UK MULTI-CENTRE TRIAL IN
Download
1 / 18

Trial Overview - PowerPoint PPT Presentation


  • 98 Views
  • Uploaded on

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.

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

PowerPoint Slideshow about 'Trial Overview' - benjamin


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
Slide1 l.jpg

Philip A Kalra

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

On behalf of the ASTRAL TMC and collaborators


Slide2 l.jpg

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








Safety immediate post op complications l.jpg
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



Mean change in scr between baseline and 1 year l.jpg
MEAN CHANGE IN SCr BETWEEN BASELINE AND 1 YEAR

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





Slide15 l.jpg
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 l.jpg
MORTALITY HOSPITALISATION FOR ANGINA, FLUID OVERLOAD OR CARDIAC FAILURE

HR=0.92, 95% CI=0.68 to 1.26


Pre specified subgroup analyses l.jpg
PRE-SPECIFIED SUBGROUP ANALYSES HOSPITALISATION FOR ANGINA, FLUID OVERLOAD OR CARDIAC FAILURE


Summary l.jpg
SUMMARY HOSPITALISATION FOR ANGINA, FLUID OVERLOAD OR CARDIAC FAILURE

  • 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


ad