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Proportion of AF high among patients undergoing carotid artery interventions
In an analysis of more than 672,000 patients undergoing carotid artery stenting or carotid endarterectomy, about 9% of patients had atrial fibrillation, which was associated with a higher rate of adverse events.
A team of researchers extracted data from the National Inpatient Sample, a representation of all U.S. hospitalizations from 2005 to 2009. In total, 672,074 patients underwent carotid artery stenting (CAS) or carotid endarterectomy (CEA) during that period.
Overall, 8.8% of patients had AF. Presence of AF was associated with increased risk for postoperative stroke among patients undergoing CEA (1.7% of population; OR = 1.57; 95% CI, 1.32-1.86). However, the same link was not observed among patients undergoing CAS.
Relative risk for the primary endpoint, a composite of postoperative stroke, cardiac complications and death, was increased among patients with AF undergoing CAS (OR = 1.43; 95% CI, 1.18-1.74) and CEA (OR = 3.18; 95% CI, 2.89-3.49). When the researchers adjusted for possible confounders, odds of the composite primary endpoint were higher among patients with AF undergoing CEA compared with CAS (OR = 1.31; 95% CI, 1.08-1.59), according to the study results.
An opposite association was observed among patients without AF. The composite primary endpoint was significantly lower among patients without AF undergoing CEA, according to the results.
“Prognostic value of atrial fibrillation may not have been identified in previous clinical trials because patients with atrial fibrillation were excluded from major trials,” the researchers said. “Continued exploration of the relationship between atrial fibrillation and major adverse events in patients undergoing CAS or CEA may lead to improvements in treatment for patients with atrial fibrillation and carotid artery disease.” – by Jennifer Byrne
Disclosure: The researchers report no relevant financial disclosures.