Immediate results of carotid endarterectomy in patients receiving statin therapyJournal: I.P. Pavlov Russian Medical Biological Herald (Vol.25, No. 3)
Publication Date: 2017-09-30
Authors : Zybin A.V. Timina I.E. Pokrovsky A.V. Harazov A.F.;
Page : 404-414
Keywords : http://journals.eco-vector.com/pavlovj/article/view/7089;
Given the retrospective analysis of the immediate result of carotid endarterectomy in patients with atherosclerotic hemodynamically significant unilateral lesion of the internal carotid artery on statins therapy. 262 carotid endarterectomy in 262 patients are executed. The postoperative period averaged 7.8 days, survival after surgical treatment of 98.86%. The initial condition of the carotid arteries was determined data by duplex scanning, the presence of risk factors and level of lipid profile that have a statistically significant influence on the development of complications in patients receiving statins therapy (p<0.05). Each risk factor did not have a statistically significant impact, however the presence of three or more factors reliably more often aggravated the course of atherosclerosis and increased the incidence of complications (p=0.04). Defined the reliable interrelation of dependence of a lipid profile level (a cholesterol and low density lipoproteins (LDL)) and weight of a course of initial atherosclerotic changes. The maximal values of cholesterol level 5.39±1.13 mmol/l were determined in patients with stenosis of internal carotid artery from 70 to 89% (р=0.05). In all cases of a stenosis of 90% there was increase in level of triglycerides to 1.75±1.05 mmol/l (р=0.05). LDL in all patients registered above the recommended values of 3.45±1.19 mmol/l. However, it is worth noting against the background of statin therapy, the level of high density lipoproteins in the average values did not decrease below 1.46±0.46 mmol/l (p=0.05). Statin therapy has a different degree of influence on the achievement of recommended values of lipid metabolism and the development of complications. In one case (0.38%) there were recorded stroke, transient ischemic attack and myocardial infarction. So effective is the use of synthetic statins III and IV generations: atorvastatin and rosuvastatin. Statin therapy in the preoperative period and continued after surgical important for achieve the surgery to prevent complications. Correction risk factors, such as hypertension, diabetes, smoking, dyslipidemia and other, helps to improve treatment outcomes.
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