title: Impact of coexisting multivessel coronary artery disease on short-term outcomes and long-term survival of patients treated with carotid stenting.
abstract: BACKGROUND
  Systemic atherosclerosis can result in both coronary artery disease (CAD) and carotid artery disease. Recently it has been shown that patients with CAD have a higher incidence of microembolization during carotid artery stenting (CAS), and it has been hypothesized that they could be at higher risk in this intervention.
  
  
  METHODS
  We retrospectively evaluated an institutional registry with 437 consecutive patients who underwent coronary angiography and CAS to evaluate their short-term outcomes and long-term survival with regard to the presence of coexisting multivessel coronary artery disease (MVD).
  
  
  RESULTS
  We performed 220 CAS procedures in MVD patients and 318 CAS procedures in non-MVD patients. The incidence of in-hospital CAS-related adverse events was 2.7% and 2.5% in the MVD and non-MVD groups, respectively (p = 0.88). At 30 days, there was no significant difference between the groups in terms of the number of patients with adverse events (hierarchically death/stroke/myocardial infarction; 8.8% vs. 5.5%; p = 0.18). The median duration of follow-up was 4.23 years. Survival free of all-cause mortality at 1, 3 and 5 years was 90% (95% CI: 86-94%), 79% (95% CI: 73-85%) and 70% (95% CI: 64-77%), and 92% (95% CI: 89-95%), 85% (95% CI: 80-90%) and 76% (95% CI: 70-82%) for the MVD and non-MVD groups (p = 0.02), respectively.
  
  
  CONCLUSIONS
  These results suggest that patients with MVD combined with carotid artery disease are probably not at higher risk of early post-CAS adverse clinical events, but they have significantly worse long-term survival rates.
authors.affiliation: Department of Cardiology, Motol University Hospital, 2 Medical School, Charles University, Prague, Czech Republic.
authors.forename: Josef
authors.initials: J
authors.lastname: Veselka
authors.affiliation: Department of Cardiology, Motol University Hospital, 2 Medical School, Charles University, Prague, Czech Republic.
authors.forename: Miloslav
authors.initials: M
authors.lastname: Špaček
authors.affiliation: Department of Cardiology, Motol University Hospital, 2 Medical School, Charles University, Prague, Czech Republic.
authors.forename: Martin
authors.initials: M
authors.lastname: Horváth
authors.affiliation: Department of Cardiology, Motol University Hospital, 2 Medical School, Charles University, Prague, Czech Republic.
authors.forename: Cyril
authors.initials: C
authors.lastname: Štěchovský
authors.affiliation: Department of Cardiology, Motol University Hospital, 2 Medical School, Charles University, Prague, Czech Republic.
authors.forename: Ingrid
authors.initials: I
authors.lastname: Homolová
authors.affiliation: Department of Cardiology, Motol University Hospital, 2 Medical School, Charles University, Prague, Czech Republic.
authors.forename: Petra
authors.initials: P
authors.lastname: Zimolová
authors.affiliation: Department of Cardiology, Motol University Hospital, 2 Medical School, Charles University, Prague, Czech Republic.
authors.forename: Petr
authors.initials: P
authors.lastname: Hájek
keywords: carotid disease; stenting; survival