  METHODS
  Prospective, observational study.
  
  
  METHODS
  University-affiliated hospital operating room and intensive care unit.
  
  
  METHODS
  One hundred twenty-eight consecutive patients who underwent CEA during a 7-year period.
  
  
  METHODS
  Patients had general anesthesia with sevoflurane or isoflurane. CEA was performed by standard methods with shunting if clinically indicated. Holter electrocardiogram (ECG) monitoring was performed during surgery and 24 hours after surgery.
  
  
  RESULTS
  The incidence of perioperative myocardial ischemia was examined, and perioperative risk factors were analyzed. Nineteen patients (15%) showed significant perioperative ECG abnormalities indicative of myocardial ischemia (10 patients during surgery, 12 patients after surgery, and 3 patients both during and after surgery). Multivariate analysis showed perioperative myocardial ischemia to be significantly associated with a history of angina (odds ratio, 11.68; 95% confidence interval, 2.64-51.70) and a history of hypertension (odds ratio, 14.08; 95% confidence interval, 1.51-131.04).
  
  
  CONCLUSIONS
  The data indicate that perioperative myocardial ischemia defined as an ECG abnormality does not often occur in patients undergoing CEA. However, angina and hypertension may be important risk factors warranting further investigation.
authors.affiliation: Department of Anesthesiology, Tojushima University School of Medicine, Kuramoto, Tokushima, Japan. kawahito@clin.med.tokushima-u.ac.jp
authors.forename: Shinji
authors.initials: S
authors.lastname: Kawahito
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kitahata
authors.forename: Katsuya
authors.initials: K
authors.lastname: Tanaka
authors.forename: Junpei
authors.initials: J
authors.lastname: Nozaki
authors.forename: Shuzo
authors.initials: S
authors.lastname: Oshita
mesh_terms: D000328:Adult; D000368:Aged; D000768:Anesthesia, General; D004562:Electrocardiography; D016894:Endarterectomy, Carotid / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D015999:Multivariate Analysis; D017202:Myocardial Ischemia / Q000175:diagnosis / Q000209:etiology*; D012307:Risk Factors