Contribution of current comorbid conditions to carotid artery stenosis in patients undergoing coronary artery bypass and stroke distribution in carotid artery stenosis groups
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Dosyalar
Tarih
2021
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Forum Multimedia Publishing, Llc
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Objective: The aim of this study was to contribute to the issue of “Who should we perform Doppler ultrasonography on?” and determine the contribution of comorbid diseases to the development of carotid artery stenosis (CAS) and pre-operative CAS by examining comorbid diseases in patients undergoing coronary artery bypass graft operation (CABG) and also discussing the effect of carotid stenosis levels on postoperative stroke.Method: Between 2011-2015, a total of 921 patients who underwent cardiac surgery retrospectively were examined. Of these, 594 CABG patients aged 60 and over who underwent preoperative carotid Doppler examination were analyzed.Results: Sixty-five percent of patients were male, and 35% were female. The mean age was 69.3 years. Sixty-nine percent of patients were in the 0-29% stenosis group, 12.9% in the 30-49% group, 14.6% in the 50-69% group, 3% in the 70-99% group, and 0.3% in the 100% occlusion group. Peripheral artery disease (PAD), age, gender, and diabe-tes mellitus (DM) were found to have significant (P < 0.05) effects on the occurrence of CAS. CAS increased by 0.9% with an increase of one year in age, 10.8% with the presence of PAD, 3% with male sex, 3.8% with presence of chronic obstructive pulmonery disease (COPD), 1.9% with presence of left main coronary disease (LMCAD), and 0.9% with pres-ence of hypertension. In the decision tree analysis, the rate of 50% and above CAS in the presence of PAH + DM and age older than 65 years was 62.5%. Cerebrovascular accident (CVA) distribution was 2.1% in the 0-29% group, 2.5% in the 30-49% group, 4.5% in the 50-69% group, and 11.1% in the 70-99% group. Postoperative CVA was not observed in 10 patients who underwent carotid endarterectomy (CE). Postoperative CVA developed in six patients with 50% or more stenosis who did not undergo CE. Conclusion: For the preoperative detection of CAS in patients undergoing CABG, the association of advanced age, PAD, DM, male gender, COPD, LMCAD, and hyperten-sion risk factors should be considered. We suggest that carotid screening should be performed in those over 65 years of age and with PAD+DM. Studies with large populations are needed to observe the effects of aortic atherosclerosis load, surgical proce-dure, and unilateral/bilateral CAS presence on the development of stroke in patients with severe CAS and postoperative CVA.
Açıklama
Anahtar Kelimeler
Intima-Media Thickness, Risk-Factors, Disease, Endarterectomy, Surgery, Plaque
Kaynak
Heart Surgery Forum
WoS Q Değeri
Q4
Scopus Q Değeri
Q3
Cilt
24
Sayı
4
Künye
Işık, M., & Velioğlu, Y. (2021, August). Contribution of Current Comorbid Conditions to Carotid Artery Stenosis in Patients Undergoing Coronary Artery Bypass and Stroke Distribution in Carotid Artery Stenosis Groups. In The Heart Surgery Forum (Vol. 24, No. 4, pp. E724-E730).