Author(s): Quesado, João ; Dias, Lara ; Pereira-Macedo, Juliana ; Duarte-Gamas, Luís ; Khairy, Ahmed ; Pinheiro, Marina ; Reis, Pedro ; Andrade, José P. ; Rocha-Neves, João ; Marreiros, Ana
Date: 2023
Persistent ID: http://hdl.handle.net/10400.1/20016
Origin: Sapientia - Universidade do Algarve
Subject(s): Chronic kidney-disease; Glomerular-filtration-rate; Cell distribution width; Atrial-fibrillation; Regional anesthesia; Outcomes; Score; Thromboembolism; Management; Stroke
Background: R2CHA2DS2-VA score has been used to predict short and long-term outcomes in many cardiovascular diseases. This study aims to validate the R2CHA2DS2-VA score as a long-term major adverse cardiovascular events (MACE) predictor after carotid endarterectomy (CEA). Secondary outcomes were also assessed regarding the incidence of all-cause mortality, acute myocardial infarction (AMI), major adverse limb events (MALE), and acute heart failure (AHF).Methods: From January 2012 to December 2021, patients (n 1/4 205) from a Portuguese tertiary care and referral center that underwent CEA with regional anesthesia (RA) for carotid stenosis (CS) were selected from a previously collected prospective database, and a posthoc analysis was performed. Demographics and comorbidities were registered. Clinical adverse events were assessed 30 days after the procedure and in the subsequent long-term surveillance period. Statistical analysis was performed by the Kaplan-Meier method and Cox proportional hazards regression.Results: Of the patients enrolled, 78.5% were males with a mean age of 70.44 & PLUSMN; 8.9 years. Higher scores of R2CHA2DS2-VA were associated with long-term MACE (adjusted hazard ratio (aHR) 1.390; 95% confidence interval (CI) 1.173-1.647); and mortality (aHR 1.295; 95% CI 1.08-1.545). Conclusions: This study demonstrated the potential of the R2CHA2DS2-VA score to predict long-term outcomes, such as AMI, AHF, MACE, and all-cause mortality, in a population of pa-tients submitted to carotid endarterectomy.
