Print this pageThe Influence Of Concurrent Carotid Endarterectomy On Coronary Bypass: A Case Controlled Study
Background: Concurrent Carotid Endarterectomy (CEA) and Coronary Artery Bypass Graft (CABG) is associated with an increased incidence of stroke and death compared to isolated CABG. It is unclear whether this reflects two concurrent operative procedures or the increased risk in patients with more extensive atherosclerosis. Methods: To address this question a case controlled study was performed using data from the New York State Cardiac Database from 1997-1998. Patients who underwent combined CEA-CABG were compared to all isolated CABG patients and a risk matched cohort of isolated CABG patients. Results: The 35,539 isolated CABG patients had fewer post operative complications than the 744 combined CEA-CABG patients, but also had a lower overall risk profile. After propensity matching for confounding variables, no differences in length of stay, stroke, myocardial infarction, death or total adverse events were observed. Conclusions: While increased complications are reported after CEA-CABG, these do not differ from those of a risk-matched cohort of isolated CABG patients. Thus the major morbidity of combined CEA-CABG is due to inherent patient risk and not the addition of CEA to CABG. Outcomes of all operations on CPB and cohort of CABG alone matched to CEA/CABG using propensity scores.
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