Abstract WP071: Short-term Outcomes in Patients with Atrial Arrythmia Undergoing Carotid Stent Placement in the Real World

Introduction: Patients with atrial fibrillation or flutter have been excluded from randomized clinical trials evaluating the effectiveness of carotid artery stent placement (CAS) in patients with internal carotid artery (ICA) stenosis. However, in general practice, approximately 15% of the patients being treated by CAS have atrial fibrillation and those patients may be at higher risk for periprocedural complications. We evaluated the risk of stroke, myocardial infarction and/or death within 30 days in patients undergoing CAS in patients with atrial arrythmia using real world data. Methods: We analyzed the data for patients with ICA stenosis who underwent CAS as part of the national Vascular Quality Initiative (VQI). We divided the patients based on presence or atrial arrythmia. We performed logistic regression analysis to identify the effect of atrial arrythmia on the combined endpoint of any stroke or death within 30 days after adjusting for adjusting for age, gender, severity of stenosis strata, and qualifying ischemic event type (asymptomatic, ischemic stroke, or transient ischemic attack). Results: A total of 1246 (14.1%) had atrial arrythmia among 8857 patients who underwent CAS. The proportion of patients who developed any stroke or death within 30 days was not different between patients with and those without atrial arrythmia (2.6% versus 2.5%, P=NS). The proportion of patients who developed any stroke within 30 days was not different between patients with and those without atrial arrythmia (1.9% versus 2.0%, P=NS). There were no differences in rates of myocardial infarction (0.3% versus 0.4%) or post procedural hematoma/bleeding (2.8% versus 2.4%). The proportion of patients who developed any stroke within 30 days was not different between symptomatic patients with and those without atrial arrythmia (1.9% versus 2.0%, P=NS). The odds ratio for any stroke or death within 30 days was not significantly different between patients with and those without atrial arrythmia (odds ratio [OR] 1.03, 95% confidence interval [CI] 0.71-1.54) after adjusting for potential confounders. Conclusion: Patients with atrial arrythmia can undergo CAS without any additional risk in regard to any stroke or death within 30 days in both asymptomatic and symptomatic patients with ICA stenosis.