CARP Trial

NEJM - 2004
Coronary artery revascularization before major vascular surgery

Multicentre RCT

Population

500 patients – Veteran’s affairs medical centres

Patients at increased risk of periop cardiac complications and with clinically significant
CAD

AAA surgery or distal (leg) revascularization procedures

Intervention
Coronary artery revacularisation – PTCA in 60% - CAGs 40%
No coronary artery revascularisation

Outcome

Primary outcome – long term mortality

Message

Re-vascularisation before major vascular surgery does not alter long term outcome
Patients with stable CAD before major vascular surgery do not require revascularisation