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Intraplaque haemorrhage at carotid artery surgery--a predictor of cardiovascular mortality

Falke, P; Mätzsch, Thomas LU ; Sternby, N H; Bergqvist, D and Stavenow, L (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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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Journal of Internal Medicine
volume
238
issue
2
pages
131 - 135
publisher
Wiley-Blackwell Publishing Ltd
external identifiers
  • pmid:7629480
  • scopus:0029083922
ISSN
1365-2796
language
English
LU publication?
yes
id
5471a5f9-e4cc-4413-8b50-5fc521c9b3df (old id 1109273)
date added to LUP
2008-07-28 09:09:22
date last changed
2017-01-01 07:21:10
@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 Publishing Ltd},
  series       = {Journal of Internal Medicine},
  title        = {Intraplaque haemorrhage at carotid artery surgery--a predictor of cardiovascular mortality},
  volume       = {238},
  year         = {1995},
}