Abstract
Objective: To evaluate the impact of statins on carotid restenosis (CR) >50% and future cardiovascular events (CVE), in patients undergoing carotid endarterectomy (CEA).
Methods: 570 consecutive patients (656 CEAs) operated between 1990 and 2009, were included in this retrospective study. The study cohort was followed for an average of 82 months (median 80, range 12- 180 months). Endpoints were the development of CR >50%, the occurrence of CVE (myocardial infarction, stroke) and overall mortality. Kaplan-Meier curves and Cox regression models were used to assess outcomes.
Results: 92 restenosis events were recorded. Freedom from restenosis >50% at 5, 10 and 15 years of follow-up was 92, 82 and 69%, respectively. Compared with statin-receivers, statin-free patients had a significantly higher 15-year restenosis rate (41 vs 10%; P = .001), a significantly higher CVE rate (49 vs 14%; P = .001) and a significantly higher mortality rate (24 vs 18%; P = .034). Adjusting for other covariates statins were independently associated with lower restenosis rate (hazard ratio [HR], 0.52; 95% CI, 0.31-0.88; P= .016), cardiovascular events (HR, 0.40; 95% CI, 0.26-0.61; P < 0.001) and long-term mortality (HR, 0.56; 95% CI, 0.33-0.95; P = .032).
Conclusion: Statins not only reduce cardiovascular events and mortality but may also have an important effect on the anatomic durability of CEA. These data support the use of statins in patients with carotid stenosis undergoing CEA.
Keywords: Carotid endarterectomy, restenosis, mortality, echolucent plaque, statins.
Current Vascular Pharmacology
Title:Statins Influence Long Term Restenosis and Cardiovascular Events Following Carotid Endarterectomy
Volume: 13 Issue: 2
Author(s): Efthymios D. Avgerinos, John D. Kakisis, Konstantinos G. Moulakakis, Triantafillos G. Giannakopoulos, George Sfyroeras, Constantinos N. Antonopoulos, Nikolaos P. Kadoglou and Christos D. Liapi
Affiliation:
Keywords: Carotid endarterectomy, restenosis, mortality, echolucent plaque, statins.
Abstract: Objective: To evaluate the impact of statins on carotid restenosis (CR) >50% and future cardiovascular events (CVE), in patients undergoing carotid endarterectomy (CEA).
Methods: 570 consecutive patients (656 CEAs) operated between 1990 and 2009, were included in this retrospective study. The study cohort was followed for an average of 82 months (median 80, range 12- 180 months). Endpoints were the development of CR >50%, the occurrence of CVE (myocardial infarction, stroke) and overall mortality. Kaplan-Meier curves and Cox regression models were used to assess outcomes.
Results: 92 restenosis events were recorded. Freedom from restenosis >50% at 5, 10 and 15 years of follow-up was 92, 82 and 69%, respectively. Compared with statin-receivers, statin-free patients had a significantly higher 15-year restenosis rate (41 vs 10%; P = .001), a significantly higher CVE rate (49 vs 14%; P = .001) and a significantly higher mortality rate (24 vs 18%; P = .034). Adjusting for other covariates statins were independently associated with lower restenosis rate (hazard ratio [HR], 0.52; 95% CI, 0.31-0.88; P= .016), cardiovascular events (HR, 0.40; 95% CI, 0.26-0.61; P < 0.001) and long-term mortality (HR, 0.56; 95% CI, 0.33-0.95; P = .032).
Conclusion: Statins not only reduce cardiovascular events and mortality but may also have an important effect on the anatomic durability of CEA. These data support the use of statins in patients with carotid stenosis undergoing CEA.
Export Options
About this article
Cite this article as:
Avgerinos D. Efthymios, Kakisis D. John, Moulakakis G. Konstantinos, Giannakopoulos G. Triantafillos, Sfyroeras George, Antonopoulos N. Constantinos, Kadoglou P. Nikolaos and Liapi D. Christos, Statins Influence Long Term Restenosis and Cardiovascular Events Following Carotid Endarterectomy, Current Vascular Pharmacology 2015; 13 (2) . https://dx.doi.org/10.2174/15701611113119990130
DOI https://dx.doi.org/10.2174/15701611113119990130 |
Print ISSN 1570-1611 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-6212 |
Call for Papers in Thematic Issues
Ischemic Cardiovascular Diseases: Mechanisms, Diagnosis and Therapy
Ischemic cardiovascular disease includes myocardial infarction, coronary atherosclerotic heart disease, angina pectoris, etc., constitute the leading cause of patient mortality by preventing tissues from getting sufficient oxygen and nutrients. Ischemic heart disease, as a clinical condition, is characterized by myocardial ischemia, causing an imbalance between myocardial blood supply and demand, ...read more
TREATMENT OF CARDIOVASCULAR DISEASE IN CHRONIC AND END STAGE KIDNEY DISEASE
Cardiovascular disease still remains the leading cause of death in Chronic and End Stage Kidney Disease, accounting for more than half of all deaths in dialysis patients. During the past decade, research has been focused on novel therapeutic agents that might delay or even reverse cardiovascular disease and vascular calcification, ...read more
- Author Guidelines
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
- Announcements
Related Articles
-
Processing and Regulation Mechanisms within Antigen Presenting Cells: A Possibility for Therapeutic Modulation
Current Pharmaceutical Design Restoring the Dysfunctional Endothelium
Current Pharmaceutical Design Cardiac Complications in Hypertension and Diabetes: Role of Sympathetic Nervous Activity
Current Hypertension Reviews An Overview of Nanoformulated Nutraceuticals and their Therapeutic Approaches
Current Nutrition & Food Science Editorial (Thematic Issue: Current Updates on Association Between Alzheimer’s Disease and Type 2 Diabetes Mellitus - Volume II)
CNS & Neurological Disorders - Drug Targets Pleiotropic Effects of Statins in Atherosclerotic Disease: Focus on the Antioxidant Activity of Atorvastatin
Current Topics in Medicinal Chemistry The Adverse Effects of Smoking on Health Outcomes in Bipolar Disorder: A Review and Synthesis of Biological Mechanisms
Current Molecular Medicine Hypothermia and Alzheimer's Disease Neuropathogenic Pathways
Current Alzheimer Research Therapeutic Implications of Gene Deletion of Ligands and Receptors of Members of TNF Superfamily
Medicinal Chemistry Reviews - Online (Discontinued) Progress in Nutritional and Health Profile of Milk and Dairy Products: A Novel Drug Target
Endocrine, Metabolic & Immune Disorders - Drug Targets Metformin and Pregnancy Outcomes: Evidence Gaps and Unanswered Questions
Current Clinical Pharmacology Insulin Resistance and Endothelial Dysfunction: A Mutual Relationship in Cardiometabolic Risk
Current Pharmaceutical Design Promising Recent Regenerative Medicine Patents in Plastic and Reconstructive Surgery: Nanotechnology, Structural Fat Grafting, Bone Repair and Regeneration, and Microvascular Surgery
Recent Patents on Regenerative Medicine Understanding the Role of Aldose Reductase in Ocular Inflammation
Current Molecular Medicine Model for Gestational Diabetes on Web Based Parameters
Recent Patents on Engineering Medical Treatment of Critical Limb Ischemia: Current State and Future Directions
Current Vascular Pharmacology Drug Interactions with Angiotensin Receptor Blockers: Role of Human Cytochromes P450
Current Drug Metabolism Perioperative Glycemic Management in Insulin Pump Patients Undergoing Noncardiac Surgery
Current Pharmaceutical Design Mediterranean Diet and the Metabolic Syndrome: The Role of Protein
Current Nutrition & Food Science Interleukin-21 in Immune and Allergic Diseases
Inflammation & Allergy - Drug Targets (Discontinued)