Aim. Analysis of influence of risk factors (RF) on progression of atherosclerosis of brachiocephalic arteries after unilateral carotid endarterectomy (CEA) with the underlying treatment with statins. Materials and Methods. 262 Cases (262 patients) were analyzed. Influence of RFs on the frequency of cerebral circulation disorders (CCD), myocardial infarction (MI), survival rate, condition of the carotid arteries and on lipid profile with the underlying treatment with statins was evaluated. In the early period the results were evaluated in 100% of patients, in a long-term period – in 93.5%. Patients were arranged in groups: a group that received simvastatin – 41.6% in the preoperative period and 24.5% in the long-term period, a group of atorvastatin – 51.9% and 54.7%, a group of rosuvastatin – 6.5% and 20.8%, respectively. Predominating (83.2%) were patients with more than 3 RFs (according to SCORE scale). Results. Lethality rate in the analyzed sample group was 6.5%, the rate of fatal cardio-vascular complications (CVC) – 7 cases (2.3%), of non-fatal CCD – 5 cases (1.9%). A significant influence on the progression of alterations in the carotid artery was found in patients with 3 RFs (p=0.03). The length of atherosclerotic plaque (ASP) was maximal in patients with 5 RFs (0.01). In the presence of more than 3 RFs, elevation of the total cholesterol (CL) and of low density lipoproteins (LDLP) was noted, p=0.001. In the long-term period in the atorvastatin group the level of LDLP decreased by 19%, p=0.0001, in the rosuvastatin group the level of HDLP increased by 3.4%, p=0.02. In the rosuvastatin group, the recommended values of CL were achieved 64.7% more often in comparison with the simvastatin group, p=0.03. The rate of CVC increased in patients >68 years of age, р=0.04. The lethality rate increased in case of body mass index (BMI) ≥25-30 kg/m2 (р=0.05) and in case of type 2 diabetes mellitus (p=0.03). The influence of the following factors on long-term results was demonstrated: smoking (p=0.04), arterial hypertension (p=0.019), chronic cardiac insufficiency (p=0.01), a tendency to bradycardia (p=0.03), atherosclerotic lesions of more than one arterial pool (p=0.006). RFs influenced the rate of development of restenosis of the internal carotid artery (ICA) >50% on the side of the operation in 4 observations (1.5%). In the atorvastatin group the most significant positive influence on lipid spectrum was observed in comparison with other groups (by 47.1%, р=0.001).Therapy with atorvastatin stabilized the wall of ICA and of the contralateral common carotid artery (CCA) 17.6% (p=0.05) more frequently in comparison with simvastatin and rosuvastatin. Conclusion. A direct influence of RFs on the progression of atherosclerotic alterations in the carotid arteries and on the rate of development of cardiovascular complications in the perioperative and long-term periods, and also influence of underlying statin therapy on the parameters of lipid metabolism, and a higher effectiveness of synthetic statins were determined.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
customersupport@researchsolutions.com
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.
Copyright © 2025 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.