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P144 Background: High serum creatinine (SCr) is a  predictor of mortality in patients with hypertension, myocardial  infarction (MI), and stroke. In men it is associated with stroke.Objective: Examine the relationship between SCr and the risk  of stroke, MI, and vascular death (VD) in patients with symptomatic  internal carotid artery (ICA) stenosis.Methods: Data from  1977 male NASCET patients with baseline SCr measurements were analyzed.Results: Increased levels of SCr were associated with older  age and a higher prevalence of hypertension, history of MI or angina,  and intermittent claudication. No association was found between the  level of SCr and a history of diabetes or hyperlipidemia or with the  type and location of prior cerebrovascular ischemic events. The  Kaplan-Meier risk for the outcomes of stroke at 5 years, MI at 5 years,  and the combined outcome of stroke, MI, or VD at 5 years increased with  increasing levels of SCr (all at a p&lt; 0.001, table). This increased  risk was unconfounded and remained statistically significant after  adjusting for all baseline characteristics using Cox proportional  hazards regression model. The causes of stroke were similar in all SCr  level groups (70% large artery, 22% lacunar, 8% cardioembolic). The  risk of death from any cause at 5 years increased with increased SCr  levels, cardiac disorders were the predominant cause of death.Conclusion: A mild to moderate elevation of serum creatinine  level is an independent risk factor for stroke, MI, and VD in male  patients with recent ischemic symptoms attributable to carotid artery  stenosis.

Serum Creatinine Concentration and the Risk of Stroke, Myocardial Infarction, and Vascular Death in Patients with Symptomatic Carotid Stenosis.