open access

Vol 66, No 8 (2008)
Other
Published online: 2008-08-27
Submitted: 2012-12-28
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Original article
Renal artery stenosis in patients with coronary artery disease

Tadeusz Przewłocki, Anna Kabłak-Ziembicka, Wiesława Tracz, Artur Kozanecki, Grzegorz Kopeć, Paweł Rubiś, Magdalena Kostkiewicz, Agnieszka Rosławiecka, Daniel Rzeźnik, Tomasz Stompor
Kardiol Pol 2008;66(8):856-862.

open access

Vol 66, No 8 (2008)
Other
Published online: 2008-08-27
Submitted: 2012-12-28

Abstract


Background: Renal dysfunction is an important factor of cardiovascular risk. Renal artery stenosis (RAS) is a potential cause of secondary hypertension and by renal ischemia may lead to progressive renal insuficiency. In RAS patients a significant increase in prevalence of coronary artery disease (CAD) as well as revascularisation rate and mortality rate was observed.
Aim: To determine the prevalence of RAS in patients with suspected CAD.
Methods: The study group consisted of 1036 consecutive patients (700 men; 67.6% ) in the mean age of 62.1±9.7 (25–85) years admitted to coronary angiography. Simultaneously renal angiography was performed in all patients.
Results: Stenosis ł50% in at least one main branch of coronary artery was found in 633 (66.1%) patients. The proportion of patients with one, two or three vessel CAD was respectively 291 (46%), 169 (26%) and 173 (27.3%). Non-significant coronary lesions <50% were found in 108 (10.4%) patients, whereas in 295 (28.5%) patients no angiographic evidence of CAD was documented. In the whole group of patients RAS was found in 339 (32.7%) of patients &#8211; 124 (12%) had bilateral lesions. RAS prevalence in patients with CAD was 38.3% (284/741) and its frequency increased with severity of CAD: from 25% (27/108) in patients with insignificant coronary lesions up to 36.4% (106/291), 40.2% (68/169) and 48% (83/173) in 1, 2, and 3-vessel disease, respectively (p <0.001). RAS prevalence in patients with normal coronary arteries was 18.6% (55/295). RAS <30% was detected in 194 (18,7%) patients; RAS between 30-49% in 81 patients (8.7%); RAS 50&#8211;69% in 38 patients (3.7%) and RAS ł70% in the remaining 26 patients (2.5%). RAS ł50% was noted in 8 (2.7%) patients without coronary lesions; in 5 (4.6%) with insignificant coronary artery atherosclerosis and 51 (8%) with coronary artery stenosis >50% (p=0.0008). Stepwise regression analysis identified 4 independent predictors of RAS ł50%: CAD severity (p=0.014), serum creatinine concentration (p <0.001), cigarette smoking (p=0.02) and stenosis of aortic arch branches (p <0.001).
Conclusions: RAS is a frequent finding in patients with suspected CAD. CAD severity, number of involved aortic arch arteries, cigarette smoking and serum creatinine are independent RAS predictors.

Abstract


Background: Renal dysfunction is an important factor of cardiovascular risk. Renal artery stenosis (RAS) is a potential cause of secondary hypertension and by renal ischemia may lead to progressive renal insuficiency. In RAS patients a significant increase in prevalence of coronary artery disease (CAD) as well as revascularisation rate and mortality rate was observed.
Aim: To determine the prevalence of RAS in patients with suspected CAD.
Methods: The study group consisted of 1036 consecutive patients (700 men; 67.6% ) in the mean age of 62.1&#177;9.7 (25&#8211;85) years admitted to coronary angiography. Simultaneously renal angiography was performed in all patients.
Results: Stenosis ł50% in at least one main branch of coronary artery was found in 633 (66.1%) patients. The proportion of patients with one, two or three vessel CAD was respectively 291 (46%), 169 (26%) and 173 (27.3%). Non-significant coronary lesions <50% were found in 108 (10.4%) patients, whereas in 295 (28.5%) patients no angiographic evidence of CAD was documented. In the whole group of patients RAS was found in 339 (32.7%) of patients &#8211; 124 (12%) had bilateral lesions. RAS prevalence in patients with CAD was 38.3% (284/741) and its frequency increased with severity of CAD: from 25% (27/108) in patients with insignificant coronary lesions up to 36.4% (106/291), 40.2% (68/169) and 48% (83/173) in 1, 2, and 3-vessel disease, respectively (p <0.001). RAS prevalence in patients with normal coronary arteries was 18.6% (55/295). RAS <30% was detected in 194 (18,7%) patients; RAS between 30-49% in 81 patients (8.7%); RAS 50&#8211;69% in 38 patients (3.7%) and RAS ł70% in the remaining 26 patients (2.5%). RAS ł50% was noted in 8 (2.7%) patients without coronary lesions; in 5 (4.6%) with insignificant coronary artery atherosclerosis and 51 (8%) with coronary artery stenosis >50% (p=0.0008). Stepwise regression analysis identified 4 independent predictors of RAS ł50%: CAD severity (p=0.014), serum creatinine concentration (p <0.001), cigarette smoking (p=0.02) and stenosis of aortic arch branches (p <0.001).
Conclusions: RAS is a frequent finding in patients with suspected CAD. CAD severity, number of involved aortic arch arteries, cigarette smoking and serum creatinine are independent RAS predictors.
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Keywords

artery stenosis; coronary artery disease; predictors

About this article
Title

Original article
Renal artery stenosis in patients with coronary artery disease

Journal

Kardiologia Polska (Polish Heart Journal)

Issue

Vol 66, No 8 (2008)

Pages

856-862

Published online

2008-08-27

Bibliographic record

Kardiol Pol 2008;66(8):856-862.

Keywords

artery stenosis
coronary artery disease
predictors

Authors

Tadeusz Przewłocki
Anna Kabłak-Ziembicka
Wiesława Tracz
Artur Kozanecki
Grzegorz Kopeć
Paweł Rubiś
Magdalena Kostkiewicz
Agnieszka Rosławiecka
Daniel Rzeźnik
Tomasz Stompor

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