Abstract Details

Title The Effect of Pre-Existing Atrial Fibrillation on In-Hospital Outcomes in Patients Undergoing Carotid Endarterectomy or Stent Placement in General Practice

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) S22 - (-)

Poster/Presentation
Number 002

Objective

Background Atrial fibrillation (AF) was a common comorbid condition among patients who underwent carotid endarterectomy (CEA) and carotid artery stent placement (CAS); however the outcomes of patients with AF undergoing CAS have not been fully examined.

Design/Methods Data from the Nationwide Inpatient Sample was analyzed, which is representative of admissions in the US from 2005 to 2009. Primary end points included postoperative stroke, cardiac complications, postoperative mortality, and composite of these endpoints. Multivariate regression analysis was performed to determine the association of AF (versus without AF); and the association of CEA (versus CAS) with the occurrence of postoperative stroke, cardiac complications or death. Covariates in the logistic regression included patient gender, age, ethnicity, comorbid conditions, symptom status (symptomatic vs asymptomatic status), and hospital characteristics.

Results Of the 672,074 patients who underwent CAS or CEA, 8.8% of the procedures were performed in patients with AF. For patients undergoing CEA, AF was associated with an increased risk of postoperative stroke (P0.0001; OR, 1.57: 95% CI, 1.32-1.86) but not in patients undergoing CAS. The relative risk of composite endpoint of postoperative stroke, cardiac complications, and mortality was increased in patients with AF undergoing CAS (OR 1.43, 95% CI 1.18-1.74) and those undergoing CEA (OR 3.18, 95% CI 2.89-3.49). After adjustment for potential confounders, the odds of composite endpoint of postoperative stroke, cardiac complications, and mortality (OR, 1.31, 95% CI 1.08 - 1.59) were significantly higher among patients who underwent CEA (versus CAS). An inverse relationship was seen in patients without AF in whom the composite endpoint was significantly lower in patients undergoing CEA.

Conclusions Almost 10% of CAS and CEA are performed in patients with AF in general practice. Higher rates of adverse events are observed among these patients particularly those undergoing CEA.

Authors/Disclosures
Syeda L. Alqadri, MD (KabaFusion Holders LLC) PRESENTER	No disclosure on file
Masaki Watanabe (University of Minnesota)	No disclosure on file
Saqib A. Chaudhry, MD	Dr. Chaudhry has nothing to disclose.
	No disclosure on file
Shahram Majidi, MD (Icahn School of Medicine at Mount Sinai)	Dr. Majidi has nothing to disclose.
	No disclosure on file
Hamza I. Maqsood, MD (Dept of Neurology)	Dr. Qureshi has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for AstraZeneca.
	No disclosure on file

��ɫ��

��ɫ��