Cargando…

Pre-Procedural Statin Use Is Associated with Improved Long-Term Survival and Reduced Major Cardiovascular Events in Patients Undergoing Carotid Artery Stenting: A Retrospective Study

Carotid artery stenting (CAS) is a minimal invasive procedure used to resolve carotid occlusion that can be affected by peri-procedural complications. Statin use before CAS has shown to reduce peri-procedural risk and improve survival, though time-dependent cofactors that influence mortality has not...

Descripción completa

Detalles Bibliográficos
Autores principales: Colussi, GianLuca, Zuttion, Francesca, Bais, Bruno, Dolso, Pierluigi, Valente, Mariarosaria, Gigli, Gian Luigi, Gasparini, Daniele, Sponza, Massimo, Catena, Cristiana, Sechi, Leonardo A., Cavarape, Alessandro
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6162515/
https://www.ncbi.nlm.nih.gov/pubmed/30227674
http://dx.doi.org/10.3390/jcm7090286
_version_ 1783359164718776320
author Colussi, GianLuca
Zuttion, Francesca
Bais, Bruno
Dolso, Pierluigi
Valente, Mariarosaria
Gigli, Gian Luigi
Gasparini, Daniele
Sponza, Massimo
Catena, Cristiana
Sechi, Leonardo A.
Cavarape, Alessandro
author_facet Colussi, GianLuca
Zuttion, Francesca
Bais, Bruno
Dolso, Pierluigi
Valente, Mariarosaria
Gigli, Gian Luigi
Gasparini, Daniele
Sponza, Massimo
Catena, Cristiana
Sechi, Leonardo A.
Cavarape, Alessandro
author_sort Colussi, GianLuca
collection PubMed
description Carotid artery stenting (CAS) is a minimal invasive procedure used to resolve carotid occlusion that can be affected by peri-procedural complications. Statin use before CAS has shown to reduce peri-procedural risk and improve survival, though time-dependent cofactors that influence mortality has not been considered. The aim of this study was to evaluate long-term survival of patients who undergo CAS considering new occurred major adverse cardiovascular event (MACE) as time-dependent cofactor. In this study, 171 high cardiovascular risk patients (age 72 ± 8 years, 125 males) were enrolled after CAS procedure and were followed for a median of 8.4 years. Death occurred in 44% of patients with a mean time to death of 69 ± 39 months and MACE in 34% with a mean time of 35 ± 42 months. In patients who used or not statins at baseline, death occurred in 33% and 65%, respectively (p < 0.001). Survival analysis showed that statin use reduced risk of death (hazard ratio HR 0.36, 95% confidence interval CI 0.23–0.58, p < 0.0001). Including MACE as time-dependent variable did not change beneficial effects of statins. Additionally, statin use was associated with a protective effect on MACE (HR 0.48, 95% CI 0.27–0.85, p = 0.012); particularly, the prevalence of stroke was reduced by 59% (p = 0.018). In multivariate analysis, effects of statins were independent of demographic and anthropometric variables, prevalence of cardiovascular risk factors, renal function, antiplatelet use, and MACE occurrence. In conclusion, use of statins before CAS procedure is associated with increased long-term survival and reduced MACE occurrence. This evidence supports the hypothesis that statin use before CAS might be beneficial in high risk patients.
format Online
Article
Text
id pubmed-6162515
institution National Center for Biotechnology Information
language English
publishDate 2018
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-61625152018-10-02 Pre-Procedural Statin Use Is Associated with Improved Long-Term Survival and Reduced Major Cardiovascular Events in Patients Undergoing Carotid Artery Stenting: A Retrospective Study Colussi, GianLuca Zuttion, Francesca Bais, Bruno Dolso, Pierluigi Valente, Mariarosaria Gigli, Gian Luigi Gasparini, Daniele Sponza, Massimo Catena, Cristiana Sechi, Leonardo A. Cavarape, Alessandro J Clin Med Article Carotid artery stenting (CAS) is a minimal invasive procedure used to resolve carotid occlusion that can be affected by peri-procedural complications. Statin use before CAS has shown to reduce peri-procedural risk and improve survival, though time-dependent cofactors that influence mortality has not been considered. The aim of this study was to evaluate long-term survival of patients who undergo CAS considering new occurred major adverse cardiovascular event (MACE) as time-dependent cofactor. In this study, 171 high cardiovascular risk patients (age 72 ± 8 years, 125 males) were enrolled after CAS procedure and were followed for a median of 8.4 years. Death occurred in 44% of patients with a mean time to death of 69 ± 39 months and MACE in 34% with a mean time of 35 ± 42 months. In patients who used or not statins at baseline, death occurred in 33% and 65%, respectively (p < 0.001). Survival analysis showed that statin use reduced risk of death (hazard ratio HR 0.36, 95% confidence interval CI 0.23–0.58, p < 0.0001). Including MACE as time-dependent variable did not change beneficial effects of statins. Additionally, statin use was associated with a protective effect on MACE (HR 0.48, 95% CI 0.27–0.85, p = 0.012); particularly, the prevalence of stroke was reduced by 59% (p = 0.018). In multivariate analysis, effects of statins were independent of demographic and anthropometric variables, prevalence of cardiovascular risk factors, renal function, antiplatelet use, and MACE occurrence. In conclusion, use of statins before CAS procedure is associated with increased long-term survival and reduced MACE occurrence. This evidence supports the hypothesis that statin use before CAS might be beneficial in high risk patients. MDPI 2018-09-17 /pmc/articles/PMC6162515/ /pubmed/30227674 http://dx.doi.org/10.3390/jcm7090286 Text en © 2018 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Colussi, GianLuca
Zuttion, Francesca
Bais, Bruno
Dolso, Pierluigi
Valente, Mariarosaria
Gigli, Gian Luigi
Gasparini, Daniele
Sponza, Massimo
Catena, Cristiana
Sechi, Leonardo A.
Cavarape, Alessandro
Pre-Procedural Statin Use Is Associated with Improved Long-Term Survival and Reduced Major Cardiovascular Events in Patients Undergoing Carotid Artery Stenting: A Retrospective Study
title Pre-Procedural Statin Use Is Associated with Improved Long-Term Survival and Reduced Major Cardiovascular Events in Patients Undergoing Carotid Artery Stenting: A Retrospective Study
title_full Pre-Procedural Statin Use Is Associated with Improved Long-Term Survival and Reduced Major Cardiovascular Events in Patients Undergoing Carotid Artery Stenting: A Retrospective Study
title_fullStr Pre-Procedural Statin Use Is Associated with Improved Long-Term Survival and Reduced Major Cardiovascular Events in Patients Undergoing Carotid Artery Stenting: A Retrospective Study
title_full_unstemmed Pre-Procedural Statin Use Is Associated with Improved Long-Term Survival and Reduced Major Cardiovascular Events in Patients Undergoing Carotid Artery Stenting: A Retrospective Study
title_short Pre-Procedural Statin Use Is Associated with Improved Long-Term Survival and Reduced Major Cardiovascular Events in Patients Undergoing Carotid Artery Stenting: A Retrospective Study
title_sort pre-procedural statin use is associated with improved long-term survival and reduced major cardiovascular events in patients undergoing carotid artery stenting: a retrospective study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6162515/
https://www.ncbi.nlm.nih.gov/pubmed/30227674
http://dx.doi.org/10.3390/jcm7090286
work_keys_str_mv AT colussigianluca preproceduralstatinuseisassociatedwithimprovedlongtermsurvivalandreducedmajorcardiovasculareventsinpatientsundergoingcarotidarterystentingaretrospectivestudy
AT zuttionfrancesca preproceduralstatinuseisassociatedwithimprovedlongtermsurvivalandreducedmajorcardiovasculareventsinpatientsundergoingcarotidarterystentingaretrospectivestudy
AT baisbruno preproceduralstatinuseisassociatedwithimprovedlongtermsurvivalandreducedmajorcardiovasculareventsinpatientsundergoingcarotidarterystentingaretrospectivestudy
AT dolsopierluigi preproceduralstatinuseisassociatedwithimprovedlongtermsurvivalandreducedmajorcardiovasculareventsinpatientsundergoingcarotidarterystentingaretrospectivestudy
AT valentemariarosaria preproceduralstatinuseisassociatedwithimprovedlongtermsurvivalandreducedmajorcardiovasculareventsinpatientsundergoingcarotidarterystentingaretrospectivestudy
AT gigligianluigi preproceduralstatinuseisassociatedwithimprovedlongtermsurvivalandreducedmajorcardiovasculareventsinpatientsundergoingcarotidarterystentingaretrospectivestudy
AT gasparinidaniele preproceduralstatinuseisassociatedwithimprovedlongtermsurvivalandreducedmajorcardiovasculareventsinpatientsundergoingcarotidarterystentingaretrospectivestudy
AT sponzamassimo preproceduralstatinuseisassociatedwithimprovedlongtermsurvivalandreducedmajorcardiovasculareventsinpatientsundergoingcarotidarterystentingaretrospectivestudy
AT catenacristiana preproceduralstatinuseisassociatedwithimprovedlongtermsurvivalandreducedmajorcardiovasculareventsinpatientsundergoingcarotidarterystentingaretrospectivestudy
AT sechileonardoa preproceduralstatinuseisassociatedwithimprovedlongtermsurvivalandreducedmajorcardiovasculareventsinpatientsundergoingcarotidarterystentingaretrospectivestudy
AT cavarapealessandro preproceduralstatinuseisassociatedwithimprovedlongtermsurvivalandreducedmajorcardiovasculareventsinpatientsundergoingcarotidarterystentingaretrospectivestudy