Prevention

Surgical complications are more likely with associated cardiovascular disease:  

• history of angina ^b or a recent MI ^b
• peripheral vascular disease ^b
• mitral or aortic valve disease ^b

Why?

A recent myocardial infarction increases the risk of surgical complications

Patient	Prognostic Factor	Outcome	CER	RR (95% CI)	NNF+ (95% CI)
undergoing carotid endarterectomy b	myocardial infarction within past 6 months independent	death, stroke, myocardial infarction at 30 days	11%	2.87 (1.09 to 6.41)	5 (2 to 100)

Angina, peripheral vascular disease and valve disease increase the risk of surgical complications

Patient	Prognostic Factor	Outcome	CER	OR (95% CI)	NNF+ (95% CI)
undergoing carotid endarterectomy b	history of angina independent	stroke or death at 30 days	8.6%	1.90 (1.03 to 3.40)	15 (6 to 430)
undergoing carotid endarterectomy b	peripheral vascular disease independent	stroke or death at 30 days	8.6%	2.19 (1.40 to 3.60)	12 (6 to 33)
carotid endarterectomy b	mitral valve disorder independent	death at discharge	1.2%	1.81	110
carotid endarterectomy	aortic valve disorder independent	death at discharge	1.2%	2.61	54