| Intima media thickness of the common carotid artery in vascular surgery patients: a predictor of postoperative cardiovascular events. | |
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MedLine Citation:
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PMID: 19619695 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Cardiovascular (CV) complications are the leading cause of morbidity and mortality in vascular surgery patients. The Revised Cardiac Risk (RCR) index, identifying cardiac risk factors, is commonly used for preoperative risk stratification. However, a more direct marker of the underlying atherosclerotic disease, such as the common carotid artery intimamedia thickness (CCA-IMT) may be of predictive value as well. The current study evaluated the prognostic value of the CCA-IMT for postoperative CV outcome. METHODS: In 508 vascular surgery patients, the CCA-IMT was measured using high-resolution B-mode ultrasonography. We recorded the RCR factors: ischemic heart disease, heart failure, cerebrovascular disease, diabetes mellitus, and renal dysfunction. Repeated Troponin T measurements and electrocardiograms were performed postoperatively. The study end point was the composite of 30-day CV events and long-term CV mortality. Multivariable regression analyses were used to assess the additional value of CCA-IMT for the prediction of cardiac events. RESULTS: In total, 30-day events and long-term cardiovascular mortality were noted in 122 (24%) and 81 (16%) patients, respectively. The optimal predictive value of CCA-IMT, using receiver-operating characteristic curve analysis, for the prediction of CV events was calculated to be 1.25 mm (sensitivity 70%, specificity 80%). An increased CCA-IMT was independently associated with 30-day CV events (OR 2.20, 95% CI 1.38-3.52) and long-term CV mortality (HR 6.88, 95% CI 4.11-11.50), respectively. CONCLUSIONS: This study shows that an increased CCA-IMT has prognostic value in vascular surgery patients to predict 30-day CV events and long-term CV mortality, incremental to the RCR index. |
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Authors:
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Willem-Jan Flu; Jan-Peter van Kuijk; Sanne E Hoeks; Ruud Kuiper; Olaf Schouten; Dustin Goei; Tamara Winkel; Yvette R B M van Gestel; Hence J M Verhagen; Jeroen J Bax; Don Poldermans |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: American heart journal Volume: 158 ISSN: 1097-6744 ISO Abbreviation: Am. Heart J. Publication Date: 2009 Aug |
Date Detail:
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Created Date: 2009-07-21 Completed Date: 2009-08-21 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0370465 Medline TA: Am Heart J Country: United States |
Other Details:
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Languages: eng Pagination: 202-8 Citation Subset: AIM; IM |
Affiliation:
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Department of Anesthesiology, Erasmus Medical Center, Rotterdam 3015 GE, The Netherlands. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Aorta, Abdominal / pathology Aortic Aneurysm, Abdominal / epidemiology, surgery Cardiovascular Diseases / epidemiology*, pathology Carotid Artery, Common / pathology* Constriction, Pathologic Female Humans Male Middle Aged Postoperative Complications / epidemiology*, pathology Prognosis ROC Curve Risk Factors Troponin T / blood Tunica Media / pathology* Vascular Surgical Procedures* |
| Chemical | |
Reg. No./Substance:
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0/Troponin T |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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