| Suboptimal control of atherosclerotic disease risk factors after cardiac and cerebrovascular procedures. | |
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MedLine Citation:
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PMID: 17255549 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND AND PURPOSE: Undergoing a carotid endarterectomy, a coronary artery bypass graft, or a percutaneous coronary intervention provides an opportunity to optimize control of blood pressure and low-density lipoprotein. METHODS: Using Veterans Administration databases, we determined whether patients who underwent a carotid endarterectomy (n=252), coronary artery bypass graft (n=486), or percutaneous coronary intervention (n=720) in 2002 to 2003 at 5 Veterans Administration Healthcare Systems had guideline-recommended control of blood pressure and low-density lipoprotein in 12-month periods before and after a vascular procedure. Postprocedure control of risk factors across procedure groups was compared using chi(2) tests and multivariate logistic regression. RESULTS: The proportion of patients undergoing carotid endarterectomy who had optimal control of both blood pressure and low-density lipoprotein increased from 23% before the procedure to 33% after the procedure (P=0.05) compared with increases from 32% to 43% for coronary artery bypass graft (P=0.001) and from 29% to 45% for percutaneous coronary intervention (P=0.002). Compared with the carotid endarterectomy group, the percutaneous coronary intervention group was more likely to achieve optimal control of blood pressure (OR: 1.92, 95% CI: 1.42 to 2.59) or low-density lipoprotein (OR: 1.51, 95% CI: 1.01 to 2.26) and the coronary artery bypass graft group was more likely to achieve optimal control of blood pressure (OR: 1.53, 95% CI: 1.42 to 2.59). Postprocedure cardiology visits, increase in medication intensity, and greater frequency of outpatient visits were also associated with optimal postprocedure risk factor control. CONCLUSIONS: Although modest improvements in risk factor control were detected, a majority of patients in each vascular procedure group did not achieve optimal risk factor control. More effective risk factor control programs are needed among most vascular procedure patients. |
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Authors:
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Eric M Cheng; Steve M Asch; Robert H Brook; Stefanie D Vassar; Erin L Jacob; Martin L Lee; Donald S Chang; Ralph L Sacco; An-Fu Hsiao; Barbara G Vickrey |
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Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't Date: 2007-01-25 |
Journal Detail:
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Title: Stroke; a journal of cerebral circulation Volume: 38 ISSN: 1524-4628 ISO Abbreviation: Stroke Publication Date: 2007 Mar |
Date Detail:
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Created Date: 2007-02-27 Completed Date: 2007-03-19 Revised Date: 2007-10-30 |
Medline Journal Info:
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Nlm Unique ID: 0235266 Medline TA: Stroke Country: United States |
Other Details:
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Languages: eng Pagination: 929-34 Citation Subset: IM |
Affiliation:
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Department of Neurology, VA Greater Los Angeles Healthcare System, Los Angeles, CA 90073, USA. eric.cheng@va.gov |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Angioplasty, Transluminal, Percutaneous Coronary* Atherosclerosis / blood, epidemiology*, prevention & control Cholesterol, LDL / blood Coronary Artery Bypass* Databases, Factual Endarterectomy, Carotid* Female Hospitals, Veterans Humans Male Middle Aged Retrospective Studies Risk Factors |
| Chemical | |
Reg. No./Substance:
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0/Cholesterol, LDL |
| Comments/Corrections | |
Erratum In:
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Stroke. 2007 Nov;38(11):e154 |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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