Navigation Links
Age is a factor in choosing between two comparable stroke-prevention procedures
Date:5/28/2010

BIRMINGHAM, Ala. A published report provides the final details on how two stroke-prevention procedures are safe and equally beneficial for men and women at risk for stroke, though their effectiveness does vary by age, say researchers at the University of Alabama at Birmingham (UAB) School of Public Health in collaboration with other North American stroke investigators.

In findings reported online in the New England Journal of Medicine (NEJM) May 26, the researchers say the age of patients made a difference in comparing the two prevention procedures, and physicians should consider this and many other factors when tailoring their treatment plans for patients at risk for stroke.

The study is part of the Carotid Revascularization Endarterectomy vs. Stenting Trial (CREST). It was presented in summary form at the International Stroke Conference in San Antonio, Texas, Feb. 26.

Stroke, the third-leading cause of death in the nation, is caused by an interruption in blood flow to the brain by a clot or bleeding. The carotid arteries on each side of the neck are the major source of blood flow to the brain. The buildup of cholesterol in the wall of the carotid artery, called atherosclerotic plaque, is one cause of stroke.

CREST compares endarteroctomy, a surgical procedure to clear blocked blood flow and prevent stroke, with carotid stenting, a newer procedure that involves threading a stent and expanding a small protective device in the artery to widen the blocked area and capture dislodged plaque.

The overall safety and efficacy of the two procedures essentially is the same with equal benefits for men and women, for patients who previously have had a stroke and for those who have not, researchers say. The most notable finding in the NEJM study is the role of patient age in accounting for differences in treatment outcomes, says George Howard, Dr.PH., chair of biostatistics in UAB's School of Public Health and a CREST co-investigator.

CREST investigators did see more heart attacks in the surgical group, 2.3 percent compared to 1.1 percent in the stenting group, and they did see more strokes in the stenting group, 4.1 percent versus 2.3 percent for the surgical group in the weeks following the procedure. Overall the study found a lower stroke rate following surgery and a lower heart-attack rate after stenting a year after their procedure.

"The age-difference issue is one of the most important findings of the study, though the two treatments really were practically identical in their benefit of patients at age 70, Howard says. "At younger and younger ages, the benefit of stenting became better and better than surgery. However, this benefit of stenting was offset by better outcomes of surgery at older and older ages."

CREST is one of the largest randomized stroke-prevention trials in history, involving 2,502 patients at 117 centers in the United States and Canada during a nine-year period. It is funded by the National Institute of Neurological Disorders and Stroke (NINDS) and led by Thomas G. Brott, M.D., of the Mayo Clinic in Jacksonville, Fla. Twenty-one CREST patients are enrolled in Alabama under the medical direction of William Jordan, M.D., chief of vascular surgery at UAB.

Because people with carotid atherosclerosis also usually have atherosclerosis in the coronary arteries that supply the heart, the CREST trial tracks the rate of heart attacks, in addition to stroke and death. The average age of CREST patients is 69.

In CREST, approximately half of the 2,502 patients had recent symptoms due to carotid disease such as a minor stroke, often called a transient ischemic attack (TIA), indicating a high risk for future stroke. The other half of patients had no symptoms, but they were found to have narrowing of the carotid artery on one of a variety of tests assessing stroke risk.


'/>"/>

Contact: Troy Goodman
tdgoodman@uab.edu
205-934-8938
University of Alabama at Birmingham
Source:Eurekalert

Related medicine news :

1. Decreased food intake during hospital stays is an independent risk factor for hospital mortality
2. Computers analyze environmental factors in diabetes
3. Lifestyle factors significantly impact survival of non-Hodgkins lymphoma patients, study finds
4. Unmet expectations and smoking prove key factors in quitting bladder medication
5. Nearly Half of U.S. Adults Have Heart Risk Factors
6. Breast cancer risk factors differ among races
7. New Risk Factors for Colon Cancer Studied
8. Factors increasing the risk of atrophic gastritis and intestinal metaplasia
9. HEALTHeLINK Selects ANAKAM To Provide Cloud Based Community Wide Two Factor Authentication
10. Single Genetic Factor Key to Cardiovascular System
11. Crack and cocaine use a significant HIV risk factor for teens
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:5/26/2016)... ... May 26, 2016 , ... Despite last week’s media reports hinting at a ... to wait until March 2017 for an interest rate increase, according to Rajeev Dhawan ... Business. , “The Federal Open Market Committee (FOMC) dot charts are of interest to ...
(Date:5/26/2016)... St. Louis, Missouri (PRWEB) , ... May 26, ... ... optimal cost, quality and clinical outcomes, hosted members and suppliers for its inaugural ... with a focus on their mission of elevating the operational health of America’s ...
(Date:5/26/2016)... ... 26, 2016 , ... The Woodlands at John Knox Village , Florida’s ... care for living and healing, celebrated its grand opening, today. The Woodlands at John ... provided by Empowered Staff. , “This is an incredibly fulfilling time for John Knox ...
(Date:5/26/2016)... N.J. (PRWEB) , ... May 26, 2016 , ... ... delivery technologies and development solutions for drugs, biologics, consumer health and global clinical ... sales office in Korea to support the company’s continued investment and strategic growth ...
(Date:5/26/2016)... ... , ... Memorial Day Weekend marks the unofficial start of summer and the ... make sure your family and vehicle are ready to hit the road this weekend. ... deaths and an additional 50,500 serious injuries from motor vehicle crashes during the three-day ...
Breaking Medicine News(10 mins):
(Date:5/25/2016)... , May 25, 2016  Zymo Research Corp. ... their new reference materials that help researchers obtain ... collection to analyses. The rapid growth of the ... researchers to have standard methods to improve the ... Biases inherently exist at every step of the ...
(Date:5/25/2016)... May 25, 2016  Granger Diagnostics today announced immediate ... wounds and infections. This test ensures discovery of ... viruses. The test requires only a simple swab of ... David G. Bostwick , MD, Chief Medical ... wound healing: "We are excited to make available, ...
(Date:5/25/2016)... , May 25, 2016 ... H1 2016"market research report that provides an overview ... comparative analysis at various stages, therapeutics assessment by ... administration (RoA) and molecule type, along with latest ... also reviews key players involved in the therapeutic ...
Breaking Medicine Technology: