Attempted Validation Of The Care Carotid Stenting Risk Score

OBJECTIVE: To determine if CARE carotid stenting risk score predicts in-hospital complications from carotid artery stenting (CAS). BACKGROUND: In hospital complications of carotid artery stenting (CAS) remain a major concern. Recently, the CARE registry investigators presented an internally validated score to help predict in-hospital complications from CAS, with the greatest weightage to increasing age, followed by impending major surgery, previous stroke, symptomatic status, previous stroke and contralateral occlusion. We attempted to externally validate the CARE carotid stenting risk score in our CAS population. DESIGN/METHODS: We performed a retrospective review of CAS procedures between June 2009 and April 2012 at an urban medical center. We included all patients where every risk factor was documented. In-hospital outcomes of stroke/death and/or myocardial infarction (MI) were recorded. RESULTS: A total of 139 CAS procedures met the inclusion criteria. Most common risk factor was prior stroke (25.9%) followed by A fib (14.4%). Most patients were between 60-90 years (60-69: 35.3%; 70-79: 27.3%; 80-89: 25.9%). There were 10 (7.2%) post op complications (9 strokes, 1 MI and 0 death). Most patients had a CARE score between 4 and 9. However, the CARE carotid stenting risk score did not correlate well with in-hospital complications in this series. CONCLUSIONS: CARE carotid stenting risk score did not correlate with outcome in our population. External validation in a much larger dataset with sufficient number of outcome events is required. Disclosure: Dr. Khalid has nothing to disclose. Dr. Rayes has nothing to disclose. Dr. Bhattacharya has nothing to disclose. Dr. Chaturvedi has received personal compensation for activities with Genentech, Inc., Abbott Vascular, Boehringer Ingelheim Pharmaceuticals, Inc., and Thornhill Research.