Periprocedural myocardial infarction after carotid endarterectomy and stenting: Systematic review and meta-analysis

© 2015 American Heart Association, Inc. Background and Purpose-Carotid angioplasty and stenting (CAS) is associated with higher risk of periprocedural stroke and death when compared with carotid endarterectomy (CEA). By contrast, the risk of myocardial infarction (MI) was higher after CEA than after...

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Main Authors: Marion Boulanger, Lucie Camelière, Rui Felgueiras, Ludovic Berger, Kittipan Rerkasem, Peter M. Rothwell, Emmanuel Touzé
Format: Journal
Published: 2018
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http://cmuir.cmu.ac.th/jspui/handle/6653943832/54809
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Institution: Chiang Mai University
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spelling th-cmuir.6653943832-548092018-09-04T10:24:40Z Periprocedural myocardial infarction after carotid endarterectomy and stenting: Systematic review and meta-analysis Marion Boulanger Lucie Camelière Rui Felgueiras Ludovic Berger Kittipan Rerkasem Peter M. Rothwell Emmanuel Touzé Medicine Nursing © 2015 American Heart Association, Inc. Background and Purpose-Carotid angioplasty and stenting (CAS) is associated with higher risk of periprocedural stroke and death when compared with carotid endarterectomy (CEA). By contrast, the risk of myocardial infarction (MI) was higher after CEA than after CAS in randomized trials. However, numbers were small, and risk factors are unknown. Methods-We performed a systematic review and a meta-analysis of studies published from January 1980 to June 2014 and collected unpublished data. We extracted data on 9 predefined risk factors (age, contralateral carotid occlusion, coronary artery disease, diabetes mellitus, sex, hypertension, peripheral artery disease, type stenosis, and clinical presentation). We selected studies with data available on MI in at least 1 subgroup, calculated absolute and relative risks, and identified differential effects on risks of MI. Results-The 30-day absolute risk of MI was 0.87% (95% confidence interval, 0.69-1.07) after CEA and 0.70% (95% confidence interval, 0.54-0.88) after CAS (Pint=0.38). After CAS, patients with symptomatic stenosis and restenosis were at higher risk of MI, whereas men were at lower risk. After CEA, age, history of coronary artery disease, peripheral artery disease, and restenosis increased the risk of MI. Only the effect of sex differed between CAS and CEA with men being at lower risk of MI than women after CAS, whereas there was no difference between after CEA (Pint=0.01). Conclusions-The risk of MI after CEA and CAS did not significantly differ. Risk factors for MI are overall similar in both techniques except that men are at lower risk of MI after CAS but not after CEA. 2018-09-04T10:23:57Z 2018-09-04T10:23:57Z 2015-01-01 Journal 15244628 00392499 2-s2.0-84942845382 10.1161/STROKEAHA.115.010052 https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84942845382&origin=inward http://cmuir.cmu.ac.th/jspui/handle/6653943832/54809
institution Chiang Mai University
building Chiang Mai University Library
country Thailand
collection CMU Intellectual Repository
topic Medicine
Nursing
spellingShingle Medicine
Nursing
Marion Boulanger
Lucie Camelière
Rui Felgueiras
Ludovic Berger
Kittipan Rerkasem
Peter M. Rothwell
Emmanuel Touzé
Periprocedural myocardial infarction after carotid endarterectomy and stenting: Systematic review and meta-analysis
description © 2015 American Heart Association, Inc. Background and Purpose-Carotid angioplasty and stenting (CAS) is associated with higher risk of periprocedural stroke and death when compared with carotid endarterectomy (CEA). By contrast, the risk of myocardial infarction (MI) was higher after CEA than after CAS in randomized trials. However, numbers were small, and risk factors are unknown. Methods-We performed a systematic review and a meta-analysis of studies published from January 1980 to June 2014 and collected unpublished data. We extracted data on 9 predefined risk factors (age, contralateral carotid occlusion, coronary artery disease, diabetes mellitus, sex, hypertension, peripheral artery disease, type stenosis, and clinical presentation). We selected studies with data available on MI in at least 1 subgroup, calculated absolute and relative risks, and identified differential effects on risks of MI. Results-The 30-day absolute risk of MI was 0.87% (95% confidence interval, 0.69-1.07) after CEA and 0.70% (95% confidence interval, 0.54-0.88) after CAS (Pint=0.38). After CAS, patients with symptomatic stenosis and restenosis were at higher risk of MI, whereas men were at lower risk. After CEA, age, history of coronary artery disease, peripheral artery disease, and restenosis increased the risk of MI. Only the effect of sex differed between CAS and CEA with men being at lower risk of MI than women after CAS, whereas there was no difference between after CEA (Pint=0.01). Conclusions-The risk of MI after CEA and CAS did not significantly differ. Risk factors for MI are overall similar in both techniques except that men are at lower risk of MI after CAS but not after CEA.
format Journal
author Marion Boulanger
Lucie Camelière
Rui Felgueiras
Ludovic Berger
Kittipan Rerkasem
Peter M. Rothwell
Emmanuel Touzé
author_facet Marion Boulanger
Lucie Camelière
Rui Felgueiras
Ludovic Berger
Kittipan Rerkasem
Peter M. Rothwell
Emmanuel Touzé
author_sort Marion Boulanger
title Periprocedural myocardial infarction after carotid endarterectomy and stenting: Systematic review and meta-analysis
title_short Periprocedural myocardial infarction after carotid endarterectomy and stenting: Systematic review and meta-analysis
title_full Periprocedural myocardial infarction after carotid endarterectomy and stenting: Systematic review and meta-analysis
title_fullStr Periprocedural myocardial infarction after carotid endarterectomy and stenting: Systematic review and meta-analysis
title_full_unstemmed Periprocedural myocardial infarction after carotid endarterectomy and stenting: Systematic review and meta-analysis
title_sort periprocedural myocardial infarction after carotid endarterectomy and stenting: systematic review and meta-analysis
publishDate 2018
url https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84942845382&origin=inward
http://cmuir.cmu.ac.th/jspui/handle/6653943832/54809
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