[Diagnosis and treatment of acute coronary syndromes after carotid endarterectomy].
OBJECTIVE
To summarize the incidence, diagnosis and treatment of acute coronary syndrome (ACS) after carotid endarterectomy (CEA).


METHODS
From 2003 to 2009, 159 CEA were performed in 143 cases with severe atherosclerotic carotid artery stenosis. The clinical datas of ACS after CEA were collected.


RESULTS
The average age was 66.2 +/- 9.0 years old, varying from 40 to 86. There were 5 cases (3.1%) suffered from 30-day perioperative stroke/death totally, of which 4 cases (3.6%) in the symptomatic carotid stenosis group and 1 case (2.1%) in the asymptomatic group. 13 cases (8.2%) were diagnosed as ACS after CEA, 12 of them recovered after medicine, but one case aggravated even after the conservative treatment. Percutaneous coronary angioplasty and stenting was performed then. All cases were cured without death. Diabetes mellitus (RR = 7.727, P = 0.001), smoking (RR = 8.138, P = 0.020) and cardiac infarction history (RR = 8.138, P = 0.020) are significant risk factors for ACS after CEA.


CONCLUSIONS
ACS is an important non-neurological complication after CEA. Diabetes mellitus, smoking and cardiac infarction history are significant risk factors for ACS after CEA. Early diagnosis and appropriate medical intervention for ACS can improve the safety of CEA.
Wu
Wei-Wei
WW
Vascular Surgery Department, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing 100032, China.
Liu
Chang-Wei
CW
Liu
Bao
B
Ye
Wei
W
Chen
Yue-Xin
YX
Chen
Yu
Y
Zeng
Rong
R
Song
Xiao-Jun
XJ
D054058:Acute Coronary Syndrome / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016894:Endarterectomy, Carotid / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D012307:Risk Factors