Slide1 l.jpg
This presentation is the property of its rightful owner.
Sponsored Links
1 / 18

Philip A Kalra Lead Nephrologist for ASTRAL, Hope Hospital, Salford, UK, On behalf of the ASTRAL TMC and collaborators PowerPoint PPT Presentation


  • 74 Views
  • Uploaded on
  • Presentation posted in: General

UK MULTI-CENTRE TRIAL IN ATHEROSCLEROTIC RENOVASCULAR DISEASE ASTRAL A ngioplasty and ST ent for R enal A rtery L esions. Philip A Kalra Lead Nephrologist for ASTRAL, Hope Hospital, Salford, UK, On behalf of the ASTRAL TMC and collaborators. ASTRAL Trial Schema.

Download Presentation

Philip A Kalra Lead Nephrologist for ASTRAL, Hope Hospital, Salford, UK, On behalf of the ASTRAL TMC and collaborators

An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -

Presentation Transcript


  • UK MULTI-CENTRE TRIAL IN ATHEROSCLEROTIC RENOVASCULAR DISEASE

  • ASTRAL

  • Angioplasty and STent for Renal Artery Lesions

Philip A Kalra

Lead Nephrologist for ASTRAL, Hope Hospital, Salford, UK,

On behalf of the ASTRAL TMC and collaborators


ASTRAL Trial Schema

No revascularisationMedical Treatment only

Revascularisation

with angioplasty and/or stent

(and medical treatment)

Diagnosis of ARVD (Unilateral or Bilateral)Revascularisation not contraindicated

Uncertain whether to revasculariseRandomisation


PATIENT CHARACTERISTICS BY RANDOMISED TREATMENT


LABORATORY DATA BY RANDOMISED TREATMENT


LABORATORY DATA BY RANDOMISED TREATMENT


ANGIOGRAPHIC DATA BY RANDOMISED TREATMENT


CONCOMITANT MEDICINE BY RANDOMISED TREATMENT


CONCOMITANT MEDICINE BY RANDOMISED TREATMENT


SAFETY – IMMEDIATE POST-OP COMPLICATIONS

  • 24 patients experienced an immediate post-op complication

    • Revascularisation = 23 / 308 (7%)

    • Medical = 1 / 18 (6%)

  • Most patients (88%) had one complication


PLOT OF SCr OVER TIME


MEAN CHANGE IN SCr BETWEEN BASELINE AND 1 YEAR

Negative change = Improvement in SCr (i.e. reduction in SCr)


MEAN CHANGE IN SCr


MEAN CHANGE IN SYSTOLIC BP


PLOT OF DIASTOLIC BP OVER TIME


TIME TO FIRST OF MI, STROKE, VASCULAR DEATH OR HOSPITALISATION FOR ANGINA, FLUID OVERLOAD OR CARDIAC FAILURE

HR=0.90, 95% CI=0.66 to 1.15


MORTALITY

HR=0.92, 95% CI=0.68 to 1.26


PRE-SPECIFIED SUBGROUP ANALYSES


SUMMARY

  • Currently no evidence of a benefit for revascularisation on renal function in the ARVD patients entered into ASTRAL – those in whom clinicians ‘uncertain’ of whether to revascularise

  • Also no evidence of differences between the arms for any of the secondary endpoints (i.e. blood pressure, major events)

  • No evidence of differences in treatment effect across the various subgroups

  • Longer follow-up is needed

  • Plan to update meta-analysis published in NDT in 2003 to include ASTRAL and other trials


  • Login