Impact of Statin Pretreatment on the Complications of Carotid Stenting in Asymptomatic Patients: Observational Study
Background: Carotid stenosis is a known risk factor for ischemic stroke, and carotid artery stenting is an effective preventive procedure. However, the stroke risk reduction for asymptomatic patients is small. Therefore, it is important to reduce the risk of complications, particularly in asymptomatic carotid stenosis. Statins are known to reduce the overall risk of periprocedural complications, although there is a lack of data focusing on asymptomatic patients. We aimed to investigate whether different doses of statin pretreatment can reduce periprocedural complications of carotid artery stenting in patients with asymptomatic carotid artery stenosis.
Methods: Between July 2003 and June 2013, 276 consecutive patients received carotid artery stenting (CAS) for asymptomatic carotid stenosis. Periprocedural complications included the outcome of stroke, myocardial infarction, or death within 30 days of CAS. Statin pretreatment was categorized as no-statin (n=87, 31.5%), standard-dose (<40 mg, n=139, 50.4%), and high-dose statin (≥40 mg, n=50, 18.1%) according to the atorvastatin equivalent dose. Cochran-Armitage (CA) trend test was performed for periprocedural complications to investigate the association with statin dose.
Results: The overall periprocedural complication rate was 3.3%. There was no significant difference in the risk of periprocedural complications between the three groups (no statin: n=3 [3.4%]; standard-dose: n=4 [2.9%]; high-dose n=2 [4.0%] p = 0.923). CA trend test did not demonstrate a trend in the proportion of periprocedural complications across increasing statin equivalent dose (p = 0.919).
Conclusions: Statin pretreatment before CAS showed neither absolute nor dose-dependent effects against periprocedural complications in asymptomatic patients with CAS.
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Supplementary Table I. Summary of statin drug and dose use before carotid artery stenting. Supplementary Table II. Periprocedural complications within 30 days of stenting for asymptomatic carotid artery stenosis
Posted 17 Dec, 2020
On 18 Jan, 2021
Received 02 Jan, 2021
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Received 02 Jan, 2021
On 21 Dec, 2020
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On 21 Dec, 2020
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On 21 Dec, 2020
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On 21 Dec, 2020
On 21 Dec, 2020
Invitations sent on 21 Dec, 2020
On 16 Dec, 2020
On 15 Dec, 2020
On 15 Dec, 2020
On 28 Nov, 2020
Impact of Statin Pretreatment on the Complications of Carotid Stenting in Asymptomatic Patients: Observational Study
Posted 17 Dec, 2020
On 18 Jan, 2021
Received 02 Jan, 2021
Received 02 Jan, 2021
Received 02 Jan, 2021
Received 02 Jan, 2021
Received 02 Jan, 2021
Received 02 Jan, 2021
On 21 Dec, 2020
On 21 Dec, 2020
On 21 Dec, 2020
On 21 Dec, 2020
On 21 Dec, 2020
On 21 Dec, 2020
On 21 Dec, 2020
On 21 Dec, 2020
On 21 Dec, 2020
Invitations sent on 21 Dec, 2020
On 16 Dec, 2020
On 15 Dec, 2020
On 15 Dec, 2020
On 28 Nov, 2020
Background: Carotid stenosis is a known risk factor for ischemic stroke, and carotid artery stenting is an effective preventive procedure. However, the stroke risk reduction for asymptomatic patients is small. Therefore, it is important to reduce the risk of complications, particularly in asymptomatic carotid stenosis. Statins are known to reduce the overall risk of periprocedural complications, although there is a lack of data focusing on asymptomatic patients. We aimed to investigate whether different doses of statin pretreatment can reduce periprocedural complications of carotid artery stenting in patients with asymptomatic carotid artery stenosis.
Methods: Between July 2003 and June 2013, 276 consecutive patients received carotid artery stenting (CAS) for asymptomatic carotid stenosis. Periprocedural complications included the outcome of stroke, myocardial infarction, or death within 30 days of CAS. Statin pretreatment was categorized as no-statin (n=87, 31.5%), standard-dose (<40 mg, n=139, 50.4%), and high-dose statin (≥40 mg, n=50, 18.1%) according to the atorvastatin equivalent dose. Cochran-Armitage (CA) trend test was performed for periprocedural complications to investigate the association with statin dose.
Results: The overall periprocedural complication rate was 3.3%. There was no significant difference in the risk of periprocedural complications between the three groups (no statin: n=3 [3.4%]; standard-dose: n=4 [2.9%]; high-dose n=2 [4.0%] p = 0.923). CA trend test did not demonstrate a trend in the proportion of periprocedural complications across increasing statin equivalent dose (p = 0.919).
Conclusions: Statin pretreatment before CAS showed neither absolute nor dose-dependent effects against periprocedural complications in asymptomatic patients with CAS.