• George Galyfos, Costas Tsioufis, Dimitris Theodorou, Stilianos Katsaragakis, Georgios Zografos, and Konstantinos Filis.
• First Department of Propaedeutic Surgery, University of Athens Medical School, Hippocration Hospital, Athens, Greece. Electronic address: georgegalyfos@hotmail.com.
• J Stroke Cerebrovasc Dis. 2015 Mar 1; 24 (3): 711-7.

BackgroundWe compared postoperative cardiac damage, defined as cardiac troponin I (cTnI) elevation, in low, medium, and high cardiac risk patients, after carotid endarterectomy (CEA).MethodsThe Vascular Study Group of New England Cardiac Risk Index (VSG-CRI) criteria for stratifying patients considered for vascular surgery into low, medium, and high cardiac risk groups were used prospectively. For all patients (n = 324), cTnI value assessments were made before surgery and on postoperative days 1, 3, and 7. Postoperative cTnI values ranging from .05 to .5 ng/mL were classified as myocardial ischemia; values more than .5 ng/mL were classified as myocardial infarction. Cardiac damage was defined as either myocardial ischemia or infarction.ResultsMortality was .003%, stroke rate was null, and symptomatic myocardial infarction was null as well. Low-risk patients (16 of 140) and medium-risk patients (28 of 160) increased their troponin levels on days 1 and 3 postoperatively. However, none of the high-risk patients (n = 24) showed any postoperative cardiac damage. Low and medium cardiac risk patients showed higher troponin values on each separate day, in comparison with high cardiac risk patients.ConclusionsCEA is followed by a high incidence of asymptomatic cTnI increase that is associated with late cardiac events. However, high cardiac risk patients as defined by the VSG-CRI criteria do not seem to suffer higher cardiac damage after CEA compared with low and medium cardiac risk patients.Copyright © 2015 National Stroke Association. Published by Elsevier Inc. All rights reserved.

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