CARDIOVASCULAR SURGERY DEPARTMENT, IMAM KHOMEINI MEDICAL CENTER, TEHRAN UNIVERSITY OF MEDICAL SCIENCES, TEHRAN, IRAN
Background: Carotid artery studies in ischemic heart disease patients have revealed that only 40.6% of them have intact carotid arteries and the remainder has variant degrees of atherosclerotic changes in their carotid arteries. Myocardial ischemia and cerebrovascular accidents have similar risk factors. The purpose of this study is to determine the common risk factors and incidence of carotid endarterectomy, Methods: This is a case series study in 3340 coronary artery bypass graft (CABG) patients in the cardiac surgery department at our center conducted between April 1998 and Dec. 2001, with special emphasis on 60 patients who underwent simultaneous CABG and carotid endarterectomy.
Results: There were sixty (60) patients with simultaneous CABG - carotid endarterectomy (CE) among the 3340 CABG patients (1.8%). The mean age of isolated CABG patients was 57.6 years, and the mean age of CABG -CE patients was 66.3 years. The mortality rate of CABG patients was 2% and the mortality rate in CABG - CE patients was 13.3%. In CABG - CE patients, 81.6% had three-vessel coronary artery disease, 16% had left main disease, and 25% had a history of stroke. Risk factors in CABG – CE patients were hypertension 60%, smoking 60%, hyperlipidemia 55%, diabetes mellitus 30%, COPD 10%, and peripheral vascular disease 20%.
Conclusion: This study showed that risk factors in CABG and CE patients are multifactorial, and smoking and hypertension are the most important risk factors.