Document Detail


Intima media thickness of the common carotid artery in vascular surgery patients: a predictor of postoperative cardiovascular events.
MedLine Citation:
PMID:  19619695     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
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:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  American heart journal     Volume:  158     ISSN:  1097-6744     ISO Abbreviation:  Am. Heart J.     Publication Date:  2009 Aug 
Date Detail:
Created Date:  2009-07-21     Completed Date:  2009-08-21     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  202-8     Citation Subset:  AIM; IM    
Affiliation:
Department of Anesthesiology, Erasmus Medical Center, Rotterdam 3015 GE, The Netherlands.
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MeSH Terms
Descriptor/Qualifier:
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:
0/Troponin T

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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