Document Detail


Risk score for peri-interventional complications of carotid artery stenting.
MedLine Citation:
PMID:  16990579     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND PURPOSE: Routinely available independent risk factors for the peri-interventional outcome of patients undergoing elective carotid artery stenting (CAS) are lacking. The rationale of the study was to create a risk score identifying high-risk patients. METHODS: We prospectively enrolled 606 consecutive patients assigned to CAS at a secondary care hospital. Various biochemical, clinical, and lesion-related risk factors were prospectively defined. The primary end point reflecting periprocedural complications encompassed minor and major stroke, nonfatal myocardial infarction and all-cause mortality within 30 days. RESULTS: Three percent of patients (n=18) experienced a nonfatal minor (n=13) or major (n=5) stroke. 1.3% of patients (n=8) died from fatal stroke (n=4) or other causes (n=4). No myocardial infarction was observed within 30 days after stenting. Multivariable analysis revealed diabetes mellitus with inadequate glycemic control (HbA1c > 7%), age > or = 80 years, ulceration of the carotid artery stenosis, and a contralateral stenosis > or = 50% as independent risk factors. A risk score formed with these variables showed a superior predictive value (C-statistic = 0.73) compared with single risk factors. The presence of 2 or more of these risk factors identified patients with a risk of 11% for a periprocedural complication compared with 2% in patients with a score of 0 or 1. CONCLUSIONS: In patients undergoing elective CAS, a risk score based on routinely accessible variables was able to identify patients at high-risk for atherothrombotic events and all-cause death within 30 days after the intervention.
Authors:
Robert Hofmann; Alexander Niessner; Alexander Kypta; Clemens Steinwender; Jürgen Kammler; Klaus Kerschner; Michael Grund; Franz Leisch; Kurt Huber
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Publication Detail:
Type:  Clinical Trial; Journal Article     Date:  2006-09-21
Journal Detail:
Title:  Stroke; a journal of cerebral circulation     Volume:  37     ISSN:  1524-4628     ISO Abbreviation:  Stroke     Publication Date:  2006 Oct 
Date Detail:
Created Date:  2006-09-27     Completed Date:  2006-10-16     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0235266     Medline TA:  Stroke     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2557-61     Citation Subset:  IM    
Affiliation:
Cardiovascular Division, City Hospital Linz, Austria, A-4020 Linz, Krankenhausstr. 9. robert.hofmann@akh.linz.at
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Carotid Arteries / surgery
Carotid Stenosis / surgery*
Female
Follow-Up Studies
Humans
Male
Middle Aged
Myocardial Infarction / epidemiology,  etiology
Postoperative Complications / epidemiology*,  mortality
Risk Assessment
Risk Factors
Stents*
Stroke / epidemiology,  etiology
Comments/Corrections
Comment In:
Perspect Vasc Surg Endovasc Ther. 2007 Sep;19(3):339-41   [PMID:  17911570 ]

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


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