[Lowering the risk of cardiologic complications in carotid endarterectomy].
The aim of the study was to decrease the risk of ischemia and myocardial infarction (MI) in intraoperative and early postoperative period after carotid endarterectomy (CEA).


METHODS
295 patients underwent CEA from 2001 till May 2005 in the Clinics of faculty surgery, Samarsky state medical university. Besides clinical investigation, patients underwent Doppler ultrasonography of brachiocephalic arteries, transcranial Doppler, brain CT (if appropriate), echocardiography, repeated ECG and intraoperative ECG monitoring.


RESULTS
Patients were divided into 3 groups. The first group (n=78, 26.4%) did not receive any special preoperative cardiological care. Among them MI developed in 8 patients (10.2%) on the first postoperative day. The second group (n=131, 44.4%) received nitrates, desaggregants, calcium antagonists, ACE and metabolic drugs preoperatively. In this group there were 6 cases (4.6%) of MI in early postoperative period. The third group (n=86, 29.2%) received cardioselective lipophilic beta-blockers (Atenolol, Metoprolol), in addition to drugs that were given for the second group. No cases of MI in early postoperative period were registered in the third group. Differences were statistically significant (p<0.05).


CONCLUSIONS
Inclusion of beta-blockers into preoperative medical care before CEA procedure significantly decreases the risk of myocardial ischemia and infarction in early postoperative period (24 hours).
Vachev
A N
AN
Shchukin
Iu V
IuV
Surkova
E A
EA
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D016893:Carotid Stenosis / Q000601:surgery*; D004452:Echocardiography; D016894:Endarterectomy, Carotid / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000379:methods; D017202:Myocardial Ischemia / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D011183:Postoperative Complications; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D014057:Tomography, X-Ray Computed; D018608:Ultrasonography, Doppler
D000319:Adrenergic beta-Antagonists