title: The interval between carotid artery stenting and open heart surgery is related to perioperative complications.
abstract: OBJECTIVE
  To assess 30-day outcomes and the optimal interval between carotid artery stenting (CAS) and open heart surgery (OHS).
  
  
  BACKGROUND
  Whether or not they show symptoms of carotid atherosclerosis, patients with significant carotid stenosis who underwent OHS face a high risk of perioperative stroke. Planning appropriate treatment for carotid stenosis before OHS has become an important clinical issue.
  
  
  METHODS
  From January 2005 to June 2010, 154 inpatients scheduled for CAS and OHS were recruited and followed up for 30 days after OHS. The primary end point was a composite of major stroke or neurological death. The secondary end points included a composite of major stroke, myocardial infarction (MI) or any death, minor stroke, and acute kidney injury (AKI).
  
  
  RESULTS
  The incidence of the primary end point, the composite of major stroke, MI or any death, minor stroke and AKI was 3.2%, 5.8%, 2.6%, and 4.5%, respectively. Only an interval between CAS and OHS of ≤5 days could independently predict the incidence of the primary end point (OR, 14.06, 95% CI, 1.52-130.13; P=0.020). Moreover, congestive heart failure (OR, 7.07, 95% CI, 1.55-21.27; P=0.012) and an interval between CAS and OHS of ≤5 days (OR, 7.05, 95% CI, 1.58-31.40; P=0.010) were identified as independent risk factors for the composite of major stroke, MI, or any death.
  
  
  CONCLUSIONS
  Our findings indicate that CAS followed by OHS is safe and feasible. More importantly, an interval between CAS and OHS of >5 days may decrease periprocedural complications, especially major stroke and neurological death.
authors.affiliation: Department of Cardiology, Fuwai Hospital and National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
authors.forename: Hui
authors.initials: H
authors.lastname: Dong
authors.affiliation: Department of Cardiology, Fuwai Hospital and National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
authors.forename: Xiongjing
authors.initials: X
authors.lastname: Jiang
authors.affiliation: Department of Cardiology, Fuwai Hospital and National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
authors.forename: Meng
authors.initials: M
authors.lastname: Peng
authors.affiliation: Department of Cardiology, Fuwai Hospital and National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
authors.forename: Yubao
authors.initials: Y
authors.lastname: Zou
authors.affiliation: Department of Cardiology, Fuwai Hospital and National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
authors.forename: Wuqiang
authors.initials: W
authors.lastname: Che
authors.affiliation: Department of Cardiology, Fuwai Hospital and National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
authors.forename: Haiyan
authors.initials: H
authors.lastname: Qian
authors.affiliation: Department of Cardiology, Fuwai Hospital and National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
authors.forename: Bo
authors.initials: B
authors.lastname: Xu
authors.affiliation: Department of Cardiology, Fuwai Hospital and National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Song
authors.affiliation: Department of Cardiology, Fuwai Hospital and National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
authors.forename: Yuejin
authors.initials: Y
authors.lastname: Yang
authors.affiliation: Department of Cardiology, Fuwai Hospital and National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
authors.forename: Runlin
authors.initials: R
authors.lastname: Gao
mesh_terms: D058186:Acute Kidney Injury / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality; D000368:Aged; D000800:Angioplasty, Balloon / Q000009:adverse effects* / Q000295:instrumentation* / Q000401:mortality; D006348:Cardiac Surgical Procedures / Q000009:adverse effects* / Q000401:mortality; D016893:Carotid Stenosis / Q000150:complications / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D005260:Female; D006331:Heart Diseases / Q000150:complications / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality; D016017:Odds Ratio; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D015607:Stents; D020521:Stroke / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality; D013997:Time Factors; D061665:Time-to-Treatment; D016896:Treatment Outcome
keywords: cardiac surgical procedures; carotid stenosis; interval; stents; stroke