Abstract 21070: Impact of Glomerular Filtration Rate on Clinical Outcomes Following Carotid Artery Revascularization in 12,304 Patients from the CARE Registry®
Background: Chronic kidney disease (CKD) is associated with increased mortality and adverse cardiovascular events after coronary intervention. There is limited data evaluating the impact of CKD in patients undergoing carotid artery revascularization.
Methods: The Carotid Artery Revascularization and Endarterectomy (CARE) Registry® is a voluntary registry that receives data from 168 participating hospitals. For the purpose of this study, we examined registry patients undergoing carotid artery revascularization by either carotid endarterectomy (CEA) or carotid artery stenting (CAS) from 05/2005 thru 03/2010. Patients were divided into 3 groups by their estimated glomerular filtration rate (GFR) using the MDRD equation with baseline serum creatinine.
Results: A total of 12,304 patients were included in the analysis. Patients with lower GFRs had multiple comorbidities and were more likely to undergo CAS than CEA (Table). CKD was associated with higher in-hospital and 30 day death, stroke and MI event rates. However, in multivariate analysis adjusting for various baseline and procedural characteristics, CKD was not an independent predictor of adverse events (OR 0.97, 95% CI: 0.82–1.15).
Conclusions: Patients with CKD have worse baseline characteristics and, paradoxically, are more likely to undergo contrast-based CAS. The presence of CKD is associated with worse outcomes following carotid artery revascularization but is not an independent predictor of in-hospital and 30-day event rates. Further analysis will be performed to determine the effect of CKD within each treatment type (CAS/CEA), after controlling for comorbid conditions (gender, diabetes, and hypertension) and to determine the relationship of CKD with procedure related contrast induced nephropathy.
- © 2010 by American Heart Association, Inc.