title: Combined carotid endarterectomy and coronary artery bypass grafting versus coronary artery bypass grafting alone: a retrospective review of outcomes at our institution.
abstract: BACKGROUND
  It remains controversial whether patients with concomitant carotid and coronary disease should undergo operative repair separately or in combination.
  
  
  METHODS
  Patients with documented cerebrovascular disease undergoing coronary artery bypass grafting (CABG) alone were matched by propensity scoring with patients undergoing combined carotid endarterectomy (CEA)/CABG procedures and compared for the occurrence of stroke, myocardial infarction (MI), and mortality.
  
  
  RESULTS
  Of the 4943 patients undergoing CABG, 908 had known cerebrovascular disease. Among these, 134 underwent concomitant CEA, and these were propensity matched with 134 patients undergoing CABG only. No differences were observed in the perioperative risks of stroke (4% vs 3%, odds ratio [OR] 1.5, 95% confidence interval [CI] 0.4-5.5), MI (0.7% vs 0.7%, not significant [NS]), or combined cardiovascular events (6% vs 10%, OR 0.5, 95% CI [0.2-1.3]), although mortality (1% vs 8%, OR 0.2, 95% CI [0.04-0.8] was higher with CABG only.
  
  
  CONCLUSIONS
  Addition of CEA to CABG did not significantly alter the risk of perioperative stroke relative to propensity-matched patients undergoing CABG alone.
authors.affiliation: Division of Vascular Surgery, Department of Surgery, Medical University of South Carolina, Charleston, SC, USA.
authors.forename: Amanda M
authors.initials: AM
authors.lastname: Dick
authors.forename: Thomas
authors.initials: T
authors.lastname: Brothers
authors.forename: Jacob G
authors.initials: JG
authors.lastname: Robison
authors.forename: Bruce M
authors.initials: BM
authors.lastname: Elliott
authors.forename: John M
authors.initials: JM
authors.lastname: Kratz
authors.forename: J Matthew
authors.initials: JM
authors.lastname: Toole
authors.forename: Arthur J
authors.initials: AJ
authors.lastname: Crumbley
authors.forename: Fred A
authors.initials: FA
authors.lastname: Crawford
mesh_terms: D000368:Aged; D016893:Carotid Stenosis / Q000150:complications / Q000401:mortality / Q000601:surgery*; D001026:Coronary Artery Bypass / Q000009:adverse effects / Q000401:mortality; D003324:Coronary Artery Disease / Q000150:complications / Q000401:mortality / Q000601:surgery*; D016894:Endarterectomy, Carotid / Q000009:adverse effects / Q000401:mortality; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology; D016017:Odds Ratio; D057216:Propensity Score; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D013022:South Carolina; D020521:Stroke / Q000209:etiology; D013997:Time Factors; D016896:Treatment Outcome