Article Figures & Data
Figures
- Figure 1.
Cumulative proportion of ipsilateral stroke from Kaplan-Meier analyses by degree of ICA stenosis, eGFR level (ml/min per 1.73 m2), and treatment group is shown.
Tables
Characteristic eGFR <60(n = 524) eGFR ≥60(n = 966) P Age <0.001 >65 yr (%) 73.3 44.4 mean (range) 69 (38 to 89) 64 (31 to 85) Female gender (%) 37.6 27.1 <0.001 Black race (%) 1.5 3.8 0.01 Qualifying (presenting) ischemic event (%) stroke (not TIA) 41.2 38.8 0.37 hemispheric (not retinal) 72.1 71.3 0.74 History of (%) TIA or stroke within past 6 moa 54.8 55.7 0.73 hypertension 73.7 54.3 <0.001 diabetes 22.5 21.0 0.50 MI 24.0 18.0 0.006 CHF 3.8 2.0 0.03 arrhythmia 4.2 5.3 0.36 hyperlipidemia 35.7 34.5 0.64 intermittent claudication 17.0 13.8 0.10 Smoking within past 12 mo (%) 34.5 50.2 <0.001 Systolic BP >160 mmHg (%) 23.5 16.7 0.001 Diastolic BP >90 mmHg (%) 13.0 12.0 0.59 Glucose >7 mmol/L (>126 mg/dl) (%) 20.0 21.2 0.59 Degree of ICA stenosis 70 to 99% (%) 41.4 44.5 0.25 eGFR (ml/min per 1.73 m2; mean [range]) 49 (19 to 60) 79 (60 to 153) – Serum creatinine (μmol/L; mean [range]) 127 (86 to 292) 87 (39 to 133) – Serum creatinine (mg/dl; mean [range]) 1.5 (0.9 to 3.3) 1.0 (0.4 to 1.5) – -
Characteristics were compared using a χ2 test. TIA, transient ischemic attack; ICA, internal carotid artery stenosis; MI, myocardial infarction.
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↵aIn addition to the qualifying (presenting) event.
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- Table 2.
Two-year risks for outcomes by treatment and CKD status (eGFR, ml/min per 1.73 m2) in patients with high-grade internal carotid artery stenosis (70 to 99%)
Parameter Medical Risk (%)(n = 126)a(n = 197)b Surgical Risk (%)(n = 91)a(n = 233)b RRR (%) Absolute Risk Difference (%; 95% CI) P Interaction Test (P) Risk Difference RRR Ipsilateral strokec eGFR <60 31.6 5.6 82.3 26.0 (15.1 to 36.8) <0.001 0.018 0.051 eGFR ≥60 19.3 9.5 50.8 9.8 (1.9 to 17.7) 0.047 Death (any cause) eGFR <60 9.4 9.7 −3.2 −0.3 (−11.1 to 10.5) 0.94 0.83 0.78 eGFR ≥60 5.9 4.9 16.9 1.0 (−4.4 to 6.4) 0.59 Any stroke, MI, or vascular death eGFR <60 40.7 17.5 57.0 23.2 (9.6 to 36.7) 0.016 0.07 0.26 eGFR ≥60 23.0 15.0 34.8 8.0 (−1.0 to 17.0) 0.13 -
Medical and surgical groups were compared using a log-rank test. RRR, relative risk reduction.
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↵aeGFR <60 ml/min per 1.73 m2.
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↵beGFR ≥60 ml/min per 1.73 m2.
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↵cTo provide a more conservative estimate of the benefits of endarterectomy, the outcome “ipsilateral stroke” includes any stroke and any death within 32 d of randomization (30 d postoperatively; median time from randomization to surgery was 2 d).
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- Table 3.
Two-year risks of outcomes by treatment and CKD status (eGFR, ml/min per 1.73 m2) in patients with moderate-grade ICA stenosis (50 to 69%)
Parameter Medical Risk (%)(n = 151)a(n = 266)b Surgical Risk (%)(n = 156)a(n = 270)b RRR (%) Absolute Risk Difference (%; 95% CI) P Interaction Test (P) Risk Difference RRR Ipsilateral strokec eGFR <60 16.0 11.0 31.2 5.0 (−2.8 to 12.8) 0.34 0.92 0.94 eGFR ≥60 13.6 9.1 33.1 4.5 (−1.0 to 9.9) 0.15 Death (any cause) eGFR <60 10.7 10.4 2.8 0.3 (−6.7 to 7.3) 0.99 0.89 0.88 eGFR ≥60 5.1 5.3 −3.9 −0.2 (−4.1 to 3.6) 0.88 Any stroke, MI, or vascular death eGFR <60 29.9 19.7 34.1 10.2 (−1.3 to 18.4) 0.08 0.26 0.35 eGFR ≥60 21.5 18.2 15.3 3.3 (−2.7 to 11.1) 0.45 -
Medical and surgical groups were compared using a log-rank test. RRR, Relative Risk Reduction.
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↵aeGFR <60 ml/min per 1.73 m2.
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↵beGFR ≥60 ml/min per 1.73 m2
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↵cTo provide a more conservative estimate of the benefits of endarterectomy, the outcome “ipsilateral stroke” includes any stroke and any death within 32 d of randomization (30 d postoperatively; median time from randomization to surgery was 2 d).
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- Table 4.
30-Day perioperative risks of outcomes by CKD status (eGFR, ml/min per 1.73 m2) for patients assigned to carotid endarterectomy (n = 744)
Parameter eGFR <60 (%; n = 245) eGFR ≥60 (%; n = 499) Risk Difference (%; 95% CI) P Any stroke or death 6.9 6.4 0.5 (−3.3 to 4.4) 0.79 Any nonfatal stroke 4.9 5.6 −0.7 (−4.1 to 2.7) 0.68 Death (any cause) 2.0 0.8 1.2 (−0.7 to 3.2) 0.15 MI, CHF, or arrhythmia 6.5 1.2 5.3 (2.1 to 8.6) <0.001 MI 2.0 0.6 1.4 (−0.5 to 3.3) 0.07 CHF 1.6 0.2 1.4 (−0.2 to 3.1) 0.025 Arrhythmia 3.6 0.6 3.0 (0.6 to 5.5) 0.002 -
Includes patients who had moderate and severe stenoses at time of randomization and actually had surgery. Patients with and without CKD were compared using a χ2 test.
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- Table 5.
30-Day perioperative unadjusted and adjusted risk ratios for patients assigned to carotid endarterectomy (n = 744) with CKD compared to those without CKD
Parameter Unadjusted Risk Ratio (95% CI) P Adjusted Risk Ratio (95% CI) P Any stroke or death 1.08 (0.61 to 1.90) 0.79 1.30 (0.73 to 2.33) 0.37 Any nonfatal stroke 0.87 (0.45 to 1.69) 0.68 1.09 (0.54 to 2.20) 0.81 Death (any cause) 2.55 (0.69 to 9.40) 0.16 2.67 (0.91 to 7.84) 0.07 MI, CHF, or arrhythmia 5.43 (2.15 to 13.71) <0.001 3.98 (1.60 to 9.90) 0.003 MI 3.39 (0.82 to 14.09) 0.09 3.14 (0.81 to 12.23) 0.10 CHF 8.14 (0.92 to 72.4) 0.06 5.82 (0.77 to 44.07) 0.09 Arrhythmia 6.11 (1.67 to 22.37) 0.006 3.99 (1.17 to 13.65) 0.027 -
Includes patients who had moderate and severe stenoses at time of randomization and actually had surgery. Patients with and without CKD were compared using log-binomial regression. Patients without CKD served as the referent group. Risk ratios were adjusted for age, gender, and a history of hypertension, MI, or smoking.
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Benefit of Carotid Endarterectomy in Patients with Chronic Kidney Disease
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Benefit of Carotid Endarterectomy in Patients with Chronic Kidney Disease
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