Does the type, number or combinations of traditional cardiovascular risk factors affect early outcome after carotid endarterectomy?
OBJECTIVE
The present study was undertaken in order to assess the 30-day complication rate of carotid endarterectomy (CEA) in relation to the patients' cardiovascular risk factors.


METHODS
Cardiovascular risk factors, operative details, morbidity and mortality of 1002 carotid endarterectomies in 852 patients were prospectively recorded in a database. The indications for surgery were asymptomatic >or=75% or symptomatic >or=50% internal carotid stenosis when other causes of stroke were excluded. Exclusion criteria were intervention for post-CEA restenosis, post-irradiation lesions, kinking of the internal carotid artery, external carotid artery stenosis, endovascular and simultaneous cardiac procedures.


RESULTS
The 30-day combined minor and major stroke and death rate was 2.7% (27/1002). Significant risk factors in logistic regression model were diabetes (stroke and death rate=5.7%, p=0.002, OR=3.31), the simultaneous presence of three cardiovascular risk factors (stroke and death rate=5.3%, p=0.012, OR=3.11) and the combination diabetes, hypertension and hyperlipidemia (stroke and death rate=9.4%, p=0.001, OR=4.22).


CONCLUSIONS
Traditional cardiovascular risk factors significantly affect the 30-day stroke and death rate after carotid endarterectomy.
Debing
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Department of Vascular Surgery, Academic Hospital, Free University of Brussels, Brussels, Belgium. erik.debing@az.vub.ac.be
Van den Brande
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D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001530:Belgium / Q000453:epidemiology; D016893:Carotid Stenosis / Q000150:complications / Q000601:surgery*; D048909:Diabetes Complications / Q000150:complications; D016894:Endarterectomy, Carotid; D005260:Female; D006801:Humans; D006949:Hyperlipidemias / Q000150:complications; D006973:Hypertension / Q000150:complications; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000401:mortality; D011446:Prospective Studies; D012307:Risk Factors; D012907:Smoking; D020521:Stroke / Q000209:etiology* / Q000401:mortality; D015996:Survival Rate