Lipid goal achievement and trends in lipid-lowering therapy in veterans undergoing carotid endarterectomy.


Journal Article

Secondary prevention of cardiovascular disease after carotid endarterectomy should include management of low-density lipoprotein (LDL) levels, but increased LDL levels are undertreated in these patients. We examined trends in statin use and LDL goal achievement in veterans undergoing carotid endarterectomy (CEA), a medically high-risk group with high rates of cardiovascular morbidity and mortality. The records of all CEA performed between 1995 and 2005 in the Connecticut Veterans' Affairs (VA) hospital were reviewed. Kaplan-Meier analysis was used to analyze long-term outcomes. ANOVA was used for comparisons between groups. A total of 309 CEA procedures were performed in 298 patients. The mean follow-up was 4.1 years. Statin use increased over time (12% in 1995, 84% in 2005) and mean LDL levels decreased (105 mg/dl in 1997, 90 mg/dl in 2007). The number of patients achieving LDL goals of 100 mg/dl or 70 mg/dl increased. Mean HDL levels decreased (53 mg/dl in 1997 and 38 mg/dl in 2007). Patients with three or more comorbid medical conditions were more likely to achieve LDL goals. At 12 years, freedom from stroke was 91%, freedom from myocardial infarction was 46% and survival was 12%. In conclusion, over the last decade, among patients who have undergone CEA, statin use has increased and LDL levels have improved.

Full Text

Cited Authors

  • Fitzgerald, TN; Popp, C; Dardik, A; Federman, DG

Published Date

  • February 2009

Published In

Volume / Issue

  • 14 / 1

Start / End Page

  • 21 - 27

PubMed ID

  • 19144776

Pubmed Central ID

  • 19144776

Electronic International Standard Serial Number (EISSN)

  • 1477-0377

International Standard Serial Number (ISSN)

  • 1358-863X

Digital Object Identifier (DOI)

  • 10.1177/1358863x08098271


  • eng