Arquivos Brasileiros de Cardiologia (Feb 2010)
Prevalência de estenose carotídea em pacientes com indicação de cirurgia de revascularização miocárdica Prevalencia de estenosis carotidea en pacientes con indicación de cirugía de revascularización miocárdica Prevalence of carotid stenosis in patients referred to myocardial revascularization surgery
Abstract
FUNDAMENTO: Embora a aterosclerose carotídea seja a principal causa de acidente vascular cerebral, a prevalência de estenose clinicamente significativa (>50%) permanece desconhecida em nosso meio, principalmente em indivíduos com indicação de cirurgia eletiva de revascularização do miocárdio. OBJETIVO: Identificar a prevalência e o grau de estenose carotídea em indivíduos com indicação de cirurgia de revascularização miocárdica em um centro de referência em cardiologia no Brasil. MÉTODOS: Estudo transversal no qual 457 pacientes consecutivos e de ambos os gêneros foram avaliados, entre maio de 2007 e abril de 2008, através de ultrassonografia com Doppler em cores de artérias carótidas, no pré-operatório de cirurgia de revascularização miocárdica eletiva. Para a análise estatística foi usado o programa SPSS 10.1. Um valor-pFUNDAMENTO: Aún cuando la aterosclerosis carotidea es la principal causa de accidente cerebrovascular, la prevalencia de estenosis clínicamente significativa (>50%) permanece desconocida en nuestro medio, principalmente en individuos con indicación de cirugía electiva de revascularización de miocardio. OBJETIVO: Identificar la prevalencia y el grado de estenosis carotidea en individuos con indicación de cirugía de revascularización miocárdica, en un centro de referencia en cardiología en Brasil. MÉTODOS: Estudio transversal, en el que fueron evaluados 457 pacientes consecutivos y de ambos géneros, entre mayo de 2007 y abril de 2008, mediante ecografía Doppler color de arterias carótidas, en el preoperatorio de cirugía de revascularización miocárdica electiva. Para el análisis estadístico se utilizó el programa SPSS 10.1. Un valor-pBACKGROUND: Although the carotid stenosis is the main cause of cerebrovascular accident, the prevalence of clinically significant stenosis (>50%) remains unknown in our country, mainly in individuals with a surgical indication for elective myocardial revascularization surgery. OBJECTIVE: To identify the prevalence and degree of carotid stenosis in individuals with a surgical indication for MRS in a reference center in Cardiology in Brazil. METHODS: Transversal study of 457 consecutive patients of both genders, evaluated between May 2007 and April 2008 through ultrasonography with color Doppler of the carotid arteries, during the preoperative period of elective MRS. The statistical analysis was performed with the SPSS program, version 10.1. A p value <0.05 was considered significant. Seven patients were lost throughout the study. RESULTS: The mean age (±standard deviation) was 62.2 ± 9.4 years and 65.6% of the patients were males. The prevalence of significant carotid stenosis was 18.7%. As for the stratification of the degree of carotid stenosis: absence of stenosis was observed in 3.6%; stenosis < 50% was observed in 77.8%; stenosis between 50% and 69% was observed in 11.6%; stenosis between 70% and 99% was observed in 6.9% and arterial occlusion was observed in 0.2% of the individuals. The sensitivity and specificity regarding the carotid bruit were 34.5% and 88.8%, respectively. CONCLUSION: The prevalence of significant carotid stenosis was high in the studied sample, which suggests this is a high-risk population for the occurrence of cerebrovascular accident.
