The Impact of the Carotid Plaque Type on Restenosis and Future Cardiovascular Events: A 12-year Prospective Study

• Published in: European journal of vascular and endovascular surgery Vol. 24; no. 3; pp. 239 - 244
• Main Authors: Liapis, C.D., Kakisis, J.D., Dimitroulis, D.A., Kostakis, A.G.
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01-09-2002
• Subjects: Adult; Aged; Aged, 80 and over; Cardiovascular Diseases - diagnostic imaging; Cardiovascular Diseases - etiology; Cardiovascular Diseases - mortality; Carotid plaques, Myocardial infarction, Restenosis, Risk factors, Stroke, Ultrasonography; Carotid Stenosis - complications; Carotid Stenosis - diagnostic imaging; Carotid Stenosis - mortality; Coronary Restenosis - diagnostic imaging; Coronary Restenosis - etiology; Coronary Restenosis - mortality; Female; Follow-Up Studies; Humans; Male; Middle Aged; Prospective Studies; Recurrence; Risk Factors; Survival Rate; Time Factors; Ultrasonography, Doppler, Color; Carotid plaques, Myocardial infarction, Restenosis, Risk factors, Stroke, Ultrasonography
• ISSN: 1078-5884; 1532-2165
• DOI: 10.1053/ejvs.2002.1714

Objectives: to evaluate the impact of the carotid plaque type on recurrent carotid stenosis, future cardiovascular events and patients' survival.
Design: open prospective study.
Patients and methods: three hundred and eight patients who underwent a total of 338 carotid endarterectomies were included in the study. All of the patients were evaluated postoperatively with clinical examination and colour duplex 1 month after the operation and every 6 months thereafter. Mean duration of follow-up was 63 months (range: 12–144). Eight patients (3%) were lost to follow-up. Restenoses, cardiovascular events and deaths were recorded and analysed with regard to the traditional risk factors and the ultrasonographic characteristics of the plaques. Statistical analysis was performed using the Kaplan–Meier method, the log rank test and Cox regression analysis.
Results: cumulative restenosis rate at 10 years of follow-up was 21% and was associated with coronary artery disease (p=0.01) and echolucent plaques (p=0.02). Life-table analysis showed a 10-year survival rate of 64% and a 10-year rate of cardiovascular events of 41%. Hypertension (p=0.003), coronary artery disease (p=0.002) and echolucent plaques (p=0.01) were associated with a higher incidence of cardiovascular events.