Most Read Articles
2 days ago
Dairy consumption during adolescence or early adulthood does not appear to be associated with the overall risk of breast cancer, although results vary by hormone receptor status of tumours, a study has shown. Specifically, dairy intake is linked to higher ER–/PR– and lower ER+/PR+ cancer risk.
Roshini Claire Anthony, 5 days ago

The combined use of piperacillin and tazobactam does not appear to be a suitable alternative to meropenem for patients with bloodstream infections caused by ceftriaxone-resistant Escherichia coli (E. coli) or Klebsiella pneumoniae (K. pneumoniae), according to results of the MERINO* trial.

3 days ago
Patients with inflammatory bowel disease are at increased risk of developing acute myocardial infarction (AMI) or heart failure, although the prevalence of traditional risk factors for such cardiovascular disorders appears to be low, as reported in a recent study.
4 days ago
Early renin-angiotensin-aldosterone system (RAAS) blockade with renin-angiotensin system inhibitors (RASI) leads to better short- and long-term renal outcomes in systemic lupus erythematosus (SLE) patients with antiphospholipid-associated nephropathy (aPLN), according to a study, adding that this renal protective effect is independent of RASI’s antihypertensive and antiproteinuric effects.

Better long-term outcomes in carotid endarterectomy than in stenting

24 Jul 2017
Huge unethical mark-ups were charged at each stage in the supply chain of coronary stents.

Carotid endarterectomy yields better short- and long-term outcomes than stenting for carotid artery stenosis, according to a new meta-analysis. However, endarterectomy is also associated with higher risks of periprocedural myocardial infarction.

Pooled data from eight trials (n=7,005) showed significantly lower risks of periprocedural myocardial infarction in patients who underwent stenting (odds ratio [OR], 0.52; 95 percent CI, 0.33 to 0.81; p=0.004).

On the other hand, the incidence of the composite outcome of death or stroke was significantly higher in stenting than in endarterectomy (OR, 1.76; 1.38 to 2.25; p<0.0001). Minor stroke (OR, 2.19; 1.59 to 3.01; p<0.0001) accounted for majority of this association; incidence major strokes (OR, 1.41; 0.95 to 2.09; p=0.09) and deaths (OR, 1.68; 0.82 to 3.44; p=0.16) were not significantly elevated.

Pooled data from seven trials (n=6,799) showed that long-term stroke was significantly more common in stenting than in endarterectomy (OR, 1.45; 1.22 to 1.73; p<0.0001). The long-term risk of the composite outcome of death, ipsilateral stroke and periprocedural stroke was significantly higher in stenting (OR, 1.25; 1.05 to 1.48; p=0.01).

On the other hand, there were no significant differences between the two groups in terms of ipsilateral stroke (OR, 1.04; 0.79 to 1.37; p=0.80) and long-term all-cause mortality (OR, 1.09; 0.95 to 1.26; p=0.21). All but one of the trials showed low risk of bias.

The meta-analysis included randomized controlled trials that compared the efficacy and safety of endarterectomy with stenting. Exclusion criteria included retrospective and observational study designs, and a follow-up period <4 years.

The databases of Embase, PubMed and the Cochrane Library Central Register of Controlled Trials were accessed. Risk of bias was determined using the Cochrane Collaboration guidelines.

Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS Doctor - Malaysia digital copy today!
Sign In To Download
Editor's Recommendations
Most Read Articles
2 days ago
Dairy consumption during adolescence or early adulthood does not appear to be associated with the overall risk of breast cancer, although results vary by hormone receptor status of tumours, a study has shown. Specifically, dairy intake is linked to higher ER–/PR– and lower ER+/PR+ cancer risk.
Roshini Claire Anthony, 5 days ago

The combined use of piperacillin and tazobactam does not appear to be a suitable alternative to meropenem for patients with bloodstream infections caused by ceftriaxone-resistant Escherichia coli (E. coli) or Klebsiella pneumoniae (K. pneumoniae), according to results of the MERINO* trial.

3 days ago
Patients with inflammatory bowel disease are at increased risk of developing acute myocardial infarction (AMI) or heart failure, although the prevalence of traditional risk factors for such cardiovascular disorders appears to be low, as reported in a recent study.
4 days ago
Early renin-angiotensin-aldosterone system (RAAS) blockade with renin-angiotensin system inhibitors (RASI) leads to better short- and long-term renal outcomes in systemic lupus erythematosus (SLE) patients with antiphospholipid-associated nephropathy (aPLN), according to a study, adding that this renal protective effect is independent of RASI’s antihypertensive and antiproteinuric effects.