Prevalence and Risk Factors Analysis of Carotid Stenosis Among Ischaemic Heart Diseases Patient in Bangladesh: A Cross-Sectional Study

Ranjan, Redoy; Adhikary, Dipal Krishna; Das, D.; Adhikary, Asit Baran

doi:10.2147/ijgm.s349846

Cited by 6 publications

(18 citation statements)

References 21 publications

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“…Several studies reported the risk factors of significant CAS, such as a history of cerebrovascular accident, diabetes mellitus, hypertension, dyslipidemia, and obesity [10][11]17]. Our study demonstrates a positive relationship between age and the severity of CAS, with older patients displaying a significant association (p < 0.001).…”

Section: Discussionsupporting

confidence: 54%

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Prevalence and Risk Factors of Carotid Artery Stenosis (CAS) Among Cardiac Surgery Patients

Alsalmi¹,

Abdeen²

2023

Cureus

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Introduction: Cardiac disease and carotid atherosclerosis rates have increased in recent years. Carotid artery stenosis (CAS) has been recognized as a high-risk factor of perioperative stroke among cardiac surgery patients.Aims: The aims of the study are to identify the prevalence and common risk factors of CAS among patients undergoing cardiac surgery that include coronary artery bypass surgery or valvular cardiac surgery.Materials and Methods: This retrospective cross-sectional study was conducted in the radiology department at Medina Cardiac Center, Al Madinah Al-Munawara. The inclusion criteria for the study were patients aged ≥ 20 years who were scheduled for coronary artery bypass surgery or valvular cardiac surgery and had carotid duplex examination before surgery. A Philips X matrix IU22 linear-array ultrasound probe (Philips, Bothell, WA) was used to scan the common carotid artery (CCA), internal carotid artery (ICA), external carotid artery (ECA), and vertebral artery.Results: Of the 261 patients in this study, 78.5% ( n = 205) were male. The mean age of patients was 61.6 ± 11.3 years (median: 62.0; range: 55.5-68.0). The overall prevalence of CAS was 71% (n = 187): 52% (n = 136) with bilateral CAS and 19.5% (n = 51) with unilateral CAS. Age group was significantly associated with bilateral CAS and the severity of CAS (p = 0.001). Diabetes mellitus, hypertension and both diabetes mellitus and hypertension together were significantly associated with CAS status (p < 0.05, for all). A significantly higher proportion of smokers had a mild level of CAS on the left side compared to non-smokers (55.8% vs. 46.5%, p = 0.033). Gender and weight status were not linked to severity of CAS. Conclusion:This study shows a high prevalence of CAS among cardiac surgery patients. In addition, older age, diabetes mellitus, and hypertension were found to be major risk factors for CAS. Gender and weight status were not associated with CAS. Preoperative carotid duplex scan is a useful exam to identify CAS among cardiac surgery patients and, therefore, to predict and reduce postoperative neurological complications.

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Section: Discussionsupporting

confidence: 54%

“…However, Ranjan et al (2022) found the overall prevalence of CAS to be 13% lower than the findings in our study. This study contrasts with the aforementioned study, in which there were specific selection criteria and the prevalence of CAS was only found in patients undergoing CABG, with other types of cardiac surgery excluded [11].…”

Section: Discussionmentioning

confidence: 69%

Prevalence and Risk Factors of Carotid Artery Stenosis (CAS) Among Cardiac Surgery Patients

Alsalmi¹,

Abdeen²

2023

Cureus

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“…Following cardiac surgery, pain disrupts the humoral and neuroendocrine systems' equilibrium, increasing stress hormone levels and myocardial oxygen demand. 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 As a result, arrhythmias and myocardial ischemia are increased. Pain also impairs mechanical ventilation and mobility restriction.…”

Section: Literature Reviewmentioning

confidence: 99%

“…Oxygen supply‐demand mismatch can lead to myocardial ischemia, detrimental to patient outcomes. 7 , 8 Optimal postoperative pain management with a regular and routine assessment of pain will improve postoperative outcomes. The patient's assessment of pain using a visual analog scale (VAS) is the most reliable and should be used when possible.…”

Section: Introductionmentioning

confidence: 99%

“…International Association for the Study of Pain (IASP) defined pain as “An unpleasant sensory and emotional experience associated with or resembling that associated with, actual, or potential tissue damage.” 6 Postoperative pain stimulates the sympathetic nervous system and increases myocardial oxygen consumption. Oxygen supply‐demand mismatch can lead to myocardial ischemia, detrimental to patient outcomes 7,8 . Optimal postoperative pain management with a regular and routine assessment of pain will improve postoperative outcomes.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of traditional and upper thoracic epidural analgesia after off‐pump coronary artery bypass graft surgery: A Quasi‐experimental study

Saha

Ranjan

Adhikary

2022

Health Science Reports

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Background and Aims Surgical trauma initiates changes in central and peripheral nervous systems that need to be treated therapeutically to facilitate postoperative pain. The quality of postoperative analgesia is expected to affect clinical outcomes positively. Albeit optimal pain relief following cardiac surgery is often complex, researchers have tried to explore several techniques other than conventional ones during the last decade to find a unique analgesic method for postcardiac surgical patients. This study aims to find a unique analgesic approach that maximizes patient satisfaction after off‐pump coronary artery bypass graft (OPCABG) surgery. Methods The current study will compare the analgesic effect of upper thoracic epidural analgesia (TEA) with conventional analgesia after OPCAB graft surgery. For this, we will use a Quasi‐experimental study design. Patients admitted for coronary artery bypass graft (CABG) surgery will be assigned into two groups. The control group (conventional) will receive intravenous opioids and nonsteroidal anti‐inflammatory medications, and the study (case) group (TEA) will receive Inj. Bupivacaine 0.25% as an infusion through the epidural catheter. Physiologic parameters like hemodynamic and respiratory variables and pain scores will be recorded in predesigned format periodically. Results We expect to analyze a total of 130 consecutive off‐pump CABG surgery patients in Group A (Case, 65 patients) and Group B (Control, 65 patients). Study variables will be the visual analog scale score, hemodynamic parameters (heart rate, mean arterial pressure, and respiratory parameters (respiratory rate, PaO 2 , PaCO 2 , PEFR, FEV 1 ). After data collection, the result will be analyzed and published in the public domain and in journals. Conclusion We expect thoracic epidural analgesia with local anesthetics will be a reliable postoperative analgesic option.

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National and Provincial-Level Prevalence and Risk Factors of Carotid Atherosclerosis in Chinese Adults

Fu,

Deng,

et al. 2024

JAMA Netw Open

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ImportanceEpidemiologic studies on carotid atherosclerosis (CAS) based on nationwide ultrasonography measurements can contribute to understanding the future risk of cardiovascular diseases and identifying high-risk populations, thereby proposing more targeted prevention and treatment measures.ObjectivesTo estimate the prevalence of CAS within the general population of China and to investigate its distribution among populations with potential risk factors and variation across diverse geographic regions.Design, Setting, and ParticipantsThis multicenter, population-based cross-sectional study used China’s largest health check-up chain database to study 10 733 975 individuals aged 20 years or older from all 31 provinces in China who underwent check-ups from January 1, 2017, to June 30, 2022.Main Outcomes and MeasuresCarotid atherosclerosis was assessed and graded using ultrasonography as increased carotid intima-media thickness (cIMT), carotid plaque (CP), and carotid stenosis (CS). The overall and stratified prevalences were estimated among the general population and various subpopulations based on demographic characteristics, geographic regions, and cardiovascular disease risk factors. Mixed-effects regression models were used to analyze the risk factors for CAS.ResultsAmong 10 733 975 Chinese participants (mean [SD] age, 47.7 [13.4] years; 5 861 566 [54.6%] male), the estimated prevalences were 26.2% (95% CI, 25.0%-27.4%) for increased cIMT, 21.0% (95% CI, 19.8%-22.2%) for CP, and 0.56% (95% CI, 0.36%-0.76%) for CS. The prevalence of all CAS grades was higher among older adults (eg, increased cIMT: aged ≥80 years, 92.7%; 95% CI, 92.2%-93.3%), male participants (29.6%; 95% CI, 28.4%-30.7%), those residing in northern China (31.0%; 95% CI, 29.1%-32.9%), and those who had comorbid conditions, such as hypertension (50.8%; 95% CI, 49.7%-51.9%), diabetes (59.0%; 95% CI, 57.8%-60.1%), dyslipidemia (32.1%; 95% CI, 30.8%-33.3%), and metabolic syndrome (31.0%; 95% CI, 29.1%-32.9%). Most cardiovascular disease risk factors were independent risk factors for all CAS stages (eg, hypertension: 1.60 [95% CI, 1.60-1.61] for increased cIMT, 1.62 [95% CI, 1.62-1.63] for CP, and 1.48 [95% CI, 1.45-1.51] for CS). Moreover, the magnitude of the association between several cardiovascular disease risk factors and increased cIMT and CP differed between the sexes and geographic regions.Conclusions and RelevanceThese findings suggest that nearly one-quarter of Chinese adults have increased cIMT or CP. The burden of this disease is unevenly distributed across geographic regions and subpopulations and may require different levels of local planning, support, and management. Addressing these disparities is crucial for effectively preventing and managing cardiovascular and cerebrovascular diseases in China.

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Prevalence and Risk Factors Analysis of Carotid Stenosis Among Ischaemic Heart Diseases Patient in Bangladesh: A Cross-Sectional Study

Cited by 6 publications

References 21 publications

Prevalence and Risk Factors of Carotid Artery Stenosis (CAS) Among Cardiac Surgery Patients

Prevalence and Risk Factors of Carotid Artery Stenosis (CAS) Among Cardiac Surgery Patients

Comparison of traditional and upper thoracic epidural analgesia after off‐pump coronary artery bypass graft surgery: A Quasi‐experimental study

National and Provincial-Level Prevalence and Risk Factors of Carotid Atherosclerosis in Chinese Adults

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