Canadian-Australasian Randomised Trial of Screening Kidney Transplant Candidates for Coronary Artery Disease
University of British Columbia
Summary
The Canadian Australasian Randomized Trial of Screening Kidney Transplant Candidates for Coronary Artery Disease (CARSK) will test the hypothesis that eliminating the regular use of non-invasive screening tests for CAD AFTER waitlist activation is not inferior to regular (i.e., annual) screening for CAD during wait-listing for the prevention of Major Adverse Cardiac Events. Secondary analyses will assess the impact of screening on the rate of transplantation, and the relative cost-effectiveness of screening.
Description
Cardiovascular disease is the commonest cause of death while on the kidney transplant waiting list and after transplantation. Current standard care involves screening for coronary artery disease prior to waitlist entry, then every 1-2 years, according to perceived risk, until transplanted. The aim of screening is two-fold. Firstly to identify patients with asymptomatic coronary disease to enable either correction, by bypass surgery or angioplasty, or removal of the patient from the list, with the ultimate aim of preventing premature cardiovascular mortality at the time of, or soon after kidney…
Eligibility
- Age range
- 18+ years
- Sex
- All
- Healthy volunteers
- No
Inclusion Criteria: 1. adults aged 18 years of age or older 2. Dialysis-dependent kidney failure and currently being assessed for OR active on the kidney transplant waiting list 3. expected to require further screening for CAD prior to transplantation (by current standard of care); 4. able to give consent; 5. anticipated to undergo transplantation more than 12 months from date of enrolment Exclusion Criteria: 1. patients with signs or symptoms suggestive of uncontrolled cardiac disease such as unstable coronary syndromes, decompensated heart failure, uncontrolled arrhythmia, and severe valv…
Interventions
- OtherNo screening
No further screening for asymptomatic coronary artery disease after wait-list entry
- OtherRegular Screening
Annual or second-yearly screening for asymptomatic coronary artery disease after wait-list entry
Locations (22)
- University of ArizonaTucson, Arizona
- The George Washington UniversityWashington D.C., District of Columbia
- University of AlbertaEdmonton, Alberta
- University of British ColumbiaVancouver, British Columbia
- Dalhousie UniversityHalifax, Nova Scotia
- St. Joseph's HealthcareHamilton, Ontario