Evaluation of Perioperative Major Adverse Cardiac Events in Patients with Coronary Artery Disease Undergoing Carotid Endarterectomy.

Abstract

Background: Major adverse cardiac events (MACE) are the leading cause of morbidity and mortality during carotid endarterectomy (CEA). The primary outcome of the study was to assess the incidence of perioperative MACE and non-MACE in patients with coronary artery disease (CAD) undergoing CEA. The secondary objectives were to analyze the incidence of MACE and non-MACE based on various perioperative risk factors.

Methods: This retrospective study included patients with CAD who underwent CEA for carotid artery disease from July 2013 to June 2023. We analyzed the incidence of perioperative MACE and non-MACE and its association with revised cardiac risk index (RCRI) score, previous coronary revascularization, beta-blocker therapy, previous myocardial infarction (MI), the time interval from stroke to CEA, and multivessel CAD.

Results: Medical records of 101 patients were studied. The incidence rates of perioperative MACE and non-MACE were around 18.8% and 15.8%, respectively. A preoperative coronary revascularized patient to develop patient's odds of developing a MACE (OR: 0.184, CI: 0.0398-0.8497) and non-MACE (OR: 0.051, CI: 0.0132-8.331) were lower than a non-revascularized patient. There were no significant differences in the incidence of perioperative MACE and non-MACE concerning RCRI score, beta-blocker therapy, previous MI, varying time intervals from stroke to surgery, and severity of CAD.

Conclusion: There was a higher incidence of perioperative MACE and non-MACE in patients with CAD undergoing CEA. Preoperative coronary revascularization reduced the incidence of perioperative cardiovascular events in these subsets of patients.