ORIGINAL ARTICLES   

Minerva Cardioangiologica 2016 October;64(5):534-41

Copyright © 2016 EDIZIONI MINERVA MEDICA

lingua: Inglese

The prognostic role of carotid plaque ultrasonography in cardiac damage after carotid endarterectomy: carotid plaque and cardiac risk

George GALYFOS ¹, Konstantinos P. TOUTOUZAS ², George BENETOS ², Manousos KONSTADOULAKIS ¹, Dimitrios THEODOROU ¹, Stilianos KATSARAGAKIS ¹, Christodoulos STEFANADIS ², Georgios ZOGRAFOS ¹, Konstantinos FILIS ¹ ✉

¹ 1st Department of Propedeutic Surgery, University of Athens Medical School, Hippocration Hospital, Athens, Greece; ² 1st Department of Cardiology, University of Athens Medical School, Hippocration Hospital, Athens, Greece

BACKGROUND: This study evaluates the correlation of ultrasound determined carotid plaque morphology with coronary risk and cardiac damage after carotid endarterectomy.
METHODS: Fifty patients (in a series of 162) scheduled for carotid endarterectomy had the indication for coronary CT-angiography preoperatively and were included in this study. Patients were classified according to ultrasonographic characteristics of carotid plaque. The Duke Criteria were used to assess the degree of coronary risk (low, medium and high risk). Cardiac damage after carotid endarterectomy was evaluated based on symptoms, cardiac Troponin I measurement and electrocardiographic findings.
RESULTS: There were no deaths, strokes or symptomatic myocardial infarctions postoperatively (30-day results). Ten patients (20%) showed asymptomatic cardiac damage postoperatively. Cardiac damage after surgery did not show any difference between the three cardiac risk groups. Echogenic and specifically Type IV carotid artery plaques (Gray-Weale Criteria) were associated with high cardiac risk preoperatively and with postoperative cardiac damage. The degree of carotid artery stenosis, and echolucent carotid plaques were not associated with postoperative cardiac damage.
CONCLUSIONS: Asymptomatic postoperative cardiac damage occurs often after carotid endarterectomy and presents independently from coronary risk. Carotid plaques of higher echogenicity are associated with severity of coronary artery disease and cardiac damage after carotid endarterectomy.