Abstract:
BACKGROUND:Carotid endarterectomy (CEA) is an effective surgical option for stroke prophylaxis for most patients. Restenosis after CEA can lead to additional interventions and adverse outcomes, but the factors that predict restenosis are poorly understood. This study examined which risk factors, such as metabolic syndrome (MetS), are associated with restenosis after CEA. STUDY DESIGN:This retrospective study examined the records of all patients who underwent CEA at the Veterans Affairs Connecticut Healthcare System during a 4-year period. Metabolic syndrome was defined as the presence of 3 or more of the following: hypertension (blood pressure ≥130 mmHg/≥85 mmHg); serum triglycerides ≥150 mg/dL; high-density lipoprotein ≤40 mg/dL; BMI ≥25 kg/m(2); and fasting blood glucose ≥110 mg/dL. Major adverse events were defined as death, stroke, or MI. Restenosis was defined as >50% stenosis on follow-up imaging. RESULTS:Seventy-eight patients underwent 79 CEAs during the study period. All patients were male and 76% were white. Mean patient age was 72.6 years. The mean duration of follow-up was 5.2 years. Sixty-seven percent of patients had MetS. Patients with MetS were comparable with those without MetS in demographics and preoperative comorbidities, except for increased hypertension and diabetes, as expected, and chronic renal insufficiency (p = 0.05). There was no significant difference in long-term survival or freedom from MAE between patients with and without MetS. Restenosis was significantly higher in patients with MetS (p = 0.02) and occurred 2 years after CEA in patients with MetS only, with a large increase in restenosis after 5 years (p = 0.018). MetS was an independent predictor of restenosis in multivariable analysis (p = 0.01). CONCLUSIONS:Metabolic syndrome is an independent predictor for restenosis after CEA in a high-risk population. More frequent and/or long-term surveillance might be warranted in patients with MetS after CEA.
journal_name
J Am Coll Surgjournal_title
Journal of the American College of Surgeonsauthors
Williams WT,Assi R,Hall MR,Protack CD,Lu DY,Wong DJ,Vasilas P,Dardik Adoi
10.1016/j.jamcollsurg.2014.04.014subject
Has Abstractpub_date
2014-10-01 00:00:00pages
771-7issue
4eissn
1072-7515issn
1879-1190pii
S1072-7515(14)00433-5journal_volume
219pub_type
杂志文章abstract:BACKGROUND:Adopting a unified staging system for pancreatic neuroendocrine tumors (PNETs) has been challenging. Currently, the American Joint Committee on Cancer (AJCC) recommends use of the pancreatic adenocarcinoma staging system for PNETs. We sought to explore the prognostic usefulness of the pancreatic adenocarcino...
journal_title:Journal of the American College of Surgeons
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journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:
更新日期:1994-10-01 00:00:00
abstract::A nationwide survey of patterns of care for carcinoma of the breast was conducted by the Commission on Cancer of the American College of Surgeons. Information regarding patient history, diagnostic tests, treatment, survival and disease status was obtained for 17,295 patients treated during 1983 and 24,356 patients tre...
journal_title:Journal of the American College of Surgeons
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doi:
更新日期:1994-03-01 00:00:00
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journal_title:Journal of the American College of Surgeons
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abstract:BACKGROUND:The majority of newly diagnosed breast cancers in the US are in women aged older than 65 years who can have additional comorbidities. Balancing the risks and benefits of treatment should take into account these competing risks of death. STUDY DESIGN:The Surveillance, Epidemiology, and End Results Program-Me...
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journal_title:Journal of the American College of Surgeons
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更新日期:2014-09-01 00:00:00
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pub_type: 杂志文章,多中心研究
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pub_type: 共识发展会议,杂志文章
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更新日期:2012-10-01 00:00:00
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journal_title:Journal of the American College of Surgeons
pub_type: 临床试验,杂志文章,随机对照试验
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journal_title:Journal of the American College of Surgeons
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journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
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