Evidence map›Paper›PMID 31555985›Full record

ArticleClinical research in cardiology : official journal of the German Cardiac Society2020

The SAPPHIRE criteria, history of myocardial infarction and diabetes predict adverse outcomes following carotid endarterectomy similar to stenting.

Roland Richard Macharzina, Carolin Müller, Matthias Vogt, Steven R Messé, Werner Vach, Thomas Winker, Michael Weinbeck, Matthias Siepe, Martin Czerny, Franz-Josef Neumann and 1 more

Open access · hybridAbstract read
In one paragraph

Article in Clinical research in cardiology : official journal of the German Cardiac Society, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
1.0field-weighted citation impact, top 20% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 8 citations in OpenAlex.

  1. Article
  2. Article
  3. Diabetes and carotid artery disease: a narrative review.Annals of translational medicine · 2020
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 4 institutions in 3 countries.

Roland Richard MacharzinaDepartment of Cardiology and Angiology II, University Heart Center Freiburg-Bad Krozingen, Suedring 15, 79189, Bad Krozingen, Germany. macharzina@gmail.com.
Carolin MüllerDepartment of Surgery, Ortenau Klinikum Lahr, Lahr, Germany.
Matthias VogtDepartment of Cardiovascular Surgery, University Heart Center Freiburg-Bad Krozingen, Bad Krozingen, Germany.
Steven R MesséDepartment of Neurology, University of Pennsylvania, Philadelphia, USA.
Werner VachFunctional Biomechanics Laboratory, University Hospital Basel, Spitalstrasse 21, 4031, Basel, Switzerland.
Thomas WinkerInstitute of Neurology, University Heart Center Freiburg-Bad Krozingen, Bad Krozingen, Germany.
Michael WeinbeckDepartment of Cardiovascular Surgery, University Heart Center Freiburg-Bad Krozingen, Bad Krozingen, Germany.
Matthias SiepeDepartment of Cardiovascular Surgery, University Heart Center Freiburg-Bad Krozingen, Bad Krozingen, Germany.
Martin CzernyDepartment of Cardiovascular Surgery, University Heart Center Freiburg-Bad Krozingen, Bad Krozingen, Germany.
Franz-Josef NeumannDepartment of Cardiology and Angiology II, University Heart Center Freiburg-Bad Krozingen, Suedring 15, 79189, Bad Krozingen, Germany.
Thomas ZellerDepartment of Cardiology and Angiology II, University Heart Center Freiburg-Bad Krozingen, Suedring 15, 79189, Bad Krozingen, Germany.
Universitäts-Herzzentrum Freiburg-Bad Krozingen · DEOrtenau Klinikum · DEUniversity Hospital of Basel · CHUniversity of Pennsylvania · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimsIdentifying factors associated with worse outcome following carotid endarterectomy (CEA) is important to improve prevention of major adverse cardiovascular and cerebrovascular events (MACCE), yet rarely used for registries. We intended to identify predictors of MACCE following CEA as recently analysed for stenting. METHODS AND

resultsPatients undergoing CEA at 2 centers over 13 years were entered into a database. Baseline clinical characteristics, procedural factors and a panel of clinical and lesion-related high-risk features (SHR) and exclusion criteria (SE), empirically compiled for stratification in the SAPPHIRE trial, were differentially analysed using Cox regressions. The analysis included 748 operations; 262 (35%) asymptomatic, 208 (28%) with previous strokes, and 278 (37%) with transient ischemic attacks (TIA). The overall 30-day MACCE rate was 6.7%, 5.0% in asymptomatic and 7.6% in symptomatic patients. Previous MI (HR 2.045, p = 0.022), diabetes (HR 2.111, p = 0.011) and symptomatic patients (HR 2.045, p = 0.044) were independently associated with MACCE. SE patients (n = 81) had a MACCE rate of 13.6%; the MACCE rate of the remainder dropped to 5.8% (4.7% in asymptomatic and 6.5% in symptomatic patients). Hazard ratio for SHR patients was 2.069 (CI 1.087-3.941) and 2.389 for SE (CI 1.223-4.666), each compared to all patients with lower risk and adjusted for symptomatic status. Among SHR and SE criteria NYHA 3-4, contralateral occlusions and intraluminal thrombus were significant determinants and MI < 4 weeks before CEA showed a strong trend (p = 0.05).

conclusionPatients identified by SHR and SE criteria, prior MI and diabetes warrant increased attention to prevent MACCE following CEA.

Indexed as

AdultAgedAged, 80 and overCarotid StenosisCohort StudiesDiabetes ComplicationsEndarterectomy, CarotidFemaleHumansLogistic ModelsMaleMiddle AgedMyocardial InfarctionOdds RatioPostoperative ComplicationsRegistriesCarotid artery stenosisDiabetesEndarterectomyMyocardial infarctionSAPPHIRE trialStroke

Identifiers

PMID31555985
PMCPMC7182626
OpenAlexW2976362110

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.