{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,21]],"date-time":"2025-08-21T17:45:05Z","timestamp":1755798305743},"reference-count":15,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2019,2]]},"abstract":"<jats:sec>\n            <jats:title>Background and Purpose\u2014<\/jats:title>\n            <jats:p>We investigated whether procedural stroke or death risk of carotid artery stenting (CAS) compared with carotid endarterectomy (CEA) is different in patients with and without history of coronary heart disease (CHD) and whether the treatment-specific impact of age differs.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods\u2014<\/jats:title>\n            <jats:p>We combined individual patient data of 4754 patients with symptomatic carotid stenosis from 4 randomized trials (EVA-3S [Endarterectomy Versus Angioplasty in Patients With Symptomatic Severe Carotid Stenosis], SPACE [Stent-Protected Angioplasty Versus Carotid Endarterectomy], ICSS [International Carotid Stenting Study], and CREST [Carotid Revascularization Endarterectomy Versus Stenting Trial]). Procedural risk was defined as any stroke or death \u226430 days after treatment. We compared procedural risk between both treatments with Cox regression analysis, stratified by history of CHD and age (&lt;70, 70\u201374, \u226575 years). History of CHD included myocardial infarction, angina, or coronary revascularization.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results\u2014<\/jats:title>\n            <jats:p>\n              One thousand two hundred ninety-three (28%) patients had history of CHD. Procedural stroke or death risk was higher in patients with history of CHD. Procedural risk in patients treated with CAS compared with CEA was consistent in patients with history of CHD (8.3% versus 4.6%; hazard ratio [HR], 1.96; 95% CI, 0.67\u20135.73) and in those without (6.9% versus 3.6%; HR, 1.93; 95% CI, 1.40\u20132.65;\n              <jats:italic>P<\/jats:italic>\n              <jats:sub>interaction<\/jats:sub>\n              =0.89). In patients with history of CHD, procedural risk was significantly higher after CAS compared with CEA in patients aged \u226575 (CAS-to-CEA HR, 2.78; 95% CI, 1.32\u20135.85), but not in patients aged &lt;70 (HR, 1.71; 95% CI, 0.79\u20133.71) and 70 to 74 years (HR, 1.09; 95% CI, 0.45\u20132.65). In contrast, in patients without history of CHD, procedural risk after CAS was higher in patients aged 70 to 74 (HR, 3.62; 95% CI, 1.80\u20137.29) and \u226575 years (HR, 2.64; 95% CI, 1.52\u20134.59), but equal in patients aged &lt;70 years (HR, 1.05; 95% CI, 0.63\u20131.73; 3-way\n              <jats:italic>P<\/jats:italic>\n              <jats:sub>interaction<\/jats:sub>\n              =0.09).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions\u2014<\/jats:title>\n            <jats:p>History of CHD does not modify procedural stroke or death risk of CAS compared with CEA. CAS might be as safe as CEA in patients with history of CHD aged &lt;75 years, whereas for patients without history of CHD, risk after CAS compared with CEA was only equal in those aged &lt;70 years.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/strokeaha.118.023085","type":"journal-article","created":{"date-parts":[[2019,1,9]],"date-time":"2019-01-09T10:00:37Z","timestamp":1547028037000},"page":"413-418","update-policy":"http:\/\/dx.doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":8,"title":["Safety of Carotid Revascularization in Patients With a History of Coronary Heart Disease"],"prefix":"10.1161","volume":"50","author":[{"given":"Eline J.","family":"Volkers","sequence":"first","affiliation":[{"name":"From the Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus (E.J.V., A.A., L.J.K.), University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands"},{"name":"Julius Center for Health Sciences and Primary Care (E.J.V., A.A., J.P.G.), University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ale","family":"Algra","sequence":"additional","affiliation":[{"name":"From the Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus (E.J.V., A.A., L.J.K.), University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands"},{"name":"Julius Center for Health Sciences and Primary Care (E.J.V., A.A., J.P.G.), University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L. Jaap","family":"Kappelle","sequence":"additional","affiliation":[{"name":"From the Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus (E.J.V., A.A., L.J.K.), University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jean-Pierre","family":"Becquemin","sequence":"additional","affiliation":[{"name":"IVPE, Hopital Priv\u00e9 Paul D\u2019Egine, Champigny, France (J.-P.B.)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gert J.","family":"de Borst","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery (G.J.d.B.), University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin M.","family":"Brown","sequence":"additional","affiliation":[{"name":"Department of Brain Repair and Rehabilitation, UCL Institute of Neurology, University College London, United Kingdom (M.M.B., L.H.B.)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard","family":"Bulbulia","sequence":"additional","affiliation":[{"name":"MRC Population Health Research Unit, Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, United Kingdom (R.B.)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Calvet","sequence":"additional","affiliation":[{"name":"Department of Neurology, H\u00f4pital Sainte-Anne, Universit\u00e9 Paris-Descartes, DHU Neurovasc Sorbonne Paris Cit\u00e9, INSERM U894, Paris, France (D.C., J.-L.M.)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hans-Henning","family":"Eckstein","sequence":"additional","affiliation":[{"name":"Department of Vascular and Endovascular Surgery\/Vascular Center, Klinikum rechts der Isar, Technical University Munich, Germany (H.-H.E.)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gustav","family":"Fraedrich","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, Medical University of Innsbruck, Austria (G.F.)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Gregson","sequence":"additional","affiliation":[{"name":"Department of Medical Statistics, London School for Hygiene and Tropical Medicine, United Kingdom (J.G.)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alison","family":"Halliday","sequence":"additional","affiliation":[{"name":"Nuffield Department of Surgical Sciences, John Radcliffe Hospital, Oxford, United Kingdom (A.H.)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeroen","family":"Hendrikse","sequence":"additional","affiliation":[{"name":"Department of Radiology (J.H.), University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"George","family":"Howard","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, UAB School of Public Health, Birmingham, AL (G.H.)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Olav","family":"Jansen","sequence":"additional","affiliation":[{"name":"Clinic for Radiology and Neuroradiology, UKSH Campus Kiel, Germany (O.J.)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gary S.","family":"Roubin","sequence":"additional","affiliation":[{"name":"Cardiovascular Associates of the Southeast, Birmingham, AL (G.S.R.)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leo H.","family":"Bonati","sequence":"additional","affiliation":[{"name":"Department of Brain Repair and Rehabilitation, UCL Institute of Neurology, University College London, United Kingdom (M.M.B., L.H.B.)"},{"name":"Department of Neurology and Stroke Center, Department of Clinical Research, University Hospital Basel, University of Basel, Switzerland (L.H.B.)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas G.","family":"Brott","sequence":"additional","affiliation":[{"name":"Department of Neurology, Mayo Clinic, Jacksonville, FL (T.G.B.)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jean-Louis","family":"Mas","sequence":"additional","affiliation":[{"name":"Department of Neurology, H\u00f4pital Sainte-Anne, Universit\u00e9 Paris-Descartes, DHU Neurovasc Sorbonne Paris Cit\u00e9, INSERM U894, Paris, France (D.C., J.-L.M.)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter A.","family":"Ringleb","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Heidelberg Medical School, Germany (P.A.R.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jacoba P.","family":"Greving","sequence":"additional","affiliation":[{"name":"Julius Center for Health Sciences and Primary Care (E.J.V., A.A., J.P.G.), University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"on behalf of the Carotid Stenosis Trialists\u2019 Collaboration","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1159\/000341410"},{"key":"e_1_3_4_3_2","first-page":"CD000515","article-title":"Percutaneous transluminal balloon angioplasty and stenting for carotid artery stenosis.","author":"Bonati LH","year":"2012","unstructured":"Bonati, LH, Lyrer, P, Ederle, J, Featherstone, R, Brown, MM. Percutaneous transluminal balloon angioplasty and stenting for carotid artery stenosis. 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