Limited Economic Evidence of Carotid Artery Stenosis Diagnosis and Treatment: A Systematic Review

Shenoy, Amit; Aljutaili, Majed; Stollenwerk, Björn

doi:10.1016/j.ejvs.2012.08.010

Cited by 7 publications

(5 citation statements)

References 46 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Several studies have found that there is an increased risk of significant neurological deficits in IHD patients who also have significant CAS and are undergoing CABG using cardiopulmonary bypass. [8][9][10][11][12][13][14][15] The aim of this study was to investigate the current proportion and to determine the associated risk factors of CAS in IHD patients.…”

Section: Introductionmentioning

confidence: 99%

Prevalence of carotid artery stenosis in ischaemic heart disease patients in Bangladesh

et al. 2019

View full text Add to dashboard Cite

Background:Concurrent carotid artery stenosis and ischaemic heart disease rates are increasing day by day in Bangladesh. Moreover, carotid artery stenosis has been identified as a high-risk factor for postoperative ischaemic cerebral inconvenience following coronary artery bypass graft surgery.Methods:This observational cross-sectional study was performed to evaluate 200 study patients from July 2017 to June 2018. Patients with coronary artery disease scheduled for isolated elective coronary artery bypass graft surgery were included in the study, excluding those with coexisting valvular or congenital heart disease and emergency coronary artery bypass graft surgery.Results:About two-thirds of the study patients were 50–59 years old, with a mean age of 57.7 ± 3.06 years. Approximately 70% patients were male; the male:female ratio was 2.1:1. Most of the patients (74.5%) were Muslim. The majority of patients (59.0%) were overweight, and severe carotid artery stenosis was significantly higher in obese patients (p ⩽ 0.05). Furthermore, hypertension and diabetes mellitus were significantly associated with moderate to severe carotid artery stenosis (p ⩽ 0.05). Multi-vessel coronary artery disease was significantly associated with the severity of carotid artery stenosis. Bilateral carotid artery stenosis was significantly associated with the severity of carotid artery stenosis (p ⩽ 0.05).Conclusion:Routine duplex screening will identify significant carotid artery disease and will subsequently reduce the risk of perioperative stroke in ischaemic heart disease patients undergoing coronary artery bypass graft surgery.

show abstract

Section: Introductionmentioning

confidence: 99%

Prevalence of carotid artery stenosis in ischaemic heart disease patients in Bangladesh

et al. 2019

View full text Add to dashboard Cite

show abstract

“…6 , 8 , 9 The economic burden of diagnosing and treating CAS has contributed significantly to the growing overall cost of CABG procedures, which further adds to the necessity of optimizing CABG treatment strategies. 10 , 11 …”

Section: Introductionmentioning

confidence: 99%

Risk Factors for Carotid Artery Stenosis in Chinese Patients Undergoing Coronary Artery Bypass Graft Interventions

Cheng¹,

Gao²,

Wang³

et al. 2015

Medicine

View full text Add to dashboard Cite

Current guidelines established in the USA and Europe for coronary artery bypass graft (CABG) suggest that patients ≥65 and ≥70 years of age, or with certain atherosclerotic-risk factors, should be screened preoperatively for extracranial carotid artery stenosis (CAS) to assess their risk of perioperative stoke. We sought factors that should be taken into consideration when treating Chinese CABG patients using CABG guidelines based on an analysis of CAS in a large cohort of Chinese CABG patients.We analyzed data for 1558 Chinese CABG patients who were screened preoperatively for CAS using duplex ultrasonography at a single institution. We defined significant and severe CAS as ≥50% and ≥70% stenosis, respectively, in one or more common or internal carotid arteries. We investigated the prevalence of CAS, the incidence of perioperative stroke, and the risk factors for CAS in the CABG cohort.The prevalence of CAS in the CABG cohort was 21.2%. Multivariate stepwise logistic regression analysis showed that an age ≥50 years and a history of smoking (odds ratios = 8.36 and 1.83, respectively) were independent risk factors for CAS (P < 0.05 for both). The incidence of perioperative stroke among CABG patients with significant or severe CAS was significantly higher (2.4% and 2.9%, respectively) than in CABG patients with <50% stenosis (0.5%; P = 0.004 and 0.029, respectively).Chinese CABG patients with a history of smoking or ≥50 years of age should undergo preoperative screening for CAS to assess their risk of perioperative stroke.

show abstract

“…Previously, evaluations have shown CHD prevention strategies that were based on a single measure to be effective in the prevention of CHD and individual risk assessment for CHD, although to varying degrees [5] – [11] . For example, non-invasive imaging can help to reclassify individuals after first risk estimation [3] .…”

Section: Introductionmentioning

confidence: 99%

The Effectiveness of the Cardiovascular Disease Prevention Programme ‘KardioPro’ Initiated by a German Sickness Fund: A Time-to-Event Analysis of Routine Data

et al. 2014

View full text Add to dashboard Cite

BackgroundCardiovascular disease is the leading cause of morbidity and mortality in the developed world. To reduce this burden of disease, a German sickness fund (‘Siemens-Betriebskrankenkasse’, SBK) initiated the prevention programme ‘KardioPro’ including primary (risk factor reduction) and secondary (screening) prevention and guideline-based treatment. The aim of this study was to assess the effectiveness of ‘KardioPro’ as it is implemented in the real world.MethodsThe study is based on sickness fund routine data. The control group was selected from non-participants via propensity score matching. Study analysis was based on time-to-event analysis via Cox proportional hazards regression with the endpoint ‘all-cause mortality, acute myocardial infarction (MI) and ischemic stroke (1)’, ‘all-cause mortality (2)’ and ‘non-fatal acute MI and ischemic stroke (3)’.ResultsA total of 26,202 insurants were included, 13,101 participants and 13,101 control subjects. ‘KardioPro’ enrolment was associated with risk reductions of 23.5% (95% confidence interval (CI) 13.0–32.7%) (1), 41.7% (95% CI 30.2–51.2%) (2) and 3.5% (hazard ratio 0.965, 95% CI 0.811–1.148) (3). This corresponds to an absolute risk reduction of 0.29% (1), 0.31% (2) and 0.03% (3) per year.ConclusionThe prevention programme initiated by a German statutory sickness fund appears to be effective with regard to all-cause mortality. The non-significant reduction in non-fatal events might result from a shift from fatal to non-fatal events.

show abstract

Limited Economic Evidence of Carotid Artery Stenosis Diagnosis and Treatment: A Systematic Review

Cited by 7 publications

References 46 publications

Prevalence of carotid artery stenosis in ischaemic heart disease patients in Bangladesh

Prevalence of carotid artery stenosis in ischaemic heart disease patients in Bangladesh

Risk Factors for Carotid Artery Stenosis in Chinese Patients Undergoing Coronary Artery Bypass Graft Interventions

The Effectiveness of the Cardiovascular Disease Prevention Programme ‘KardioPro’ Initiated by a German Sickness Fund: A Time-to-Event Analysis of Routine Data

Contact Info

Product

Resources

About