Association between Pre-Existing Coronary Artery Disease and 5-Year Mortality in Stroke Patients with High-Grade Carotid Artery Stenosis

2020 ◽  
pp. 1-7
Author(s):  
Ching-I Wu ◽  
Chia-Lun Wu ◽  
Feng-Chieh Su ◽  
Shun-Wen Lin ◽  
Wen-Yi Huang
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Carotid Artery ◽  
Carotid Artery Stenosis ◽  
Significant Risk ◽  
Cox Proportional Hazards Model ◽  
Artery Stenosis ◽  
High Grade ◽  
Increased Risk ◽  
Artery Disease

<b><i>Background:</i></b> The coincidence of coronary artery disease (CAD) and carotid artery stenosis (CAS) was observed. However, the association between pre-existing CAD and ischemic stroke (IS) outcome in patients with high-grade CAS remains unclear. We aimed to investigate the association between pre-existing CAD and outcomes of acute IS patients with high-grade CAS. <b><i>Methods:</i></b> From January 1, 2007, to April 30, 2012, we enrolled 372 acute IS patients with high-grade CAS and prospectively observed them for 5 years. Demographic features, vascular risk factors, comorbidities, and outcomes were compared between patients with and without pre-existing CAD. <b><i>Results:</i></b> Among 372 individuals, 75 (20.2%) patients had pre-existing CAD and 297 (79.8%) patients did not have pre-existing CAD. The prevalence rates of hypertension, congestive heart failure, chronic kidney disease, and gout in patients with pre-existing CAD were significantly higher than in those without pre-existing CAD (<i>p</i> = 0.017, <i>p</i> &#x3c; 0.001, <i>p</i> = 0.002, and <i>p</i> &#x3c; 0.001, respectively). The multivariate Cox proportional hazards model revealed that pre-existing CAD was a significant risk factor for a 5-year all-cause mortality in acute IS patients with high-grade CAS (hazard ratio = 2.26; 95% confidence interval = 1.35–3.79; <i>p</i> = 0.002). <b><i>Conclusion:</i></b> Pre-existing CAD was associated with an increased risk of 5-year mortality in acute IS patients with high-grade CAS. Intensive treatment for the pre-existing CAD may reduce long-term mortality in acute IS patients with high-grade CAS.

scholarly journals Coexisting Coronary and Carotid Artery Disease – Which Technique and in Which Order? Case Report and Review of Literature

2020 ◽  
Vol 14 ◽  
pp. 117954682095179 ◽  
Author(s):  
Sina Manthey ◽  
Jenna Spears ◽  
Sheldon Goldberg
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Carotid Artery ◽  
Carotid Artery Stenosis ◽  
Treatment Guidelines ◽  
Carotid Artery Disease ◽  
Myocardial Revascularization ◽  
Internal Carotid Artery Stenosis ◽  
Artery Stenosis ◽  
Artery Disease

Coexisting carotid artery stenosis and coronary artery disease is common and there is currently no consensus in treatment guidelines on the timing, sequence and methods of revascularization. We report a case of a patient with symptomatic triple vessel coronary artery disease as well as asymptomatic severe right internal carotid artery stenosis. Our patient underwent myocardial revascularization first, because she presented with unstable angina and was asymptomatic neurologically. This article summarizes current literature about the approach to carotid and coronary artery revascularization and addresses the decision-making process regarding the timing and sequence of revascularization.

scholarly journals Prevalence of Carotid Artery Stenosis in Patients With Coronary Artery Disease in Japanese Population

Stroke ◽  
2005 ◽  
Vol 36 (10) ◽  
pp. 2094-2098 ◽  
Author(s):  
Shuzou Tanimoto ◽  
Yuji Ikari ◽  
Kengo Tanabe ◽  
Sen Yachi ◽  
Hiroyoshi Nakajima ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Carotid Artery ◽  
Carotid Artery Stenosis ◽  
Japanese Population ◽  
Artery Stenosis ◽  
Artery Disease

scholarly journals Concurrent Carotid Endarterectomy and off-Pump Coronary Artery Bypass Graft Surgery in Bangladesh: a Prospective Cohort Study

2018 ◽  
Vol 9 (1) ◽  
pp. 15-21
Author(s):  
Redoy Ranjan ◽  
Dipannita Adhikary ◽  
Heemel Saha ◽  
Sanjoy Kumar Saha ◽  
Sabita Mandal ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Carotid Artery ◽  
Carotid Endarterectomy ◽  
Carotid Artery Stenosis ◽  
Bypass Graft ◽  
Artery Stenosis ◽  
Off Pump ◽  
Co Morbidity ◽  
Artery Disease

Background: A patient of ischemic coronary artery disease (IHD) with additional carotid artery stenosis (CAS) has been distinguished as a high risk group for both heart and cerebral inconveniences following surgical intervention. We review the outcome of concurrent carotid endarterectomy (CEA) and off-pump coronary bypass grafting (OPCABG)in a patient undergoing surgical revascularization for IHD and CAS in a single surgeons practice.Materials and Methods: In the vicinity of January 2012 and December2016,fifteen patients experienced OPCABG and CEA associatively in a single Surgeon's Practice. Majority 46.66% patient have 75-90% Carotid artery stenosis and 40%patients experienced right sided lesion, though 53.33% experienced left sided lesion. 33.33% patients were found Left main coronary artery disease (>50% lesion) and 100% patients have had significant LAD lesion in this study. CEA was performed before OPCABG in all cases.Result: Themean age was 62.5±2.8 years; 80% were male. 13.33% had a perioperative stroke while one of them had TIAs (6.6%). Mean ICU stay was 36.6±4.5 hours and patients were released in 10±2 days. There was no mortality in the early postoperative period and co-morbidity was less significant; only 6.6% myocardial ischemia, 13.33% Atrial fibrillation, 6.66% TIA, and 13.33% Stroke.Conclusion: A combined strategy by means of CEA with OPCABG is safe and savvy in view of the satisfactory consequences of morbidity and mortality rates and also short ICU and hospital stay status.Anwer Khan Modern Medical College Journal Vol. 9, No. 1: Jan 2018, P 15-21

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