Analysis of Risk Factors for Myocardial Infarction Following Carotid Endarterectomy

Richard A. Yeager, Gregory (Greg) Moneta, Donald McConnell, Edward Neuwelt, Lloyd M. Taylor, John M. Porter

Research output: Contribution to journalArticle

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Abstract

A 4-year experience with 249 consecutive carotid endarterectomies performed on 224 patients is reviewed for incidence of perioperative (30-day) myocardial infarction and early survival (mean follow-up, 21 months). Except in cases of unstable angina, coronary arterial disease was evaluated only by routine history, physical examination, and electrocardiogram. By these criteria, 73% of patients had evidence of coronary arterial disease. Patients underwent carotid endarterectomy after appropriate medical management and stabilization of coronary disease symptoms (angina and/or congestive heart failure). One (0.4%) fatal and nine (3.6%) nonfatal perioperative myocardial infarctions occurred. Diabetes mellitus was the only factor associated with a significantly increased risk of perioperative myocardial infarction. Early survival of patients with active symptoms of coronary disease who did not undergo coronary bypass was similar to those patients with preceding or subsequent coronary bypass. The results of this review suggest routine clinical evaluation for coronary arterial disease is sufficient in the large majority of cases prior to carotid endarterectomy. Considering the reported high mortality of coronary bypass among vascular surgical patients, it appears that an aggressive program screening for cardiac surgical candidates either by coronary arteriography or radionuclide studies prior to carotid endarterectomy is not warranted.

Original languageEnglish (US)
Pages (from-to)1142-1145
Number of pages4
JournalArchives of Surgery
Volume124
Issue number10
DOIs
StatePublished - 1989

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Carotid Endarterectomy
Myocardial Infarction
Coronary Disease
Survival
Unstable Angina
Radioisotopes
Physical Examination
Blood Vessels
Diabetes Mellitus
Angiography
Electrocardiography
Heart Failure
History
Mortality
Incidence

ASJC Scopus subject areas

  • Surgery

Cite this

Analysis of Risk Factors for Myocardial Infarction Following Carotid Endarterectomy. / Yeager, Richard A.; Moneta, Gregory (Greg); McConnell, Donald; Neuwelt, Edward; Taylor, Lloyd M.; Porter, John M.

In: Archives of Surgery, Vol. 124, No. 10, 1989, p. 1142-1145.

Research output: Contribution to journalArticle

Yeager, Richard A. ; Moneta, Gregory (Greg) ; McConnell, Donald ; Neuwelt, Edward ; Taylor, Lloyd M. ; Porter, John M. / Analysis of Risk Factors for Myocardial Infarction Following Carotid Endarterectomy. In: Archives of Surgery. 1989 ; Vol. 124, No. 10. pp. 1142-1145.
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