The Impact of Hemoglobin A1c on Outcomes After Lower Extremity Bypass

Abstract

A total of 133,069 CEAs were performed in 120,754 patients. The majority of CEAs were performed for asymptomatic disease (84.1%), with rates increasing for symptomatic disease in recent years (Table I). The majority of symptomatic disease was previous stroke/infarct (74.6%), followed by TIA (14.1%), then amaurosis fugax (11.2%). The rates of inhospital stroke were significantly higher for symptomatic disease than for asymptomatic disease (6.1% vs 0.5%; P < .001). The majority of CEAs for symptomatic disease were performed within 2 days of hospitalization (65.9%), followed by 3 to 7 days (28.3%), 8 to 14 days (5.2%), and >14 days (0.7%). Delay of CEA by 3 to 7 days after hospitalization was associated with lower postoperative stroke (OR, 0.43; 95% CI, 0.37-0.41); however, waiting >14 days was not associated with a lower risk (Table II). Compared with TIA, amaurosis fugax was associated with a lower rate (OR, 0.15; 95%, CI, 0.08-0.30), and previous infarct/stroke was associated with a higher stroke rate (OR, 3.5; 95% CI, 2.68-4.51). Conclusions: Although this study found a significant association between lower postoperative stroke and CEA with delayed timing after admission up to 2 weeks, further studies including randomized controlled trials are needed to define the optimal timing of CEA for symptomatic carotid artery disease.