title: Contemporary incidence and risk factors for carotid artery disease in patients referred for coronary artery bypass surgery.
abstract: BACKGROUND
  In the past decade, there has been an increase in the amount of patients with medical co-morbidities referred for coronary artery bypass surgery (CABG). Significant carotid artery disease in patients undergoing CABG procedures increases the risk of neurological complications. We review the results of routine carotid screening in patients undergoing CABG to determine the contemporary incidence and risk factors for carotid artery disease.
  
  
  METHODS
  Between 2008 through 2010, 673 patients were referred for isolated coronary artery bypass surgery at a single institution. Patients were identified through a systematic review of The Department of Cardiothoracic Surgery Society of Thoracic Surgery Outcomes Database. A retrospective analysis of prospectively collected demographic, clinical data and outcomes were performed. All patients with screening preoperative carotid duplex were reviewed. We defined the degree of carotid disease as: none to mild stenosis (<50%), moderate stenosis (50-69%), severe stenosis (70-99%). Multivariate analysis was performed to identify risk factors.
  
  
  RESULTS
  559 (83%) patients underwent screening preoperative carotid ultrasonography prior to CABG. The incidence of carotid artery disease (>50% stenosis) was 36% with 18% unilateral moderate disease, 10% bilateral moderate and 8% severe disease. Risk factors associated with carotid artery disease included: advanced age, renal failure, previous stroke, peripheral vascular disease, left main coronary artery disease, and previous myocardial infarction.
  
  
  CONCLUSIONS
  There is a significant incidence of carotid artery stenosis in patients referred for CABG. Routine screening will identify patients with carotid artery disease and may reduce the risk of postoperative stroke.
authors.affiliation: Department of Cardiovascular and Thoracic Surgery, Allegheny General Hospital, Pittsburgh, PA, USA.
authors.forename: Kelly M
authors.initials: KM
authors.lastname: Wanamaker
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Moraca
authors.forename: Diane
authors.initials: D
authors.lastname: Nitzberg
authors.forename: George J
authors.initials: GJ
authors.lastname: Magovern
mesh_terms: D000368:Aged; D016893:Carotid Stenosis / Q000453:epidemiology*; D001026:Coronary Artery Bypass / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012189:Retrospective Studies; D012307:Risk Factors