title: Preoperative Coronary Stenosis Is a Determinant of Early Vascular Outcome after Carotid Endarterectomy.
abstract: OBJECTIVE
  The benefit of carotid endarterectomy (CEA) is directly influenced by the risk of perioperative adverse outcomes. However, patient-level risks and predictors including coronary stenosis are rarely evaluated, especially in Asian patients. The aim of this study was to determine the relationship between the vascular risk factors underlying CEA, including coronary stenosis, and postoperative outcome.
  
  
  METHODS
  One hundred and fifty-three consecutive CEAs from our hospital records were included in this analysis. All patients underwent coronary computed tomography angiography before CEA. Data were analyzed to determine the vascular outcomes in patients with mild-to-moderate vs. severe coronary stenosis and high vs. standard operative risk, based on the criteria for high operative risk defined in the Stenting and Angioplasty with Protection in Patients at High Risk for Endarterectomy (SAPPHIRE) trial. The vascular outcome was defined as the occurrence of postoperative (≤30 days) stroke, myocardial infarction (MI), or death.
  
  
  RESULTS
  An adverse vascular outcome occurred in 8 of the 153 CEAs, with 6 strokes, 2 MIs, and 3 deaths. The vascular outcome differed significantly between the groups with mild-to-moderate and severe coronary stenosis (p=0.024), but not between the high- and standard-operative-risk groups (stratified according to operative risk as defined in the SAPPHIRE trial). Multivariable analysis adjusting for potent predictors revealed that severe coronary stenosis (odds ratio, 6.87; 95% confidence interval, 1.20-39.22) was a significant predictor of the early vascular outcome.
  
  
  CONCLUSIONS
  Severe coronary stenosis was identified herein as an independent predictor of an adverse early vascular outcome.
authors: Department of Neurology, College of Medicine, Kyung Hee University, Seoul, Korea.|Department of Neurology, Seoul Bukbu Hospital, Seoul, Korea.
authors: Jung Hwa
authors: JH
authors: Kim
authors: Department of Neurology, College of Medicine, Kyung Hee University, Seoul, Korea. shheo73@khu.ac.kr.
authors: Sung Hyuk
authors: SH
authors: Heo
authors: Department of Neurology, College of Medicine, Kyung Hee University, Seoul, Korea.
authors: Hyo Jung
authors: HJ
authors: Nam
authors: Department of Thoracic and Cardiovascular Surgery, College of Medicine, Kyung Hee University, Seoul, Korea.
authors: Hyo Chul
authors: HC
authors: Youn
authors: Department of Radiology, College of Medicine, Kyung Hee University, Seoul, Korea.
authors: Eui Jong
authors: EJ
authors: Kim
authors: Clinical Research Center, Asan Medical Center, Seoul, Korea.
authors: Ji Sung
authors: JS
authors: Lee
authors: Department of Neurology, College of Medicine, Hanyang University, Seoul, Korea.
authors: Young Seo
authors: YS
authors: Kim
authors: Department of Neurology, College of Medicine, Hanyang University, Seoul, Korea.
authors: Hyun Young
authors: HY
authors: Kim
authors: Department of Neurology, College of Medicine, Hanyang University, Seoul, Korea.
authors: Seong Ho
authors: SH
authors: Koh
authors: Department of Neurology, College of Medicine, Kyung Hee University, Seoul, Korea.
authors: Dae Il
authors: DI
authors: Chang
keywords: carotid endarterectomy; coronary angiography; coronary artery disease; risk assessment