Does metabolic syndrome influence short and long term durability of carotid endarterectomy and stenting?

Renato Casana, Chiara Malloggi, Valerio Stefano Tolva, Andrea Odero, Richard Bulbulia, Alison Halliday, Vincenzo Silani

Research output: Contribution to journalArticle

Abstract

AIMS: The metabolic syndrome (MetS) is composed of a cluster of related cardiovascular risk factors. The aim of the present study was to determine how MetS contributes to short- (30-day) and long-term complications and restenosis after carotid endarterectomy (CEA) or stenting (CAS).

METHODS: A consecutive cohort of 752 patients undergoing CEA (n = 314) and CAS (n = 438) in a single institution was examined, of which 296 (39.4%) were identified as having MetS. All patients were followed-up with carotid duplex ultrasound scan of the supraaortic vessels and a neurological assessment of symptoms status at 30-day postprocedure and at 3, 6, and 12 months, with annual follow-up thereafter for 3 years.

RESULTS: Patients with MetS had a significant increased risk in their 30-day death, major adverse events (MAE), and restenosis rates, both after CEA and after CAS (death: 0.7% vs 0.0%; MAE: 5.3% vs 2.7%; and restenosis: 1.7% vs 0.2%; p < 0.05). The MAE and restenosis rates remained statistically different at 36 months, with both procedures (29.2% vs 24.2% and 9.5% vs 3.3%, p < 0.05, for patients with and without MetS, respectively). Among the components of MetS, high fasting serum glucose, low high-density lipoprotein cholesterol, and elevated body mass index were associated with increased risk of complications at 30 days and within 36 months.

CONCLUSIONS: The current study suggested that the presence of MetS is an important risk factor for morbidity and restenosis after CEA and CAS.

Original languageEnglish
Pages (from-to)e3084
JournalDiabetes/Metabolism Research and Reviews
Volume35
Issue number1
DOIs
Publication statusPublished - Jan 2019

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Carotid Endarterectomy
Symptom Assessment
SHORT syndrome
LDL Cholesterol
HDL Cholesterol
Fasting
Body Mass Index
Morbidity
Glucose
Serum

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Does metabolic syndrome influence short and long term durability of carotid endarterectomy and stenting? / Casana, Renato; Malloggi, Chiara; Tolva, Valerio Stefano; Odero, Andrea; Bulbulia, Richard; Halliday, Alison; Silani, Vincenzo.

In: Diabetes/Metabolism Research and Reviews, Vol. 35, No. 1, 01.2019, p. e3084.

Research output: Contribution to journalArticle

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abstract = "AIMS: The metabolic syndrome (MetS) is composed of a cluster of related cardiovascular risk factors. The aim of the present study was to determine how MetS contributes to short- (30-day) and long-term complications and restenosis after carotid endarterectomy (CEA) or stenting (CAS).METHODS: A consecutive cohort of 752 patients undergoing CEA (n = 314) and CAS (n = 438) in a single institution was examined, of which 296 (39.4{\%}) were identified as having MetS. All patients were followed-up with carotid duplex ultrasound scan of the supraaortic vessels and a neurological assessment of symptoms status at 30-day postprocedure and at 3, 6, and 12 months, with annual follow-up thereafter for 3 years.RESULTS: Patients with MetS had a significant increased risk in their 30-day death, major adverse events (MAE), and restenosis rates, both after CEA and after CAS (death: 0.7{\%} vs 0.0{\%}; MAE: 5.3{\%} vs 2.7{\%}; and restenosis: 1.7{\%} vs 0.2{\%}; p < 0.05). The MAE and restenosis rates remained statistically different at 36 months, with both procedures (29.2{\%} vs 24.2{\%} and 9.5{\%} vs 3.3{\%}, p < 0.05, for patients with and without MetS, respectively). Among the components of MetS, high fasting serum glucose, low high-density lipoprotein cholesterol, and elevated body mass index were associated with increased risk of complications at 30 days and within 36 months.CONCLUSIONS: The current study suggested that the presence of MetS is an important risk factor for morbidity and restenosis after CEA and CAS.",
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T1 - Does metabolic syndrome influence short and long term durability of carotid endarterectomy and stenting?

AU - Casana, Renato

AU - Malloggi, Chiara

AU - Tolva, Valerio Stefano

AU - Odero, Andrea

AU - Bulbulia, Richard

AU - Halliday, Alison

AU - Silani, Vincenzo

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N2 - AIMS: The metabolic syndrome (MetS) is composed of a cluster of related cardiovascular risk factors. The aim of the present study was to determine how MetS contributes to short- (30-day) and long-term complications and restenosis after carotid endarterectomy (CEA) or stenting (CAS).METHODS: A consecutive cohort of 752 patients undergoing CEA (n = 314) and CAS (n = 438) in a single institution was examined, of which 296 (39.4%) were identified as having MetS. All patients were followed-up with carotid duplex ultrasound scan of the supraaortic vessels and a neurological assessment of symptoms status at 30-day postprocedure and at 3, 6, and 12 months, with annual follow-up thereafter for 3 years.RESULTS: Patients with MetS had a significant increased risk in their 30-day death, major adverse events (MAE), and restenosis rates, both after CEA and after CAS (death: 0.7% vs 0.0%; MAE: 5.3% vs 2.7%; and restenosis: 1.7% vs 0.2%; p < 0.05). The MAE and restenosis rates remained statistically different at 36 months, with both procedures (29.2% vs 24.2% and 9.5% vs 3.3%, p < 0.05, for patients with and without MetS, respectively). Among the components of MetS, high fasting serum glucose, low high-density lipoprotein cholesterol, and elevated body mass index were associated with increased risk of complications at 30 days and within 36 months.CONCLUSIONS: The current study suggested that the presence of MetS is an important risk factor for morbidity and restenosis after CEA and CAS.

AB - AIMS: The metabolic syndrome (MetS) is composed of a cluster of related cardiovascular risk factors. The aim of the present study was to determine how MetS contributes to short- (30-day) and long-term complications and restenosis after carotid endarterectomy (CEA) or stenting (CAS).METHODS: A consecutive cohort of 752 patients undergoing CEA (n = 314) and CAS (n = 438) in a single institution was examined, of which 296 (39.4%) were identified as having MetS. All patients were followed-up with carotid duplex ultrasound scan of the supraaortic vessels and a neurological assessment of symptoms status at 30-day postprocedure and at 3, 6, and 12 months, with annual follow-up thereafter for 3 years.RESULTS: Patients with MetS had a significant increased risk in their 30-day death, major adverse events (MAE), and restenosis rates, both after CEA and after CAS (death: 0.7% vs 0.0%; MAE: 5.3% vs 2.7%; and restenosis: 1.7% vs 0.2%; p < 0.05). The MAE and restenosis rates remained statistically different at 36 months, with both procedures (29.2% vs 24.2% and 9.5% vs 3.3%, p < 0.05, for patients with and without MetS, respectively). Among the components of MetS, high fasting serum glucose, low high-density lipoprotein cholesterol, and elevated body mass index were associated with increased risk of complications at 30 days and within 36 months.CONCLUSIONS: The current study suggested that the presence of MetS is an important risk factor for morbidity and restenosis after CEA and CAS.

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