Fifteen-year experience with carotid artery stenting (from the carotid artery stenting-registry of the Arbeitsgemeinschaft Leitende Kardiologische Krankenhausärzte).
Identifieur interne : 000747 ( Ncbi/Merge ); précédent : 000746; suivant : 000748Fifteen-year experience with carotid artery stenting (from the carotid artery stenting-registry of the Arbeitsgemeinschaft Leitende Kardiologische Krankenhausärzte).
Auteurs : Nicolas Werner [Allemagne] ; Uwe Zeymer [Allemagne] ; Matthias Hochadel [Allemagne] ; Karl Eugen Hauptmann [Allemagne] ; Jens Jung [Allemagne] ; Ilse Janicke [Allemagne] ; Hartwick Haase [Allemagne] ; Matthias Leschke [Allemagne] ; Harald Mudra [Allemagne] ; Ralf Zahn [Allemagne]Source :
- The American journal of cardiology [ 1879-1913 ] ; 2015.
English descriptors
- KwdEn :
- Age Factors, Aged, Angioplasty (methods), Asymptomatic Diseases, Blood Vessel Prosthesis Implantation (methods), Carotid Artery Diseases (therapy), Embolic Protection Devices (utilization), Female, Heart Failure, Hospital Mortality, Humans, Logistic Models, Male, Middle Aged, Postoperative Complications, Registries, Stents, Stroke, Treatment Outcome.
- MESH :
- methods : Angioplasty, Blood Vessel Prosthesis Implantation.
- therapy : Carotid Artery Diseases.
- utilization : Embolic Protection Devices.
- Age Factors, Aged, Asymptomatic Diseases, Female, Heart Failure, Hospital Mortality, Humans, Logistic Models, Male, Middle Aged, Postoperative Complications, Registries, Stents, Stroke, Treatment Outcome.
Abstract
To date only sparse data are available on trends and changes in indications, patient's characteristics, and clinical outcome of patients undergoing carotid artery stenting (CAS) in clinical practice. From February 1996 to December 2010, 6,116 CAS procedures were performed in 5,976 patients at 36 hospitals within the prospective, multicenter CAS registry of the Arbeitsgemeinschaft Leitende Kardiologische Krankenhausärzte. Median age of patients was 71 years, 71.6% were men; a symptomatic stenosis was treated in 50.3% and an embolic protection device (EPD) was used in 82.5% of the patients. The overall hospital mortality or stroke rate was 3.1%. Stroke or in-hospital death occurred in 4.0% in symptomatic patients and in 2.2% in asymptomatic patients. In a logistic regression model, independent predictors of in-hospital death or stroke were heart failure (odds ratio [OR] 2.03, 95% confidence interval [CI] 1.22 to 3.36, p = 0.006), symptomatic stenosis (OR 1.52, 95% CI 1.05 to 2.18, p = 0.03), and age (OR per 10 years 1.46, 95% CI 1.17 to 1.81, p <0.001). The use of an EPD was significantly associated with a lower rate of death or stroke in the registry (OR 0.45, 95% CI 0.26 to 0.78, p = 0.004). From 1996 to 2010, mean age of patients increased by 4.1 years (p <0.001), the proportion of male patients decreased from 82.4% to 70.2% (p = 0.07), the proportion of symptomatic stenoses decreased (84.6% to 24.7%, p <0.001), and the use of EPDs increased from 1.4% to 97.2% (p <0.001). Comparing 2 periods from 1996 to 2003 and 2004 to 2010, a numeric decrease in the in-hospital stroke or death rate was seen in symptomatic (4.7% vs 3.5%, p = 0.11), and in asymptomatic patients (2.9% vs 2.1%, p = 0.27) undergoing CAS, which did not reach statistical significance. In conclusion, the proportion of symptomatic carotid artery stenoses decreased significantly; EPDs established as a standard tool and a numeric decrease of in-hospital stroke or death was seen in asymptomatic and symptomatic patients undergoing CAS in clinical practice over the last 15 years.
DOI: 10.1016/j.amjcard.2014.11.009
PubMed: 25498539
Links toward previous steps (curation, corpus...)
- to stream PubMed, to step Corpus: 000282
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pubmed:25498539Le document en format XML
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<sourceDesc><biblStruct><analytic><title xml:lang="en">Fifteen-year experience with carotid artery stenting (from the carotid artery stenting-registry of the Arbeitsgemeinschaft Leitende Kardiologische Krankenhausärzte).</title>
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<author><name sortKey="Jung, Jens" sort="Jung, Jens" uniqKey="Jung J" first="Jens" last="Jung">Jens Jung</name>
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<author><name sortKey="Janicke, Ilse" sort="Janicke, Ilse" uniqKey="Janicke I" first="Ilse" last="Janicke">Ilse Janicke</name>
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<author><name sortKey="Haase, Hartwick" sort="Haase, Hartwick" uniqKey="Haase H" first="Hartwick" last="Haase">Hartwick Haase</name>
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<author><name sortKey="Zahn, Ralf" sort="Zahn, Ralf" uniqKey="Zahn R" first="Ralf" last="Zahn">Ralf Zahn</name>
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<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Age Factors</term>
<term>Aged</term>
<term>Angioplasty (methods)</term>
<term>Asymptomatic Diseases</term>
<term>Blood Vessel Prosthesis Implantation (methods)</term>
<term>Carotid Artery Diseases (therapy)</term>
<term>Embolic Protection Devices (utilization)</term>
<term>Female</term>
<term>Heart Failure</term>
<term>Hospital Mortality</term>
<term>Humans</term>
<term>Logistic Models</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Postoperative Complications</term>
<term>Registries</term>
<term>Stents</term>
<term>Stroke</term>
<term>Treatment Outcome</term>
</keywords>
<keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Angioplasty</term>
<term>Blood Vessel Prosthesis Implantation</term>
</keywords>
<keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Carotid Artery Diseases</term>
</keywords>
<keywords scheme="MESH" qualifier="utilization" xml:lang="en"><term>Embolic Protection Devices</term>
</keywords>
<keywords scheme="MESH" xml:lang="en"><term>Age Factors</term>
<term>Aged</term>
<term>Asymptomatic Diseases</term>
<term>Female</term>
<term>Heart Failure</term>
<term>Hospital Mortality</term>
<term>Humans</term>
<term>Logistic Models</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Postoperative Complications</term>
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<front><div type="abstract" xml:lang="en">To date only sparse data are available on trends and changes in indications, patient's characteristics, and clinical outcome of patients undergoing carotid artery stenting (CAS) in clinical practice. From February 1996 to December 2010, 6,116 CAS procedures were performed in 5,976 patients at 36 hospitals within the prospective, multicenter CAS registry of the Arbeitsgemeinschaft Leitende Kardiologische Krankenhausärzte. Median age of patients was 71 years, 71.6% were men; a symptomatic stenosis was treated in 50.3% and an embolic protection device (EPD) was used in 82.5% of the patients. The overall hospital mortality or stroke rate was 3.1%. Stroke or in-hospital death occurred in 4.0% in symptomatic patients and in 2.2% in asymptomatic patients. In a logistic regression model, independent predictors of in-hospital death or stroke were heart failure (odds ratio [OR] 2.03, 95% confidence interval [CI] 1.22 to 3.36, p = 0.006), symptomatic stenosis (OR 1.52, 95% CI 1.05 to 2.18, p = 0.03), and age (OR per 10 years 1.46, 95% CI 1.17 to 1.81, p <0.001). The use of an EPD was significantly associated with a lower rate of death or stroke in the registry (OR 0.45, 95% CI 0.26 to 0.78, p = 0.004). From 1996 to 2010, mean age of patients increased by 4.1 years (p <0.001), the proportion of male patients decreased from 82.4% to 70.2% (p = 0.07), the proportion of symptomatic stenoses decreased (84.6% to 24.7%, p <0.001), and the use of EPDs increased from 1.4% to 97.2% (p <0.001). Comparing 2 periods from 1996 to 2003 and 2004 to 2010, a numeric decrease in the in-hospital stroke or death rate was seen in symptomatic (4.7% vs 3.5%, p = 0.11), and in asymptomatic patients (2.9% vs 2.1%, p = 0.27) undergoing CAS, which did not reach statistical significance. In conclusion, the proportion of symptomatic carotid artery stenoses decreased significantly; EPDs established as a standard tool and a numeric decrease of in-hospital stroke or death was seen in asymptomatic and symptomatic patients undergoing CAS in clinical practice over the last 15 years.</div>
</front>
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<Day>12</Day>
</DateCreated>
<DateCompleted><Year>2015</Year>
<Month>03</Month>
<Day>12</Day>
</DateCompleted>
<DateRevised><Year>2015</Year>
<Month>01</Month>
<Day>12</Day>
</DateRevised>
<Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1879-1913</ISSN>
<JournalIssue CitedMedium="Internet"><Volume>115</Volume>
<Issue>3</Issue>
<PubDate><Year>2015</Year>
<Month>Feb</Month>
<Day>01</Day>
</PubDate>
</JournalIssue>
<Title>The American journal of cardiology</Title>
<ISOAbbreviation>Am. J. Cardiol.</ISOAbbreviation>
</Journal>
<ArticleTitle>Fifteen-year experience with carotid artery stenting (from the carotid artery stenting-registry of the Arbeitsgemeinschaft Leitende Kardiologische Krankenhausärzte).</ArticleTitle>
<Pagination><MedlinePgn>360-6</MedlinePgn>
</Pagination>
<ELocationID EIdType="doi" ValidYN="Y">10.1016/j.amjcard.2014.11.009</ELocationID>
<ELocationID EIdType="pii" ValidYN="Y">S0002-9149(14)02083-9</ELocationID>
<Abstract><AbstractText>To date only sparse data are available on trends and changes in indications, patient's characteristics, and clinical outcome of patients undergoing carotid artery stenting (CAS) in clinical practice. From February 1996 to December 2010, 6,116 CAS procedures were performed in 5,976 patients at 36 hospitals within the prospective, multicenter CAS registry of the Arbeitsgemeinschaft Leitende Kardiologische Krankenhausärzte. Median age of patients was 71 years, 71.6% were men; a symptomatic stenosis was treated in 50.3% and an embolic protection device (EPD) was used in 82.5% of the patients. The overall hospital mortality or stroke rate was 3.1%. Stroke or in-hospital death occurred in 4.0% in symptomatic patients and in 2.2% in asymptomatic patients. In a logistic regression model, independent predictors of in-hospital death or stroke were heart failure (odds ratio [OR] 2.03, 95% confidence interval [CI] 1.22 to 3.36, p = 0.006), symptomatic stenosis (OR 1.52, 95% CI 1.05 to 2.18, p = 0.03), and age (OR per 10 years 1.46, 95% CI 1.17 to 1.81, p <0.001). The use of an EPD was significantly associated with a lower rate of death or stroke in the registry (OR 0.45, 95% CI 0.26 to 0.78, p = 0.004). From 1996 to 2010, mean age of patients increased by 4.1 years (p <0.001), the proportion of male patients decreased from 82.4% to 70.2% (p = 0.07), the proportion of symptomatic stenoses decreased (84.6% to 24.7%, p <0.001), and the use of EPDs increased from 1.4% to 97.2% (p <0.001). Comparing 2 periods from 1996 to 2003 and 2004 to 2010, a numeric decrease in the in-hospital stroke or death rate was seen in symptomatic (4.7% vs 3.5%, p = 0.11), and in asymptomatic patients (2.9% vs 2.1%, p = 0.27) undergoing CAS, which did not reach statistical significance. In conclusion, the proportion of symptomatic carotid artery stenoses decreased significantly; EPDs established as a standard tool and a numeric decrease of in-hospital stroke or death was seen in asymptomatic and symptomatic patients undergoing CAS in clinical practice over the last 15 years.</AbstractText>
<CopyrightInformation>Copyright © 2015 Elsevier Inc. All rights reserved.</CopyrightInformation>
</Abstract>
<AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Werner</LastName>
<ForeName>Nicolas</ForeName>
<Initials>N</Initials>
<AffiliationInfo><Affiliation>Medizinische Klinik B, Klinikum Ludwigshafen, Ludwigshafen, Rheinland-Pfalz, Germany. Electronic address: wernern@klilu.de.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Zeymer</LastName>
<ForeName>Uwe</ForeName>
<Initials>U</Initials>
<AffiliationInfo><Affiliation>Medizinische Klinik B, Klinikum Ludwigshafen, Ludwigshafen, Rheinland-Pfalz, Germany; Institut für Herzinfarktforschung an der Universität Heidelberg, Ludwigshafen, Rheinland-Pfalz, Germany.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Hochadel</LastName>
<ForeName>Matthias</ForeName>
<Initials>M</Initials>
<AffiliationInfo><Affiliation>Institut für Herzinfarktforschung an der Universität Heidelberg, Ludwigshafen, Rheinland-Pfalz, Germany.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Hauptmann</LastName>
<ForeName>Karl Eugen</ForeName>
<Initials>KE</Initials>
<AffiliationInfo><Affiliation>Abteilung für Innere Medizin 3, Krankenhaus der Barmherzigen Brüder, Trier, Rheinland-Pfalz, Germany.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Jung</LastName>
<ForeName>Jens</ForeName>
<Initials>J</Initials>
<AffiliationInfo><Affiliation>Medizinische Klinik I, Klinikum Worms, Worms, Rheinland-Pfalz, Germany.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Janicke</LastName>
<ForeName>Ilse</ForeName>
<Initials>I</Initials>
<AffiliationInfo><Affiliation>Klinik für Kardiologie und Angiologie, Evangelisches Klinikum Niederrhein, Duisburg, Nordrhein-Westfalen, Germany.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Haase</LastName>
<ForeName>Hartwick</ForeName>
<Initials>H</Initials>
<AffiliationInfo><Affiliation>Medizinische Klinik I, Herz-Jesu-Krankenhaus Dernbach, Dernbach, Rheinland-Pfalz, Germany.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Leschke</LastName>
<ForeName>Matthias</ForeName>
<Initials>M</Initials>
<AffiliationInfo><Affiliation>Klinik für Kardiologie, Angiologie, Pneumologie, Klinikum Esslingen, Esslingen, Baden-Württemberg, Germany.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Mudra</LastName>
<ForeName>Harald</ForeName>
<Initials>H</Initials>
<AffiliationInfo><Affiliation>Klinik für Kardiologie, Pneumologie und internistische Intensivmedizin, Klinikum Neuperlach, Städtisches Klinikum München GmbH, München, Bayern, Germany.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Zahn</LastName>
<ForeName>Ralf</ForeName>
<Initials>R</Initials>
<AffiliationInfo><Affiliation>Medizinische Klinik B, Klinikum Ludwigshafen, Ludwigshafen, Rheinland-Pfalz, Germany.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><CollectiveName>Arbeitsgemeinschaft Leitende Kardiologische Krankenhausärzte, Rheinland-Pfalz, Germany</CollectiveName>
</Author>
</AuthorList>
<Language>eng</Language>
<PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType>
</PublicationTypeList>
<ArticleDate DateType="Electronic"><Year>2014</Year>
<Month>11</Month>
<Day>13</Day>
</ArticleDate>
</Article>
<MedlineJournalInfo><Country>United States</Country>
<MedlineTA>Am J Cardiol</MedlineTA>
<NlmUniqueID>0207277</NlmUniqueID>
<ISSNLinking>0002-9149</ISSNLinking>
</MedlineJournalInfo>
<CitationSubset>AIM</CitationSubset>
<CitationSubset>IM</CitationSubset>
<MeshHeadingList><MeshHeading><DescriptorName UI="D000367" MajorTopicYN="N">Age Factors</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D017130" MajorTopicYN="N">Angioplasty</DescriptorName>
<QualifierName UI="Q000379" MajorTopicYN="Y">methods</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D058070" MajorTopicYN="N">Asymptomatic Diseases</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D019917" MajorTopicYN="N">Blood Vessel Prosthesis Implantation</DescriptorName>
<QualifierName UI="Q000379" MajorTopicYN="Y">methods</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D002340" MajorTopicYN="N">Carotid Artery Diseases</DescriptorName>
<QualifierName UI="Q000628" MajorTopicYN="Y">therapy</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D057505" MajorTopicYN="N">Embolic Protection Devices</DescriptorName>
<QualifierName UI="Q000656" MajorTopicYN="Y">utilization</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D006333" MajorTopicYN="N">Heart Failure</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D017052" MajorTopicYN="N">Hospital Mortality</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D016015" MajorTopicYN="N">Logistic Models</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D011183" MajorTopicYN="Y">Postoperative Complications</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D012042" MajorTopicYN="Y">Registries</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D015607" MajorTopicYN="Y">Stents</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D020521" MajorTopicYN="Y">Stroke</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D016896" MajorTopicYN="N">Treatment Outcome</DescriptorName>
</MeshHeading>
</MeshHeadingList>
</MedlineCitation>
<PubmedData><History><PubMedPubDate PubStatus="received"><Year>2014</Year>
<Month>07</Month>
<Day>27</Day>
</PubMedPubDate>
<PubMedPubDate PubStatus="revised"><Year>2014</Year>
<Month>11</Month>
<Day>03</Day>
</PubMedPubDate>
<PubMedPubDate PubStatus="accepted"><Year>2014</Year>
<Month>11</Month>
<Day>03</Day>
</PubMedPubDate>
<PubMedPubDate PubStatus="entrez"><Year>2014</Year>
<Month>12</Month>
<Day>16</Day>
<Hour>6</Hour>
<Minute>0</Minute>
</PubMedPubDate>
<PubMedPubDate PubStatus="pubmed"><Year>2014</Year>
<Month>12</Month>
<Day>17</Day>
<Hour>6</Hour>
<Minute>0</Minute>
</PubMedPubDate>
<PubMedPubDate PubStatus="medline"><Year>2015</Year>
<Month>3</Month>
<Day>13</Day>
<Hour>6</Hour>
<Minute>0</Minute>
</PubMedPubDate>
</History>
<PublicationStatus>ppublish</PublicationStatus>
<ArticleIdList><ArticleId IdType="pubmed">25498539</ArticleId>
<ArticleId IdType="pii">S0002-9149(14)02083-9</ArticleId>
<ArticleId IdType="doi">10.1016/j.amjcard.2014.11.009</ArticleId>
</ArticleIdList>
</PubmedData>
</pubmed>
<affiliations><list><country><li>Allemagne</li>
</country>
</list>
<tree><country name="Allemagne"><noRegion><name sortKey="Werner, Nicolas" sort="Werner, Nicolas" uniqKey="Werner N" first="Nicolas" last="Werner">Nicolas Werner</name>
</noRegion>
<name sortKey="Haase, Hartwick" sort="Haase, Hartwick" uniqKey="Haase H" first="Hartwick" last="Haase">Hartwick Haase</name>
<name sortKey="Hauptmann, Karl Eugen" sort="Hauptmann, Karl Eugen" uniqKey="Hauptmann K" first="Karl Eugen" last="Hauptmann">Karl Eugen Hauptmann</name>
<name sortKey="Hochadel, Matthias" sort="Hochadel, Matthias" uniqKey="Hochadel M" first="Matthias" last="Hochadel">Matthias Hochadel</name>
<name sortKey="Janicke, Ilse" sort="Janicke, Ilse" uniqKey="Janicke I" first="Ilse" last="Janicke">Ilse Janicke</name>
<name sortKey="Jung, Jens" sort="Jung, Jens" uniqKey="Jung J" first="Jens" last="Jung">Jens Jung</name>
<name sortKey="Leschke, Matthias" sort="Leschke, Matthias" uniqKey="Leschke M" first="Matthias" last="Leschke">Matthias Leschke</name>
<name sortKey="Mudra, Harald" sort="Mudra, Harald" uniqKey="Mudra H" first="Harald" last="Mudra">Harald Mudra</name>
<name sortKey="Zahn, Ralf" sort="Zahn, Ralf" uniqKey="Zahn R" first="Ralf" last="Zahn">Ralf Zahn</name>
<name sortKey="Zeymer, Uwe" sort="Zeymer, Uwe" uniqKey="Zeymer U" first="Uwe" last="Zeymer">Uwe Zeymer</name>
</country>
</tree>
</affiliations>
</record>
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