title: The prognostic role of carotid plaque ultrasonography in cardiac damage after carotid endarterectomy: carotid plaque and cardiac risk.
abstract: BACKGROUND
  This study evaluates the correlation of ultrasound determined carotid plaque morphology with coronary risk and cardiac damage after carotid endarterectomy.
  
  
  METHODS
  Fifty patients (in a series of 162) scheduled for carotid endarterectomy had the indication for coronary CT-angiography preoperatively and were included in this study. Patients were classified according to ultrasonographic characteristics of carotid plaque. The Duke Criteria were used to assess the degree of coronary risk (low, medium and high risk). Cardiac damage after carotid endarterectomy was evaluated based on symptoms, cardiac Troponin I measurement and electrocardiographic findings.
  
  
  RESULTS
  There were no deaths, strokes or symptomatic myocardial infarctions postoperatively (30-day results). Ten patients (20%) showed asymptomatic cardiac damage postoperatively. Cardiac damage after surgery did not show any difference between the three cardiac risk groups. Echogenic and specifically Type IV carotid artery plaques (Gray-Weale Criteria) were associated with high cardiac risk preoperatively and with postoperative cardiac damage. The degree of carotid artery stenosis, and echolucent carotid plaques were not associated with postoperative cardiac damage.
  
  
  CONCLUSIONS
  Asymptomatic postoperative cardiac damage occurs often after carotid endarterectomy and presents independently from coronary risk. Carotid plaques of higher echogenicity are associated with severity of coronary artery disease and cardiac damage after carotid endarterectomy.
authors.affiliation: 1st Department of Propedeutic Surgery, University of Athens Medical School, Hippocration Hospital, Athens, Greece - georgegalyfos@hotmail.com.
authors.forename: George
authors.initials: G
authors.lastname: Galyfos
authors.forename: Konstantinos P
authors.initials: KP
authors.lastname: Toutouzas
authors.forename: George
authors.initials: G
authors.lastname: Benetos
authors.forename: Manousos
authors.initials: M
authors.lastname: Konstadoulakis
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Theodorou
authors.forename: Stilianos
authors.initials: S
authors.lastname: Katsaragakis
authors.forename: Christodoulos
authors.initials: C
authors.lastname: Stefanadis
authors.forename: Georgios
authors.initials: G
authors.lastname: Zografos
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Filis
mesh_terms: D000368:Aged; D002340:Carotid Artery Diseases / Q000150:complications / Q000000981:diagnostic imaging* / Q000453:epidemiology; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000150:complications / Q000000981:diagnostic imaging; D016894:Endarterectomy, Carotid / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D058226:Plaque, Atherosclerotic / Q000000981:diagnostic imaging* / Q000453:epidemiology; D011183:Postoperative Complications / Q000000981:diagnostic imaging* / Q000453:epidemiology; D011379:Prognosis; D012307:Risk Factors; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography