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Title: Higher Levels of Cholesterol Bode Badly for Older Survivors of Endarterectomy: Presented at ESC

"Higher Levels of Cholesterol Bode Badly for Older Survivors of Endarterectomy: Presented at ESC"

By Ed Susman NICE, France -- May 14, 2008 -- Patients who undergo endarterectomy to remove plaque build-up in the carotid arteries should be considered for aggressive therapy to prevent hypercholesterolaemia in the years after the surgery, researchers suggested here at the 17th European Stroke Conference (ESC). In the 5 years postsurgery, 9 of 139 patients died due to heart disease or stroke, and those patients had an average total cholesterol of 5.8 mmol (226 mg/dL) compared with survivors, who had an average level of 4.9 mmol (191 mg/dL, [P < .05).

Coinvestigator Montserrat Balletbó Gómez, RN, Nursing Supervisor, Department of Neurosurgery, Hospital Universitari de Bellvitge, Barcelona, Spain, presented the study findings in a poster presentation on May 13.

Balletbó and colleagues followed 113 men and 26 women who underwent consecutive endarterectomy procedures at their institution. Patients had a mean age of 65 years (range, 46-84 years); 62% were symptomatic; 68% had high blood pressure; and 40% were diabetic.

Cholesterol evaluation and other blood tests were performed at least 1 day prior to surgery and then at least 1 month after surgery. Follow-up blood cholesterol levels were again measured at 1 year and at 5 years after carotid endarterectomy.

After 5 years, the researchers observed that 7 patients had died due to coronary artery disease and 2 others had died due to stroke. A total of 24 patients had definitive heart disease, while 10 patients had strokes.

"This study demonstrated that total cholesterol level is a predictor of fatal vascular outcome at 5 years in elderly patients subjected to carotid endarterectomy," she said. The risk for those with higher cholesterol levels was twice as high as that of patients with lower cholesterol levels, she noted.

"New studies should address the question of whether aggressive hypercholesterolaemia [treatment] and rigorous dietary control reduces the number of fatal vascular events in these patients who have undergone endarterectomy," she said.

[Presentation Title: Total Cholesterol Levels Predict Vascular Death in Patients Undergoing Carotid Endarterectomy: Results From 5-Year Follow-Up Study.]

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