title: Impact of coronary artery disease presence on the long-term follow-up of carotid artery stenting.
abstract: BACKGROUND
  Carotid artery stenting (CAS) has become an alternative for carotid endarterectomy in the treatment of carotid artery atherosclerosis, due to limited injury and comparable periprocedural risk. The impact of coronary artery disease (CAD) on long-term follow-up after CAS needs to be reconsidered due to the intensification of aggressive pharmacotherapy in CAD in recent years.
  
  
  OBJECTIVE
  To assess the impact of CAD presence on the long-term follow-up of patients after CAS.
  
  
  METHODS
  Data of 130 symptomatic and asymptomatic patients undergoing CAS with cerebral protection systems from December 2002 to December 2010 were divided into two groups: those with and those without CAD. Major adverse cardio- and cerebrovascular events (MACCE) during follow-up were defined as the combination of death (cardiac and non-cardiac), myocardial infarction (MI) and stroke or transient ischaemic attack (TIA). Long-term outcomes of patients were stratified based on the history of CAD.
  
  
  RESULTS
  The mean age of patients was 66 ± 9 years, and the majority of patients were male (80.2%). Long-term follow-up data were available in 86.2% of patients. During mean follow-up of 71.9 ± 31.7 months the all-cause mortality rate was 19.3%. The rates of MI, stroke/TIA, and MACCE were 16.7%, 12.3%, and 36.3%, respectively. The frequency of MACCE during long-term follow-up was higher in patients with CAD vs. without CAD (40.8% vs. 6.7%, p = 0.01), and the mortality rate in the two groups was 22.2% vs. 0%, (p = 0.07), respectively.
  
  
  CONCLUSIONS
  Patients with symptomatic or asymptomatic carotid stenosis are high-risk individuals. The presence of CAD increases the risk of MACCE in such patients during long-term follow-up.
authors.forename: Salech
authors.initials: S
authors.lastname: Arif
authors.affiliation: 2nd Department of Interventional Cardiology, University Hospital, Krakow, Poland. mbbartus@cyf-kr.edu.pl.
authors.forename: Stanisław
authors.initials: S
authors.lastname: Bartuś
authors.forename: Artur
authors.initials: A
authors.lastname: Dziewierz
authors.forename: Michał
authors.initials: M
authors.lastname: Chyrchel
authors.forename: Michał
authors.initials: M
authors.lastname: Brzeziński
authors.forename: Tomasz
authors.initials: T
authors.lastname: Rakowski
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Bartuś
authors.forename: Dariusz
authors.initials: D
authors.lastname: Dudek
authors.forename: Jacek
authors.initials: J
authors.lastname: Dubiel
mesh_terms: D000368:Aged; D050197:Atherosclerosis / Q000601:surgery; D002339:Carotid Arteries / Q000601:surgery*; D016893:Carotid Stenosis / Q000601:surgery*; D003324:Coronary Artery Disease / Q000150:complications*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D015607:Stents; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures