Trial reportCirculation. Cardiovascular quality and outcomes2018
Periprocedural Stroke and Myocardial Infarction as Risks for Long-Term Mortality in CREST.
Trial report in Circulation. Cardiovascular quality and outcomes, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00004732 (Carotid Revascularization Endarterectomy Versus Stenting Trial), which is not on this map. Cited by 14 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Carotid Revascularization Endarterectomy Versus Stenting Trial (CREST)
Who cites it
14 citing papers in PubMed.
- Treatment of carotid stenosis in asymptomatic, nonoctogenarian, standard risk patients with stenting versus endarterectomy trials.Journal of vascular surgery · 2022Trial
- Casper vs. Closed-Cell Stent : Carotid Artery Stenting Randomized Trial.Clinical neuroradiology · 2021Trial
- Long-term risk of major adverse cardiovascular events after carotid endarterectomy-a 9-year prospective cohort study of the Athero-Express biobank.European stroke journal · 2026Article
- CREST-2 findings are unchanged using an aggregated control group for the CAS and CEA trial.Postepy w kardiologii interwencyjnej = Advances in interventional cardiology · 2026Article
- Article
- Clinical outcomes of carotid artery stenting with open- versus closed-cell stents.Journal of neurointerventional surgery · 2026Article
- The Influence of Arterial Anatomy on Early and Late Outcomes of Carotid Artery Stenting.Cardiovascular and interventional radiology · 2026Article
- Prognostic Impact of Metabolic and Inflammatory Risk for Periprocedural MI and Long-Term Events in Three-Vessel Disease Patients.Journal of inflammation research · 2025Article
- Clinical Outcomes of Second- versus First-Generation Carotid Stents: A Systematic Review and Meta-Analysis.Journal of clinical medicine · 2022Review
- Lessons From ACST-2.Stroke · 2022Review
- Association of High Mortality With Postoperative Myocardial Infarction After Major Vascular Surgery Despite Use of Evidence-Based Therapies.JAMA surgery · 2020Observational
- Comorbidities and Health-Related Quality of Life Following Revascularization for Asymptomatic Critical Internal Carotid Artery Stenosis Treated with Carotid Endarterectomy or Angioplasty with Stenting.Medical science monitor : international medical journal of experimental and clinical research · 2019Article
- Health-related quality of life in ischaemic stroke survivors after carotid endarterectomy (CEA) and carotid artery stenting (CAS): confounder-controlled analysis.Postepy w kardiologii interwencyjnej = Advances in interventional cardiology · 2019Article
- Long-Term Mortality in Carotid Revascularization Patients.Circulation. Cardiovascular quality and outcomes · 2018Article
Corrections and comments
- Commented on by
Authors and funding
14 authors.
Funding
Abstract
backgroundThe Carotid Revascularization Endarterectomy versus Stenting Trial (CREST) previously reported increased mortality in patients who sustained a periprocedural stroke or cardiac event (myocardial infarction [MI] or biomarker only) in follow-up to 4 years. We now extend these observations to 10 years. METHODS AND
resultsCREST is a randomized controlled trial designed to compare the outcomes of carotid stenting versus carotid endarterectomy. Proportional hazards models were used to assess the association between mortality and periprocedural stroke, MI, or biomarker-only events. For 10-year follow-up, patients with periprocedural stroke were at 1.74× the risk of death compared with those without stroke (adjusted hazard ratio [HR]=1.74; 95% CI, 1.21-2.50; P<0.003). This increased risk was driven by increased early (between 0 and 90 days) mortality (adjusted HR=14.41; 95% CI, 5.33-38.94; P<0.0001), with no significant increase in late (between 91 days and 10 years) mortality (adjusted HR=1.40; 95% CI, 0.93-2.10; P=0.11). Patients with a protocol MI were at 3.61× increased risk of death compared with those without MI (adjusted HR=3.61; 95% CI, 2.28-5.73; P<0.0001), with an increased hazard both early (adjusted HR=8.20; 95% CI, 1.86-36.2; P=0.006) and late (adjusted HR=3.40; 95% CI, 2.09-5.53; P<0.0001). Patients with a biomarker-only event were at 2.04× increased risk overall (adjusted HR=2.04; 95% CI, 1.09-3.84; P=0.03) than those without MI, with an increased early hazard (adjusted HR=8.44; 95% CI, 1.09-65.5; P=0.04) and a suggestive but nonsignificant association toward higher 91-day to 10-year risk (1.88; 95% CI, 0.97-3.64; P=0.062) contributing to the increased risk.
conclusionsIn the CREST trial, patients with periprocedural events demonstrate a substantial increase in future mortality to 10 years. For stroke, this risk is largely confined to an early time frame while periprocedural MI or biomarker-only events confer a continuous increased mortality for 10 years. Strategies to reduce periprocedural events and to optimize the evaluation and management of patients with cardiac events should be considered in efforts to reduce not only early but also long-term mortality. CLINICAL
trial registrationURL: https://www.clinicaltrials.gov . Unique identifier: NCT00004732.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.