Carotid artery involvement in patients of atherosclerotic coronary artery disease undergoing coronary artery bypass grafting.

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dc.contributor.authorRath, P Cen_US
dc.contributor.authorAgarwala, M Ken_US
dc.contributor.authorDhar, P Ken_US
dc.contributor.authorLakshmi, Cen_US
dc.contributor.authorAhsan, S Aen_US
dc.contributor.authorDeb, Ten_US
dc.contributor.authorKumar, Sen_US
dc.contributor.authorNarasimham, R Ren_US
dc.contributor.authorRao, P Sen_US
dc.contributor.authorDixit, Ven_US
dc.date.accessioned2001-11-13en_US
dc.date.accessioned2009-05-27T04:30:18Z
dc.date.available2001-11-13en_US
dc.date.available2009-05-27T04:30:18Z
dc.date.issued2001-11-13en_US
dc.description.abstractBACKGROUND: Patients with concomitant critical carotid and coronary artery disease are at risk of major neurological events while undergoing coronary artery bypass grafting. The presence of carotid artery stenosis increases the stroke rate in the perioperative period. In an effort to reduce the stroke rate, many institutions perform routine preoperative noninvasive assessment of the carotid arteries. METHODS AND RESULTS: We analyzed the clinical and laboratory data of 1,200 patients who underwent coronary artery bypass surgery in the last 2 years. Carotid Doppler was normal in 186 patients (15.5%), and showed <30% stenosis in 796 (66.3%), 30%-50% in 110 (9.2%), 50%-70% stenosis in 64 (5.3%) and critical (>70%) stenosis in 44 (3.7%) patients. Conventional risk factors such as hypercholesterolemia, hypertension, smoking and family history were not independent predictors of carotid artery stenosis. However, diabetes as a risk factor had a significant association with carotid artery disease (79.6% v. 43.8%, p<0.02). There was a trend towards increased prevalence of carotid artery stenosis in patients with > or = 2 risk factors (84.3% v. 68.8%). Patients with significant carotid artery stenosis had severe coronary artery disease (triple-vessel disease 93.3%, left main coronary artery disease 12.0%). Out of 44 patients with critical carotid artery stenosis, 27 were subjected to carotid angiography. Doppler findings correlated well with angiography. Seventeen patients underwent carotid artery intervention. None had any perioperative neurological events. A total of 5 (0.4%) patients had a major stroke. Coronary artery bypass grafting was done in 27 patients with critical stenosis without any intervention. The stroke rate (11.1%) was higher in these patients compared to patients with < 70% carotid artery disease or post-carotid intervention (2.5%) patients. Thus, untreated >70% carotid artery stenosis was associated with a higher stroke rate. CONCLUSIONS: Doppler screening of the carotid artery is helpful in detecting the subgroup of patients at increased risk of stroke. Patients with critical carotid artery stenosis should be subjected to angiography. Prophylactic intervention may reduce the occurrence of stroke in the perioperative period.en_US
dc.description.affiliationCathlab and Interventional Cardiology, Apollo Heart Institute, Jubilee Hills, Hyderabad. drpcrath@hotmail.comen_US
dc.identifier.citationRath PC, Agarwala MK, Dhar PK, Lakshmi C, Ahsan SA, Deb T, Kumar S, Narasimham RR, Rao PS, Dixit V. Carotid artery involvement in patients of atherosclerotic coronary artery disease undergoing coronary artery bypass grafting. Indian Heart Journal. 2001 Nov-Dec; 53(6): 761-5en_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/6026
dc.language.isoengen_US
dc.source.urihttps://indianheartjournal.comen_US
dc.subject.meshAdulten_US
dc.subject.meshAgeden_US
dc.subject.meshCarotid Arteries --radiographyen_US
dc.subject.meshCarotid Stenosis --complicationsen_US
dc.subject.meshCoronary Artery Bypass --adverse effectsen_US
dc.subject.meshCoronary Artery Disease --complicationsen_US
dc.subject.meshFemaleen_US
dc.subject.meshHumansen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshRisk Factorsen_US
dc.subject.meshStroke --etiologyen_US
dc.titleCarotid artery involvement in patients of atherosclerotic coronary artery disease undergoing coronary artery bypass grafting.en_US
dc.typeJournal Articleen_US
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