The impact of the carotid plaque type on restenosis and future cardiovascular events: A 12-year prospective study

Abstract

Objectives: to evaluate the impact of the carotid plaque type on recurrent carotid stenosis, future cardiovascular events and patients' survival. Design: open prospective study. Patients and methods: three hundred and eight patients who underwent a total of 338 carotid endarterectomies were included in the study. All of the patients were evaluated postoperatively with clinical examination and colour duplex 1 month after the operation and every 6 months thereafter. Mean duration of follow-up was 63 months (range: 12-144). Eight patients (3%) were lost to follow-up. Restenoses, cardiovascular events and deaths were recorded and analysed with regard to the traditional risk factors and the ultrasonographic characteristics of the plaques. Statistical analysis was performed using the Kaplan-Meier method, the log rank test and Cox regression analysis. Results: cumulative restenosis rate at 10 years of follow-up was 22% and was associated with coronary artery disease (p = 0.02) and echolucent plaques (p = 0.02). Life-table analysis showed a 10-year survival rate of 64% and a 10-year rate of cardiovascular events of 41%. Hypertension (p = 0.003), coronary artery disease (p = 0.002) and echolucent plaques (p = 0.02) were associated with a higher incidence of cardiovascular events. © 2002 Elsevier Science Ltd. All rights reserved.