Age and outcomes after carotid stenting and endarterectomy: The Carotid Revascularization Endarterectomy Versus Stenting Trial

Jenifer H. Voeks, George Howard, Gary S. Roubin, Mahmoud B. Malas, David J. Cohen, W. Charles Sternbergh, Herbert D. Aronow, Mark K. Eskandari, Alice J. Sheffet, Brajesh K. Lal, James F. Meschia, Thomas G. Brott

Research output: Contribution to journalArticle

Abstract

Background and Purpose: High stroke event rates among carotid artery stenting (CAS)-treated patients in the Carotid Revascularization Endarterectomy Versus Stenting Trial (CREST) lead-in registry generated an a priori hypothesis that age may modify the relative efficacy of CAS versus carotid endarterectomy (CEA). In the primary CREST report, we previously noted significant effect modification by age. Here we extend this investigation by examining the relative efficacy of the components of the primary end point, the treatment-specific impact of age, and contributors to the increasing risk in CAS-treated patients at older ages. Methods: Among 2502 CREST patients with high-grade carotid stenosis, proportional hazards models were used to examine the impact of age on the CAS-to-CEA relative efficacy, and the impact of age on risk within CAS-treated and CEA-treated patients. Results: Age acted as a treatment effect modifier for the primary end point (P interaction=0.02), with the efficacy of CAS and CEA approximately equal at age 70 years. For CAS, risk for the primary end point increased with age (P

Original languageEnglish (US)
Pages (from-to)3484-3490
Number of pages7
JournalStroke
Volume42
Issue number12
DOIs
StatePublished - Dec 2011

Fingerprint

Carotid Endarterectomy
Carotid Arteries
Carotid Stenosis
Proportional Hazards Models
Registries
Stroke
Therapeutics

Keywords

  • Carotid artery
  • Carotid endarterectomy
  • Cerebrovascular disease
  • Stents
  • Vascular surgery

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Clinical Neurology
  • Advanced and Specialized Nursing

Cite this

Voeks, J. H., Howard, G., Roubin, G. S., Malas, M. B., Cohen, D. J., Sternbergh, W. C., ... Brott, T. G. (2011). Age and outcomes after carotid stenting and endarterectomy: The Carotid Revascularization Endarterectomy Versus Stenting Trial. Stroke, 42(12), 3484-3490. https://doi.org/10.1161/STROKEAHA.111.624155

Age and outcomes after carotid stenting and endarterectomy : The Carotid Revascularization Endarterectomy Versus Stenting Trial. / Voeks, Jenifer H.; Howard, George; Roubin, Gary S.; Malas, Mahmoud B.; Cohen, David J.; Sternbergh, W. Charles; Aronow, Herbert D.; Eskandari, Mark K.; Sheffet, Alice J.; Lal, Brajesh K.; Meschia, James F.; Brott, Thomas G.

In: Stroke, Vol. 42, No. 12, 12.2011, p. 3484-3490.

Research output: Contribution to journalArticle

Voeks, JH, Howard, G, Roubin, GS, Malas, MB, Cohen, DJ, Sternbergh, WC, Aronow, HD, Eskandari, MK, Sheffet, AJ, Lal, BK, Meschia, JF & Brott, TG 2011, 'Age and outcomes after carotid stenting and endarterectomy: The Carotid Revascularization Endarterectomy Versus Stenting Trial', Stroke, vol. 42, no. 12, pp. 3484-3490. https://doi.org/10.1161/STROKEAHA.111.624155
Voeks, Jenifer H. ; Howard, George ; Roubin, Gary S. ; Malas, Mahmoud B. ; Cohen, David J. ; Sternbergh, W. Charles ; Aronow, Herbert D. ; Eskandari, Mark K. ; Sheffet, Alice J. ; Lal, Brajesh K. ; Meschia, James F. ; Brott, Thomas G. / Age and outcomes after carotid stenting and endarterectomy : The Carotid Revascularization Endarterectomy Versus Stenting Trial. In: Stroke. 2011 ; Vol. 42, No. 12. pp. 3484-3490.
@article{77b9a7145e4144c0812205e25e0ef2e2,
title = "Age and outcomes after carotid stenting and endarterectomy: The Carotid Revascularization Endarterectomy Versus Stenting Trial",
abstract = "Background and Purpose: High stroke event rates among carotid artery stenting (CAS)-treated patients in the Carotid Revascularization Endarterectomy Versus Stenting Trial (CREST) lead-in registry generated an a priori hypothesis that age may modify the relative efficacy of CAS versus carotid endarterectomy (CEA). In the primary CREST report, we previously noted significant effect modification by age. Here we extend this investigation by examining the relative efficacy of the components of the primary end point, the treatment-specific impact of age, and contributors to the increasing risk in CAS-treated patients at older ages. Methods: Among 2502 CREST patients with high-grade carotid stenosis, proportional hazards models were used to examine the impact of age on the CAS-to-CEA relative efficacy, and the impact of age on risk within CAS-treated and CEA-treated patients. Results: Age acted as a treatment effect modifier for the primary end point (P interaction=0.02), with the efficacy of CAS and CEA approximately equal at age 70 years. For CAS, risk for the primary end point increased with age (P",
keywords = "Carotid artery, Carotid endarterectomy, Cerebrovascular disease, Stents, Vascular surgery",
author = "Voeks, {Jenifer H.} and George Howard and Roubin, {Gary S.} and Malas, {Mahmoud B.} and Cohen, {David J.} and Sternbergh, {W. Charles} and Aronow, {Herbert D.} and Eskandari, {Mark K.} and Sheffet, {Alice J.} and Lal, {Brajesh K.} and Meschia, {James F.} and Brott, {Thomas G.}",
year = "2011",
month = "12",
doi = "10.1161/STROKEAHA.111.624155",
language = "English (US)",
volume = "42",
pages = "3484--3490",
journal = "Stroke",
issn = "0039-2499",
publisher = "Lippincott Williams and Wilkins",
number = "12",

}

TY - JOUR

T1 - Age and outcomes after carotid stenting and endarterectomy

T2 - The Carotid Revascularization Endarterectomy Versus Stenting Trial

AU - Voeks, Jenifer H.

AU - Howard, George

AU - Roubin, Gary S.

AU - Malas, Mahmoud B.

AU - Cohen, David J.

AU - Sternbergh, W. Charles

AU - Aronow, Herbert D.

AU - Eskandari, Mark K.

AU - Sheffet, Alice J.

AU - Lal, Brajesh K.

AU - Meschia, James F.

AU - Brott, Thomas G.

PY - 2011/12

Y1 - 2011/12

N2 - Background and Purpose: High stroke event rates among carotid artery stenting (CAS)-treated patients in the Carotid Revascularization Endarterectomy Versus Stenting Trial (CREST) lead-in registry generated an a priori hypothesis that age may modify the relative efficacy of CAS versus carotid endarterectomy (CEA). In the primary CREST report, we previously noted significant effect modification by age. Here we extend this investigation by examining the relative efficacy of the components of the primary end point, the treatment-specific impact of age, and contributors to the increasing risk in CAS-treated patients at older ages. Methods: Among 2502 CREST patients with high-grade carotid stenosis, proportional hazards models were used to examine the impact of age on the CAS-to-CEA relative efficacy, and the impact of age on risk within CAS-treated and CEA-treated patients. Results: Age acted as a treatment effect modifier for the primary end point (P interaction=0.02), with the efficacy of CAS and CEA approximately equal at age 70 years. For CAS, risk for the primary end point increased with age (P

AB - Background and Purpose: High stroke event rates among carotid artery stenting (CAS)-treated patients in the Carotid Revascularization Endarterectomy Versus Stenting Trial (CREST) lead-in registry generated an a priori hypothesis that age may modify the relative efficacy of CAS versus carotid endarterectomy (CEA). In the primary CREST report, we previously noted significant effect modification by age. Here we extend this investigation by examining the relative efficacy of the components of the primary end point, the treatment-specific impact of age, and contributors to the increasing risk in CAS-treated patients at older ages. Methods: Among 2502 CREST patients with high-grade carotid stenosis, proportional hazards models were used to examine the impact of age on the CAS-to-CEA relative efficacy, and the impact of age on risk within CAS-treated and CEA-treated patients. Results: Age acted as a treatment effect modifier for the primary end point (P interaction=0.02), with the efficacy of CAS and CEA approximately equal at age 70 years. For CAS, risk for the primary end point increased with age (P

KW - Carotid artery

KW - Carotid endarterectomy

KW - Cerebrovascular disease

KW - Stents

KW - Vascular surgery

UR - http://www.scopus.com/inward/record.url?scp=84855685190&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84855685190&partnerID=8YFLogxK

U2 - 10.1161/STROKEAHA.111.624155

DO - 10.1161/STROKEAHA.111.624155

M3 - Article

C2 - 21980205

AN - SCOPUS:84855685190

VL - 42

SP - 3484

EP - 3490

JO - Stroke

JF - Stroke

SN - 0039-2499

IS - 12

ER -