{"id":3540,"date":"2010-09-27T14:07:40","date_gmt":"2010-09-27T18:07:40","guid":{"rendered":"http:\/\/blogs.nejm.org\/cardioexchange\/?p=3540"},"modified":"2011-07-19T17:44:47","modified_gmt":"2011-07-19T21:44:47","slug":"carotid-endarterectomy-still-beneficial-at-10-years","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/cardioexchange\/2010\/09\/27\/carotid-endarterectomy-still-beneficial-at-10-years\/","title":{"rendered":"Carotid Endarterectomy Still Beneficial At 10 Years"},"content":{"rendered":"<p>Carotid endarterectomy (CEA) in asymptomatic patients under 75 years of age reduces the long-term risk of stroke, according to <a href=\"http:\/\/www.thelancet.com\/journals\/lancet\/article\/PIIS0140-6736%2810%2961197-X\/fulltext?_eventId=login\">10-year results from the Asymptomatic Carotid Surgery Trial (ACST), published in the <em>Lancet<\/em><\/a>. The ACST investigators randomized 3120 asymptomatic patients to immediate CEA or to indefinite deferral of CEA. At 5 years, CEA had been performed on 92.1% of patients in the immediate CEA group compared to 16.5% in the deferral group. At 10 years, the net risk (death or stroke within 30 days and non-perioperative stroke) was 13.4% % in the immediate CEA group versus 17.9% in the deferral group.\u00a0The relative reduction in risk was independent of whether the patients were taking lipid-lowering therapy, but the absolute risk of stroke was lower in patients on lipid-lowering therapy.<\/p>\n<p>The authors concluded that CEA is most effective in patients with a long life expectancy, &#8220;because the potential long-term benefits of CEA are sharply curtailed in those who have less than 10 years of life expectancy&#8230; For otherwise healthy men and women younger than 75 years&#8230; the results from this trial suggest net benefit from CEA, as long as perioperative risks remain low.&#8221;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Carotid endarterectomy (CEA) in asymptomatic patients under 75 years of age reduces the long-term risk of stroke, according to 10-year results from the Asymptomatic Carotid Surgery Trial (ACST), published in the Lancet. The ACST investigators randomized 3120 asymptomatic patients to immediate CEA or to indefinite deferral of CEA. At 5 years, CEA had been performed [&hellip;]<\/p>\n","protected":false},"author":196,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[20,1,16],"tags":[442,443],"class_list":["post-3540","post","type-post","status-publish","format-standard","hentry","category-cardiac-surgery","category-general","category-vascular","tag-carotid-endarterectomy","tag-cea"],"_links":{"self":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts\/3540","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/users\/196"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/comments?post=3540"}],"version-history":[{"count":0,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts\/3540\/revisions"}],"wp:attachment":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/media?parent=3540"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/categories?post=3540"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/tags?post=3540"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}