Carotid artery stenosis in asymptomatic patients undergoing coronary artery bypass grafting: who and when should be screened?

Yükleniyor...
Küçük Resim

Tarih

2021

Dergi Başlığı

Dergi ISSN

Cilt Başlığı

Yayıncı

Polskie Towarzystowo Kardiologiczne

Erişim Hakkı

info:eu-repo/semantics/openAccess

Özet

BACKGROUND Carotid artery stenosis (CAS) is one of the major causes of stroke in coronary artery bypass grafting (CABG). AIMS The aim of this study was to determine which age groups require screening for CAS using carotid duplex ultrasound in asymptomatic patients undergoing CABG. METHODS We included 644 neurologically asymptomatic consecutive patients (mean [SD] age, 63.9 [8.8] years; men, 453 [70.3%]) who underwent elective isolated CABG between June 2015 and June 2020. Clinical, demographic, and radiological data as well as coronary angiography results were retrospectively reviewed. Patients were classified into 4 age groups: 40 to 50, 51 to 60, 61 to 70, and >70 years, as well as 3 groups depending on the CAS degree: 50% or less, 50% to 70%, and 70% or greater. Regression analysis was applied across the selected parameters to identify risk factors for significant CAS, and receiver operating characteristic analysis, to determine cutoff age and SYNTAX score of patients who had to be screened before CABG. RESULTS Overall, 8 (1.1%) patients included in the present study had stroke following CABG. Cutoff values of the SYNTAX score and CAS of 70% or greater were found to be 27 and 64 years, respectively. The sensitivity and specificity of the cutoff value were 98.4% to 98.3% and 74.3% to 55.1%, respectively. The area under the curve was 0.98 and 0.73, respectively. CONCLUSIONS Based on the receiver operating characteristic analysis, we recommended to perform screening for CAS in patients older than 64 years and with a SYNTAX score of 27 or higher, even if they are asymptomatic.

Açıklama

Anahtar Kelimeler

Carotid Artery Stenosis, Screening, Coronary Artery Bypass, SYNTAX Score

Kaynak

Kardiologia Polska

WoS Q Değeri

Q2

Scopus Q Değeri

Q3

Cilt

79

Sayı

1

Künye

Özyalçın, S., Diken, A. İ., Yalçınkaya, A., & Türkmen, U. (2021). Carotid artery stenosis in asymptomatic patients undergoing coronary artery bypass grafting: who and when should be screened?. Kardiologia Polska (Polish Heart Journal), 79(1), 25-30.