Intraplaque haemorrhage at carotid artery surgery--a predictor of cardiovascular mortality
(1995) In Journal of Internal Medicine 238(2). p.131-135- Abstract
- OBJECTIVE. To ascertain whether carotid intraplaque haemorrhage (IH) in patients undergoing carotid artery surgery is a predictor of increased cardiac mortality over a 5.5 year follow-up. DESIGN AND SUBJECTS. Carotid artery plaques were obtained at surgery from 47 consecutive patients (41 men, six women), median age 67 (range 48-81) years, with symptoms of carotid transient ischaemic attacks (TIAs) or carotid territory minor stroke. As determined at preoperative angiography, the degree of stenosis was 50-99%. Specimens were classified histologically as manifesting severe atherosclerosis, fibrous plaque, IH, or residual IH debris. SETTING. Medical Angiology and Vascular Surgery Units, Malmo General Hospital. INTERVENTION. Carotid... (More)
- OBJECTIVE. To ascertain whether carotid intraplaque haemorrhage (IH) in patients undergoing carotid artery surgery is a predictor of increased cardiac mortality over a 5.5 year follow-up. DESIGN AND SUBJECTS. Carotid artery plaques were obtained at surgery from 47 consecutive patients (41 men, six women), median age 67 (range 48-81) years, with symptoms of carotid transient ischaemic attacks (TIAs) or carotid territory minor stroke. As determined at preoperative angiography, the degree of stenosis was 50-99%. Specimens were classified histologically as manifesting severe atherosclerosis, fibrous plaque, IH, or residual IH debris. SETTING. Medical Angiology and Vascular Surgery Units, Malmo General Hospital. INTERVENTION. Carotid endarterectomy. MAIN OUTCOME MEASURE. Correlation between mortality and IH. RESULTS. At follow-up after 5.5 years, mortality was 28% (13/47) overall, 92% (12/13) in the IH subgroup [of stroke (n = 1) or myocardial infarction (n = 11)], but only 3% (1/34), of pancreatic cancer, in the non-IH subgroup (P = 0.0001). Mortality was also significantly higher in the severe atherosclerosis than in the fibrous plaque subgroup, 39% (12/31) vs. 6% (1/16) (P = 0.044), but not significantly increased in any other subgroup (fibrous plaque, residual IH, TIA, minor stroke, or acetylsalicylic acid or anticoagulant treatment). No correlation existed between IH or death and haemoglobin value or platelet count. CONCLUSIONS. Evidence of recent IH seen at carotid artery surgery may be a marker of cardiovascular mortality. As IH was also found in a post-mortem control subgroup, the difference may be due to abnormality in blood components (e.g., coagulation factors) or impaired vessel-wall healing capacity (e.g. endothelial dysfunction). (Less)
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https://lup.lub.lu.se/record/1109273
- author
- Falke, P ; Mätzsch, Thomas LU ; Sternby, N H ; Bergqvist, D and Stavenow, L
- organization
- publishing date
- 1995
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Journal of Internal Medicine
- volume
- 238
- issue
- 2
- pages
- 131 - 135
- publisher
- Wiley-Blackwell
- external identifiers
-
- pmid:7629480
- scopus:0029083922
- ISSN
- 1365-2796
- language
- English
- LU publication?
- yes
- additional info
- The information about affiliations in this record was updated in December 2015. The record was previously connected to the following departments: Emergency medicine/Medicine/Surgery (013240200)
- id
- 5471a5f9-e4cc-4413-8b50-5fc521c9b3df (old id 1109273)
- date added to LUP
- 2016-04-01 16:59:45
- date last changed
- 2021-01-03 06:03:33
@article{5471a5f9-e4cc-4413-8b50-5fc521c9b3df,
abstract = {{OBJECTIVE. To ascertain whether carotid intraplaque haemorrhage (IH) in patients undergoing carotid artery surgery is a predictor of increased cardiac mortality over a 5.5 year follow-up. DESIGN AND SUBJECTS. Carotid artery plaques were obtained at surgery from 47 consecutive patients (41 men, six women), median age 67 (range 48-81) years, with symptoms of carotid transient ischaemic attacks (TIAs) or carotid territory minor stroke. As determined at preoperative angiography, the degree of stenosis was 50-99%. Specimens were classified histologically as manifesting severe atherosclerosis, fibrous plaque, IH, or residual IH debris. SETTING. Medical Angiology and Vascular Surgery Units, Malmo General Hospital. INTERVENTION. Carotid endarterectomy. MAIN OUTCOME MEASURE. Correlation between mortality and IH. RESULTS. At follow-up after 5.5 years, mortality was 28% (13/47) overall, 92% (12/13) in the IH subgroup [of stroke (n = 1) or myocardial infarction (n = 11)], but only 3% (1/34), of pancreatic cancer, in the non-IH subgroup (P = 0.0001). Mortality was also significantly higher in the severe atherosclerosis than in the fibrous plaque subgroup, 39% (12/31) vs. 6% (1/16) (P = 0.044), but not significantly increased in any other subgroup (fibrous plaque, residual IH, TIA, minor stroke, or acetylsalicylic acid or anticoagulant treatment). No correlation existed between IH or death and haemoglobin value or platelet count. CONCLUSIONS. Evidence of recent IH seen at carotid artery surgery may be a marker of cardiovascular mortality. As IH was also found in a post-mortem control subgroup, the difference may be due to abnormality in blood components (e.g., coagulation factors) or impaired vessel-wall healing capacity (e.g. endothelial dysfunction).}},
author = {{Falke, P and Mätzsch, Thomas and Sternby, N H and Bergqvist, D and Stavenow, L}},
issn = {{1365-2796}},
language = {{eng}},
number = {{2}},
pages = {{131--135}},
publisher = {{Wiley-Blackwell}},
series = {{Journal of Internal Medicine}},
title = {{Intraplaque haemorrhage at carotid artery surgery--a predictor of cardiovascular mortality}},
volume = {{238}},
year = {{1995}},
}