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The long-term outcome of carotid artery stenting or antiplatelet therapy in patients with severe carotid artery stenosis
Objective: To identify the prognosis factors of the patients with high-degree carotid artery stenosis and evaluate the effects of carotid artery stenting and antiplatelet therapy prospectively. Methods: Patients with severe carotid artery stenosis were enrolled in this study consecutively. Intervent...
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Published in: | Neurological research (New York) 2009-05, Vol.31 (4), p.371-375 |
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creator | Sun, Yu-Heng Ma, Zhi-Gang Zheng, Hua-Guang Peng, Xiao-Xin Xin, Yan |
description | Objective: To identify the prognosis factors of the patients with high-degree carotid artery stenosis and evaluate the effects of carotid artery stenting and antiplatelet therapy prospectively.
Methods: Patients with severe carotid artery stenosis were enrolled in this study consecutively. Intervention was carotid artery stenting combined with antiplatelet therapy or antiplatelet therapy solely. No randomized method was used in this trail. Patients were monitored for 2 years after enrolling in this study. The primary end point was defined as neurological outcome (measured by modified Rankin score). The secondary end points were the composite of stroke, transient ischemic attack (TIA), acute myocardial infarction and sudden death.
Results: One hundred and three patients were enrolled into this work between May 2001 and August 2006 at the Fourth Hospital, Peking University. Forty patients were treated with stent placement, and 63 patients were treated only with antiplatelet drug. The baseline characteristics (gender, age, medical history, blood pressure, total cholesterol and triglyceride) were similar between the groups. Binary logistic analysis indicated that intra-artery intervention was an independent protective factor for malignant functional outcome (modified Rankin scale 3-6; relative risk: 0.13, p |
doi_str_mv | 10.1179/174313209X444062 |
format | article |
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Methods: Patients with severe carotid artery stenosis were enrolled in this study consecutively. Intervention was carotid artery stenting combined with antiplatelet therapy or antiplatelet therapy solely. No randomized method was used in this trail. Patients were monitored for 2 years after enrolling in this study. The primary end point was defined as neurological outcome (measured by modified Rankin score). The secondary end points were the composite of stroke, transient ischemic attack (TIA), acute myocardial infarction and sudden death.
Results: One hundred and three patients were enrolled into this work between May 2001 and August 2006 at the Fourth Hospital, Peking University. Forty patients were treated with stent placement, and 63 patients were treated only with antiplatelet drug. The baseline characteristics (gender, age, medical history, blood pressure, total cholesterol and triglyceride) were similar between the groups. Binary logistic analysis indicated that intra-artery intervention was an independent protective factor for malignant functional outcome (modified Rankin scale 3-6; relative risk: 0.13, p<0.001, 95% confidence interval: 0.036-0.46). For further follow-up, the median time of cardiovascular events in the two groups were 55 and 54 months, respectively. K-M analysis showed no statistical significance difference.
Conclusion: Carotid artery stenting combined with antiplatelet therapy may be helpful for high-risk patients with severe carotid artery stenosis. The benefit/harm of intra-artery intervention for patients with stroke or TIA suffered as a result of severe carotid artery stenosis in the long-term needs further evaluation.</description><identifier>ISSN: 0161-6412</identifier><identifier>EISSN: 1743-1328</identifier><identifier>DOI: 10.1179/174313209X444062</identifier><identifier>PMID: 19508821</identifier><language>eng</language><publisher>England: Taylor & Francis</publisher><subject>Aged ; Analysis of Variance ; Angiography, Digital Subtraction - methods ; Angioplasty, Balloon - methods ; ANTIPLATELET ; Carotid Arteries - surgery ; CAROTID ARTERY ; Carotid Stenosis - drug therapy ; Carotid Stenosis - therapy ; Female ; FOLLOW-UP ; Humans ; Logistic Models ; Male ; Middle Aged ; Platelet Aggregation Inhibitors - therapeutic use ; Retrospective Studies ; STENOSIS ; STENTS ; Survival Analysis ; Treatment Outcome</subject><ispartof>Neurological research (New York), 2009-05, Vol.31 (4), p.371-375</ispartof><rights>2009 Maney Publishing 2009</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c380t-ac8b1e53b77f381bcf92f655f9f5ea65bfc40ff8067468baf638feb8cf241be53</citedby><cites>FETCH-LOGICAL-c380t-ac8b1e53b77f381bcf92f655f9f5ea65bfc40ff8067468baf638feb8cf241be53</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19508821$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Sun, Yu-Heng</creatorcontrib><creatorcontrib>Ma, Zhi-Gang</creatorcontrib><creatorcontrib>Zheng, Hua-Guang</creatorcontrib><creatorcontrib>Peng, Xiao-Xin</creatorcontrib><creatorcontrib>Xin, Yan</creatorcontrib><title>The long-term outcome of carotid artery stenting or antiplatelet therapy in patients with severe carotid artery stenosis</title><title>Neurological research (New York)</title><addtitle>Neurol Res</addtitle><description>Objective: To identify the prognosis factors of the patients with high-degree carotid artery stenosis and evaluate the effects of carotid artery stenting and antiplatelet therapy prospectively.
Methods: Patients with severe carotid artery stenosis were enrolled in this study consecutively. Intervention was carotid artery stenting combined with antiplatelet therapy or antiplatelet therapy solely. No randomized method was used in this trail. Patients were monitored for 2 years after enrolling in this study. The primary end point was defined as neurological outcome (measured by modified Rankin score). The secondary end points were the composite of stroke, transient ischemic attack (TIA), acute myocardial infarction and sudden death.
Results: One hundred and three patients were enrolled into this work between May 2001 and August 2006 at the Fourth Hospital, Peking University. Forty patients were treated with stent placement, and 63 patients were treated only with antiplatelet drug. The baseline characteristics (gender, age, medical history, blood pressure, total cholesterol and triglyceride) were similar between the groups. Binary logistic analysis indicated that intra-artery intervention was an independent protective factor for malignant functional outcome (modified Rankin scale 3-6; relative risk: 0.13, p<0.001, 95% confidence interval: 0.036-0.46). For further follow-up, the median time of cardiovascular events in the two groups were 55 and 54 months, respectively. K-M analysis showed no statistical significance difference.
Conclusion: Carotid artery stenting combined with antiplatelet therapy may be helpful for high-risk patients with severe carotid artery stenosis. The benefit/harm of intra-artery intervention for patients with stroke or TIA suffered as a result of severe carotid artery stenosis in the long-term needs further evaluation.</description><subject>Aged</subject><subject>Analysis of Variance</subject><subject>Angiography, Digital Subtraction - methods</subject><subject>Angioplasty, Balloon - methods</subject><subject>ANTIPLATELET</subject><subject>Carotid Arteries - surgery</subject><subject>CAROTID ARTERY</subject><subject>Carotid Stenosis - drug therapy</subject><subject>Carotid Stenosis - therapy</subject><subject>Female</subject><subject>FOLLOW-UP</subject><subject>Humans</subject><subject>Logistic Models</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Platelet Aggregation Inhibitors - therapeutic use</subject><subject>Retrospective Studies</subject><subject>STENOSIS</subject><subject>STENTS</subject><subject>Survival Analysis</subject><subject>Treatment Outcome</subject><issn>0161-6412</issn><issn>1743-1328</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><recordid>eNqFkU1LAzEQhoMotn7cPUlO3laTTTab4EmKX1DwUsHbkk0nbWR3syap2n_vlhYEUTzNMPO8z-VF6IySS0pLdUVLzijLiXrhnBOR76Hx5pQNN7mPxoQKmglO8xE6ivGVEKpyqQ7RiKqCSJnTMfqcLQE3vltkCUKL_SoZ3wL2FhsdfHJzrMPwWeOYoEuuW2AfsB62vtEJGkg4LSHofo1dh3ud3EBF_OHSEkd4hwC_eXx08QQdWN1EON3NY_R8dzubPGTTp_vHyc00M0ySlGkjawoFq8vSMklrY1VuRVFYZQvQoqit4cRaSUTJhay1FUxaqKWxOaf1EDxGF1tvH_zbCmKqWhcNNI3uwK9iJUpWECbkv2BOiGIlVwNItqAJPsYAtuqDa3VYV5RUm1qqn7UMkfOde1W3MP8O7HoYgOst4DrrQ6s_fGjmVdLrxgcbdGdcrNif-i-VY54J</recordid><startdate>20090501</startdate><enddate>20090501</enddate><creator>Sun, Yu-Heng</creator><creator>Ma, Zhi-Gang</creator><creator>Zheng, Hua-Guang</creator><creator>Peng, Xiao-Xin</creator><creator>Xin, Yan</creator><general>Taylor & Francis</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope><scope>7X8</scope></search><sort><creationdate>20090501</creationdate><title>The long-term outcome of carotid artery stenting or antiplatelet therapy in patients with severe carotid artery stenosis</title><author>Sun, Yu-Heng ; Ma, Zhi-Gang ; Zheng, Hua-Guang ; Peng, Xiao-Xin ; Xin, Yan</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c380t-ac8b1e53b77f381bcf92f655f9f5ea65bfc40ff8067468baf638feb8cf241be53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Aged</topic><topic>Analysis of Variance</topic><topic>Angiography, Digital Subtraction - methods</topic><topic>Angioplasty, Balloon - methods</topic><topic>ANTIPLATELET</topic><topic>Carotid Arteries - surgery</topic><topic>CAROTID ARTERY</topic><topic>Carotid Stenosis - drug therapy</topic><topic>Carotid Stenosis - therapy</topic><topic>Female</topic><topic>FOLLOW-UP</topic><topic>Humans</topic><topic>Logistic Models</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Platelet Aggregation Inhibitors - therapeutic use</topic><topic>Retrospective Studies</topic><topic>STENOSIS</topic><topic>STENTS</topic><topic>Survival Analysis</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Sun, Yu-Heng</creatorcontrib><creatorcontrib>Ma, Zhi-Gang</creatorcontrib><creatorcontrib>Zheng, Hua-Guang</creatorcontrib><creatorcontrib>Peng, Xiao-Xin</creatorcontrib><creatorcontrib>Xin, Yan</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Neurological research (New York)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sun, Yu-Heng</au><au>Ma, Zhi-Gang</au><au>Zheng, Hua-Guang</au><au>Peng, Xiao-Xin</au><au>Xin, Yan</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The long-term outcome of carotid artery stenting or antiplatelet therapy in patients with severe carotid artery stenosis</atitle><jtitle>Neurological research (New York)</jtitle><addtitle>Neurol Res</addtitle><date>2009-05-01</date><risdate>2009</risdate><volume>31</volume><issue>4</issue><spage>371</spage><epage>375</epage><pages>371-375</pages><issn>0161-6412</issn><eissn>1743-1328</eissn><abstract>Objective: To identify the prognosis factors of the patients with high-degree carotid artery stenosis and evaluate the effects of carotid artery stenting and antiplatelet therapy prospectively.
Methods: Patients with severe carotid artery stenosis were enrolled in this study consecutively. Intervention was carotid artery stenting combined with antiplatelet therapy or antiplatelet therapy solely. No randomized method was used in this trail. Patients were monitored for 2 years after enrolling in this study. The primary end point was defined as neurological outcome (measured by modified Rankin score). The secondary end points were the composite of stroke, transient ischemic attack (TIA), acute myocardial infarction and sudden death.
Results: One hundred and three patients were enrolled into this work between May 2001 and August 2006 at the Fourth Hospital, Peking University. Forty patients were treated with stent placement, and 63 patients were treated only with antiplatelet drug. The baseline characteristics (gender, age, medical history, blood pressure, total cholesterol and triglyceride) were similar between the groups. Binary logistic analysis indicated that intra-artery intervention was an independent protective factor for malignant functional outcome (modified Rankin scale 3-6; relative risk: 0.13, p<0.001, 95% confidence interval: 0.036-0.46). For further follow-up, the median time of cardiovascular events in the two groups were 55 and 54 months, respectively. K-M analysis showed no statistical significance difference.
Conclusion: Carotid artery stenting combined with antiplatelet therapy may be helpful for high-risk patients with severe carotid artery stenosis. The benefit/harm of intra-artery intervention for patients with stroke or TIA suffered as a result of severe carotid artery stenosis in the long-term needs further evaluation.</abstract><cop>England</cop><pub>Taylor & Francis</pub><pmid>19508821</pmid><doi>10.1179/174313209X444062</doi><tpages>5</tpages></addata></record> |
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subjects | Aged Analysis of Variance Angiography, Digital Subtraction - methods Angioplasty, Balloon - methods ANTIPLATELET Carotid Arteries - surgery CAROTID ARTERY Carotid Stenosis - drug therapy Carotid Stenosis - therapy Female FOLLOW-UP Humans Logistic Models Male Middle Aged Platelet Aggregation Inhibitors - therapeutic use Retrospective Studies STENOSIS STENTS Survival Analysis Treatment Outcome |
title | The long-term outcome of carotid artery stenting or antiplatelet therapy in patients with severe carotid artery stenosis |
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