title: Female and obese patients might have higher risk from surgical repair of asymptomatic carotid artery stenosis.
abstract: BACKGROUND
  To investigate the results after carotid endarterectomy performed for asymptomatic carotid stenosis (ACS) in a single high-volume center and define the factors that increase perioperative stroke and mortality rate.
  
  
  METHODS
  This observational study that analyzes prospectively collected data includes 1,567 patients with ACS operated in the period between 2007 and 2012.
  
  
  RESULTS
  Most patients were male, 1,037 (66.18%), with mean age of 63.6 years. Perioperative death rate was 0.38%. The most frequent causes of death were stroke and myocardial infarction. The total perioperative stroke/transient ischemic attack rate was 2.81%. Logistic regression analysis confirmed that females (P = 0.028) and obese (P = 0.060) patients have higher risk of perioperative stroke after surgical repair of ACS with odds ratio (OR) of 2.008 and 2.342. The early mortality was significantly higher in candidates for coroanary artery bypass grafting (P = 0.018). Stroke and mortality are related to obesity and ischemic heart disease with OR of 2.407 and 2.097, respectively.
  
  
  CONCLUSIONS
  According to our results, female and obese patients are prone to stroke after carotid endarterectomy. Further study of the effects of female gender and obesity on surgical outcomes is warranted before medical therapy is considered the preferred treatment for these patients.
authors.affiliation: Faculty of Medicine, University of Belgrade, Belgrade, Serbia; Clinic for Vascular and Endovascular Surgery, Clinical Center of Serbia, Belgrade, Serbia.
authors.forename: Lazar
authors.initials: L
authors.lastname: Davidovic
authors.affiliation: Faculty of Medicine, University of Belgrade, Belgrade, Serbia; Clinic for Vascular and Endovascular Surgery, Clinical Center of Serbia, Belgrade, Serbia. Electronic address: dr.koncar@gmail.com.
authors.forename: Igor
authors.initials: I
authors.lastname: Koncar
authors.affiliation: Faculty of Medicine, University of Belgrade, Belgrade, Serbia; Clinic for Vascular and Endovascular Surgery, Clinical Center of Serbia, Belgrade, Serbia.
authors.forename: Marko
authors.initials: M
authors.lastname: Dragas
authors.affiliation: Faculty of Medicine, University of Belgrade, Belgrade, Serbia; Clinic for Vascular and Endovascular Surgery, Clinical Center of Serbia, Belgrade, Serbia.
authors.forename: Miroslav
authors.initials: M
authors.lastname: Markovic
authors.affiliation: Faculty of Medicine, University of Belgrade, Belgrade, Serbia; Clinic for Vascular and Endovascular Surgery, Clinical Center of Serbia, Belgrade, Serbia.
authors.forename: Nikola
authors.initials: N
authors.lastname: Ilic
authors.affiliation: Clinic for Vascular and Endovascular Surgery, Clinical Center of Serbia, Belgrade, Serbia.
authors.forename: Perica
authors.initials: P
authors.lastname: Mutavdzic
authors.affiliation: Clinic for Vascular and Endovascular Surgery, Clinical Center of Serbia, Belgrade, Serbia.
authors.forename: Igor
authors.initials: I
authors.lastname: Banzic
authors.affiliation: Clinic for Vascular and Endovascular Surgery, Clinical Center of Serbia, Belgrade, Serbia.
authors.forename: Natasa
authors.initials: N
authors.lastname: Ristanovic
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D058070:Asymptomatic Diseases; D016893:Carotid Stenosis / Q000150:complications / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D015897:Comorbidity; D016894:Endarterectomy, Carotid / Q000009:adverse effects* / Q000401:mortality; D005260:Female; D061847:Hospitals, High-Volume; D006801:Humans; D002546:Ischemic Attack, Transient / Q000209:etiology / Q000401:mortality; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000209:etiology / Q000401:mortality; D017202:Myocardial Ischemia / Q000150:complications / Q000401:mortality; D009765:Obesity / Q000150:complications* / Q000175:diagnosis / Q000401:mortality; D016017:Odds Ratio; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D055771:Serbia / Q000453:epidemiology; D012737:Sex Factors; D020521:Stroke / Q000209:etiology / Q000401:mortality; D016896:Treatment Outcome