da Rosa Marcelo P, Schwendler Ricardo, Lopes Rodrigo, Portal Vera L
Department of Atherogenesis and Thrombosis of the Instituto de Cardiologia do Rio Grande do Sul/Fundação Universitária de Cardiologia, Brazil.
Open Cardiovasc Med J. 2013 Sep 6;7:76-81. doi: 10.2174/1874192401307010076. eCollection 2013.
Vascular disease resulting from arteriosclerosis is a severe worldwide health risk. Early diagnosis and intervention is important to control adverse cerebral and cardiovascular events. The aim of this study was to assess the potential predictors of mortality in patients submitted to coronary bypass surgery.
Cohort study included asymptomatic cerebrovascular disease patients scheduled for coronary artery bypass grafting admitted to the cardiology reference center. All patients were submitted to carotid artery ultrasound assessment prior to surgery and were followed up during the entire in-hospital postoperative period. Carotid artery stenosis was considered clinically significant when cross sectional area ≥50%. Significance was set at p <0.05. Logistic regression was used to identify independent predictors of mortality.
Of 455 patients with a mean age of 62.2 years 65.6% were males. The prevalence of carotid artery stenosis was 18.7%. It was absent in 3.6% of the patients, below 50% in 77.8%, between 50 and 69% in 11.6%, and between 70 and 99% in 6.9%. The carotid artery was occluded in 0.2% of the sample. An overall mortality of 12%, affecting 35 men (P=0.001) with stenosis ≥50%. After logistic regression analysis, carotid artery stenosis ≥50% was confirmed as being an independent predictor of mortality (P=0.005).
In this series carotid artery stenosis showed a high prevalence in the sample assessed and was an independent predictor of mortality.
动脉硬化导致的血管疾病是全球范围内严重的健康风险。早期诊断和干预对于控制不良的脑和心血管事件至关重要。本研究的目的是评估接受冠状动脉搭桥手术患者死亡的潜在预测因素。
队列研究纳入了计划在心脏病学参考中心接受冠状动脉搭桥术的无症状脑血管疾病患者。所有患者在手术前均接受颈动脉超声评估，并在术后整个住院期间进行随访。当横截面积≥50%时，颈动脉狭窄被认为具有临床意义。显著性设定为p<0.05。采用逻辑回归分析确定死亡的独立预测因素。
455例患者平均年龄62.2岁，男性占65.6%。颈动脉狭窄的患病率为18.7%。3.6%的患者无颈动脉狭窄，77.8%的患者狭窄程度低于50%，11.6%的患者狭窄程度在50%至69%之间，6.9%的患者狭窄程度在70%至99%之间。样本中0.2%的患者颈动脉闭塞。总体死亡率为12%，35名狭窄程度≥50%的男性患者死亡（P=0.001）。经过逻辑回归分析，颈动脉狭窄≥50%被确认为死亡的独立预测因素（P=0.005）。
在本系列研究中，颈动脉狭窄在所评估的样本中患病率较高，并且是死亡的独立预测因素。
