title: History of transient ischaemic attack, myocardial infarction and hyperlipidaemia affects outcome following carotid artery stenting.
abstract: OBJECTIVE
  This prospective registry study was intended to evaluate outcomes and predictors of adverse events following carotid artery stenting (CAS).
  
  
  RESULTS
  Patients received neurological and duplex exams before CAS, prior to discharge and at 30- and 180-day follow-up. Multiple regression analysis included patient- and procedure-related characteristics. The MACCE endpoint comprised stroke, myocardial infarction and death. Three hundred and seventy-five consecutive patients underwent CAS between 1998 and 2011. Mean age was 69±9.1 years; 53% were symptomatic within the preceding six months. Mean time to CAS was 23 days in patients with TIA and 31 days with stroke (p=0.029). The MACCE rate was 1.6% during intervention and 4.0%, 5.6% and 5.9% at discharge, day 30 and day 180, respectively. TIA occurred in 31 cases (9.6%) within 30 days. A history of TIA was independently associated with MACCE (OR: 2.88; p=0.04). Furthermore, a history of hyperlipidaemia (OR: 4.02, p=0.029), MI (OR: 2.93, p=0.007) and age ≥70 (OR: 1.89, p=0.033) were independent predictors for the combined endpoint MACCE plus TIA.
  
  
  CONCLUSIONS
  TIA is an underappreciated adverse event following CAS. Pre-procedural TIA was an independent risk factor for adverse outcomes, while stroke was not, probably related to the timing of the procedure relative to the index event.
authors.affiliation: Department of Cardiology and Angiology II, University Heart Center Freiburg - Bad Krozingen, Bad Krozingen, Germany.
authors.forename: Roland Richard
authors.initials: RR
authors.lastname: Macharzina
authors.forename: Christian
authors.initials: C
authors.lastname: Claus
authors.forename: Steven R
authors.initials: SR
authors.lastname: Messé
authors.forename: Tanja
authors.initials: T
authors.lastname: Boehme
authors.forename: Werner
authors.initials: W
authors.lastname: Vach
authors.forename: Thomas
authors.initials: T
authors.lastname: Winker
authors.forename: Aljoscha
authors.initials: A
authors.lastname: Rastan
authors.forename: Ulrich
authors.initials: U
authors.lastname: Beschorner
authors.forename: Elias
authors.initials: E
authors.lastname: Noory
authors.forename: Franz-Josef
authors.initials: FJ
authors.lastname: Neumann
authors.forename: Thomas
authors.initials: T
authors.lastname: Zeller
mesh_terms: D000367:Age Factors; D000368:Aged; D017130:Angioplasty / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D002340:Carotid Artery Diseases / Q000150:complications / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D006949:Hyperlipidemias / Q000150:complications* / Q000175:diagnosis / Q000401:mortality; D002546:Ischemic Attack, Transient / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality; D009460:Neurologic Examination; D016017:Odds Ratio; D011446:Prospective Studies; D012042:Registries; D018570:Risk Assessment; D012307:Risk Factors; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome; D018616:Ultrasonography, Doppler, Duplex