CREST trial

Moriishita R, A scientific rationale for the CREST trial results Evidence for the mechanism of action of cilostazol in restanosis, Atheroscler Suppl 2006 6 41-46. 

In determining the risk of death or stroke associated with carotid stenting it is of critical importance to recognize four factors that have been associated with increased procedural complications following carotid stenting (Table 2). The most important of these factors is advanced age. In the lead-in phase of the multicenter CREST trial, the risk of 30-day stroke or death among 749 patients was directly related to age (<60 years, 1.7% 60-69 years, 1.3% 7079, 5.3% >80 years, 12.1 %, p = 0.006). Though the risk attributable to advanced age in this analysis appeared to be independent... 

Shoptaw S., Watson D.W., Reiber C. et al. Randomized controlled pilot trial of cabergoline, hydergine and levodopa/carbidopa Los Angeles Cocaine Rapid Efficacy Screening Trial (CREST). Addiction. 100(Suppl. 1) 78, 2005. 

Abbreviations CDK, cyclin-dependent kinase CREST, cilostazol for restenosis trial MACE, major adverse cardiac events ORAR, oral rapamycin to prevent restenosis ORBIT, oral rapamune to inhibit restenosis REAR, peroxisome proliferator-activated receptor PRESTO, prevention of restenosis with tranilast and its outcomes SMC. smooth muscle cell ThR, target lesion revascularization tREAT, Tranilast restenosis following angioplasty trials TVR, target vessel failure. ... 

Randomized trials conducted with cilostazol 200 mg daily have shown that it is effective in reducing restenosis (45-47). Douglas et al. undertook the Cilostazol for Restenosis Trial (CREST), a randomized, double-blind, placebo-controlled trial to determine whether cilostazol would reduce renarrowing in patients after stent implantation in native coronary arteries. Seven hundred and five patients who had successful coronary stent implantation received, in addition to... 

Douglas JS Jr, Holmes DR Jr, Kereiakes DJ, et al. Cilostazol for Ftestenosis Trial (CREST) Investigators. Coronary stent restenosis in patients treated with cilostazol. Circulation 2005 I 12 2826-2832. 

Carotid Revascularization Endarterectomy versus Stenting Trial (CREST) (2006). Stroke 37 e36... 

Data regarding the role of CAS in low-surgical-risk patients with asymptomatic CAS are limited. The Carotid Revascularization Endarterectomy versus Stenting Trial (CREST) lead-in registry has reported data for investigators during the roll-in phase (51). The 30-day rate of stroke and death in the 960 asymptomatic patients was 4.0%, and if limited to only patients under the age of 80 years is 3.3%. The 30-day rate of death and major stroke in patients under the age of 80 years was 1.4%. 

There are two ongoing prospective clinical randomized trials of CAS versus CEA in low-surgical risk patients in the United States (ACT 1, CREST). The Asymptomatic Carotid Stenosis Stenting versus Endarterectomy Trial (ACT 1, Abbott Vascular) is in the enrollment phase and it will randomize up to 1658... 

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