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From the Calgary Stroke Program, Department of Clinical Neurosciences, University of Calgary; Departments of Clinical Neurosciences, Medicine, and Community Health Sciences (Drs. Hill, Kennedy, and Ghali), Faculty of Medicine, University of Calgary; Centre for Health and Policy Studies (Dr. Shrive), Department of Community Health Sciences, University of Calgary; Faculty of Medicine and Capital Health (Dr. Feasby), University of Alberta, Edmonton.
Address correspondence and reprint requests to Dr. Michael D. Hill, Assistant Professor, Calgary Stroke Program, Department of Clinical Neurosciences, University of Calgary, Foothills Hospital, Rm. 1242A, 1403 29th Street NW, Calgary, Alberta, T2N 2T9, Canada; e-mail: michael.hill{at}calgaryhealthregion.ca
Stroke neurologists are commonly asked to review patients who require coronary artery bypass grafting (CABG) but who also have comorbid severe carotid stenosis; such patients may be offered simultaneous carotid endarterectomy (CEA). In Canada, 0.51% of CABG procedures were combined CEA-CABG. The adjusted stroke and death rate was 2.67-fold greater in the combined CEA-CABG group compared to CABG alone. Randomized trials of the combined procedure are needed.
Editorial, see page 1332
Additional material related to this article can be found on the Neurology Web site. Go to www.neurology.org and scroll down the Table of Contents for the April 26 issue to find the title link for this article.
M.D.H. was supported by the Heart & Stroke Foundation of Alberta/NWT/Nunavut and the Canadian Institutes for Health Research. F.M.S. was supported Canada Graduate Scholarship from CIHR and by an AHFMR Studentship. J.K. was supported by the Canadian Stroke Network, the Heart and Stroke Foundation of Canada, the Canadian Institutes of Health Research, and AstraZeneca W.A.G. was supported by the Alberta Heritage Foundation for Medical Research and holds a Canada Research Chair in Health Services Research.
M.D.H. participated in the design and analysis and primarily wrote the manuscript. F.M.S. participated in the design of the study and conducted the statistical analysis and contributed to the drafting and editing of the final manuscript. J.K., T.E.F., F.S., W.A.G. participated in the design of the study and contributed to the drafting and editing of the final manuscript.
Received September 16, 2004. Accepted in final form December 21, 2004.
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