Open AccessSurvival and Prognostic Factors After Carotid Artery Stenting in Patients with Concomitant Coronary Disease
Author(s) -
Georgi Goranov,
M Tokmakova,
Petar Nikolov
Publication year - 2021
Publication title -
open access macedonian journal of medical sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.288
H-Index - 17
ISSN - 1857-9655
DOI - 10.3889/oamjms.2021.7194
Subject(s) - medicine , cardiology , coronary artery disease , concomitant , revascularization , myocardial infarction , proportional hazards model , stenosis , stroke (engine) , log rank test , carotid stenting , carotid artery disease , surgery , carotid endarterectomy , mechanical engineering , engineering
AIM: The aim of the study was to analyze the prognostic factors in patients after carotid artery stenting (CAS).METHODS: In 329 patients after CAS, the median survival (MS) and overall survival (OS) were calculated for a follow-up period of 2–101 months. All patients underwent coronary angiography before carotid stenting and, if indicated, coronary revascularization. Four groups of factors were analyzed: Carotid disease, coronary artery disease (CAD), underlying cardiac pathology, and concomitant diseases.RESULTS: MS in all patients was 86 months, OS at 1, 3, 5, and 9 years was - 94%, 85%, 73%, and 51%, respectively. Event free survival was 85 months. Log Rank-Mantel-Cox analysis demonstrated significantly reduced MS in 21 tested factors, most of them related to CAD. Two-step multifactorial Cox regression analysis defined only 7 of them as independent prognostic factors for the survival of patients after CAS: Left main stenosis, complete revascularization, late myocardial infarction, stroke, age over 70 years, valvular disease, and carotid score.CONCLUSION: Survival of patients after CAS is limited mainly by CAD and underlying cardiac pathology. Staged revascularization treatment strategy may improve the prognosis and survival of patients with both carotid and coronary disease.