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Abstract：
UNASSIGNED: Severe carotid artery stenosis (sCAS) is frequently discovered at the time of evaluation for coronary arterial revascularization. However, there has been controversy regarding the optimal management of sCAS. This study evaluated the potential effects of untreated sCAS at time of coronary artery bypass grafting (CABG) in contemporary practice.
UNASSIGNED: This was a retrospective study from a multihospital healthcare system including patients undergoing isolated CABG between 2011 and 2018. Patients were stratified by the presence of sCAS (≥80% stenosis) in at least 1 carotid artery. Perioperative and 5-year stroke were compared, and multivariable analysis was used to identify risk-adjusted predictors of stroke and mortality.
UNASSIGNED: A total of 5475 patients were included, 459 (8.4%) with sCAS and 5016 (91.6%) without sCAS. Patients with sCAS experienced more frequent perioperative stroke (4.4% vs 1.2%; P < .001), with most attributable to ischemic or embolic etiologies. The median duration of follow-up was 4.6 years (interquartile range, 3.0-6.5 years). One-year and 5-year survival were both lower in patients with sCAS (P < .001). In multivariable analysis, sCAS was associated with increased risk-adjusted hazard for both mortality (hazard ratio [HR], 1.28; 95% confidence interval [CI], 1.02-1.60; P = .030) and stroke (HR, 1.76; 95% CI, 1.20-2.59; P = .004). The strongest risk-adjusted predictor for stroke was a previous history of stroke (HR, 2.51; 95% CI, 1.77-3.55; P < .001).
UNASSIGNED: This contemporary analysis of CABG procedures reveals that concurrent sCAS continues to confer a significant stroke risk, especially in those with history of previous stroke. Although whether sCAS lesions are responsible for most strokes is unclear, they likely serve as a surrogate for other stroke risk factors.
UNASSIGNED: This was a retrospective study from a multihospital healthcare system including patients undergoing isolated CABG between 2011 and 2018. Patients were stratified by the presence of sCAS (≥80% stenosis) in at least 1 carotid artery. Perioperative and 5-year stroke were compared, and multivariable analysis was used to identify risk-adjusted predictors of stroke and mortality.
UNASSIGNED: A total of 5475 patients were included, 459 (8.4%) with sCAS and 5016 (91.6%) without sCAS. Patients with sCAS experienced more frequent perioperative stroke (4.4% vs 1.2%; P < .001), with most attributable to ischemic or embolic etiologies. The median duration of follow-up was 4.6 years (interquartile range, 3.0-6.5 years). One-year and 5-year survival were both lower in patients with sCAS (P < .001). In multivariable analysis, sCAS was associated with increased risk-adjusted hazard for both mortality (hazard ratio [HR], 1.28; 95% confidence interval [CI], 1.02-1.60; P = .030) and stroke (HR, 1.76; 95% CI, 1.20-2.59; P = .004). The strongest risk-adjusted predictor for stroke was a previous history of stroke (HR, 2.51; 95% CI, 1.77-3.55; P < .001).
UNASSIGNED: This contemporary analysis of CABG procedures reveals that concurrent sCAS continues to confer a significant stroke risk, especially in those with history of previous stroke. Although whether sCAS lesions are responsible for most strokes is unclear, they likely serve as a surrogate for other stroke risk factors.
摘要：
未经证实：在评估冠状动脉血运重建时经常发现严重颈动脉狭窄（sCAS）。然而,关于sCAS的优化管理一直存在争议。这项研究评估了在当代实践中冠状动脉旁路移植术（CABG）时未治疗的sCAS的潜在影响。
UNASSIGNED：这是一项来自多医院医疗保健系统的回顾性研究，其中包括2011年至2018年接受隔离CABG的患者。根据至少1条颈动脉中存在sCAS（≥80％狭窄）对患者进行分层。比较围手术期和5年卒中，多变量分析用于确定卒中和死亡率的风险校正预测因子.
未经授权：共纳入5475例患者，有sCAS的459(8.4%)和无sCAS的5016(91.6%)。sCAS患者的围手术期卒中发生率更高（4.4%vs1.2%；P<.001），主要归因于缺血性或栓塞病因。中位随访时间为4.6年(四分位间距，3.0-6.5年）。sCAS患者的1年和5年生存率均较低（P<0.001）。在多变量分析中，SCAS与两种死亡率的风险调整风险增加相关(风险比[HR]，1.28；95%置信区间[CI]，1.02-1.60；P=.030）和中风（HR，1.76；95%CI，1.20-2.59；P=.004）。中风的最强风险调整预测因子是以前的中风史(HR，2.51；95%CI，1.77-3.55；P<.001）。
UNASSIGNED：对CABG手术的当代分析显示，并发sCAS继续赋予显著的卒中风险，尤其是那些有中风史的人。尽管尚不清楚sCAS病变是否与大多数中风有关，它们可能作为其他卒中风险因素的替代.
UNASSIGNED：这是一项来自多医院医疗保健系统的回顾性研究，其中包括2011年至2018年接受隔离CABG的患者。根据至少1条颈动脉中存在sCAS（≥80％狭窄）对患者进行分层。比较围手术期和5年卒中，多变量分析用于确定卒中和死亡率的风险校正预测因子.
未经授权：共纳入5475例患者，有sCAS的459(8.4%)和无sCAS的5016(91.6%)。sCAS患者的围手术期卒中发生率更高（4.4%vs1.2%；P<.001），主要归因于缺血性或栓塞病因。中位随访时间为4.6年(四分位间距，3.0-6.5年）。sCAS患者的1年和5年生存率均较低（P<0.001）。在多变量分析中，SCAS与两种死亡率的风险调整风险增加相关(风险比[HR]，1.28；95%置信区间[CI]，1.02-1.60；P=.030）和中风（HR，1.76；95%CI，1.20-2.59；P=.004）。中风的最强风险调整预测因子是以前的中风史(HR，2.51；95%CI，1.77-3.55；P<.001）。
UNASSIGNED：对CABG手术的当代分析显示，并发sCAS继续赋予显著的卒中风险，尤其是那些有中风史的人。尽管尚不清楚sCAS病变是否与大多数中风有关，它们可能作为其他卒中风险因素的替代.
