Renal artery stenosis predicts coronary artery disease in patients with hypertension.

In hypertensive patients with indication of renal arteriography to investigate renal artery stenosis (RAS) there are no recommendations regarding when to investigate coronary artery disease (CAD). Moreover, the predictors of CAD in patients with RAS are not clear. We aimed to evaluate the frequency...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Thiago A Macedo, Rodrigo P Pedrosa, Valeria Costa-Hong, Luiz J Kajita, Gustavo R Morais, Jose J G De Lima, Luciano F Drager, Luiz A Bortolotto
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2013
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/2ff1642f52324870a335c9f882060d9b
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:2ff1642f52324870a335c9f882060d9b
record_format	dspace
spelling	oai:doaj.org-article:2ff1642f52324870a335c9f882060d9b2021-11-18T07:53:27ZRenal artery stenosis predicts coronary artery disease in patients with hypertension.1932-620310.1371/journal.pone.0058635https://doaj.org/article/2ff1642f52324870a335c9f882060d9b2013-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/23516521/pdf/?tool=EBIhttps://doaj.org/toc/1932-6203In hypertensive patients with indication of renal arteriography to investigate renal artery stenosis (RAS) there are no recommendations regarding when to investigate coronary artery disease (CAD). Moreover, the predictors of CAD in patients with RAS are not clear. We aimed to evaluate the frequency and the determinants of CAD in hypertensive patients referred to renal angiography. Eighty-two consecutive patients with high clinical risk suggesting the presence of RAS systematically underwent renal angiography and coronary angiography during the same procedure. Significant arterial stenosis was defined by an obstruction ≥ 70% to both renal and coronary territories. Significant CAD was present in 32/82 (39%) and significant RAS in 32/82 (39%) patients. Both CAD and RAS were present in 25.6% from the 82 patients. Patients with severe CAD were older (63 ± 12 vs. 56 ± 13 years; p = 0.03) and had more angina (41 vs. 16%; p = 0.013) compared to patients without severe CAD. Significant RAS was associated with an increased frequency of severe CAD compared to patients without significant RAS (66% vs. 22%, respectively; p<0.001). Myocardial scintigraphy showed ischemia in 21.8% of the patients with CAD. Binary logistic regression analysis showed that RAS ≥ 70% was independently associated with CAD ≥ 70% (OR: 11.48; 95% CI 3.2-40.2; p<0.001), even in patients without angina (OR: 13.48; 95%CI 2.6-12.1; p<0.001). Even considering a small number of patients with significant RAS, we conclude that in hypertensive patients referred to renal angiography, RAS ≥ 70% may be a strong predictor of severe CAD, independently of angina, and dual investigation should be considered.Thiago A MacedoRodrigo P PedrosaValeria Costa-HongLuiz J KajitaGustavo R MoraisJose J G De LimaLuciano F DragerLuiz A BortolottoPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 8, Iss 3, p e58635 (2013)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Thiago A Macedo Rodrigo P Pedrosa Valeria Costa-Hong Luiz J Kajita Gustavo R Morais Jose J G De Lima Luciano F Drager Luiz A Bortolotto Renal artery stenosis predicts coronary artery disease in patients with hypertension.
description	In hypertensive patients with indication of renal arteriography to investigate renal artery stenosis (RAS) there are no recommendations regarding when to investigate coronary artery disease (CAD). Moreover, the predictors of CAD in patients with RAS are not clear. We aimed to evaluate the frequency and the determinants of CAD in hypertensive patients referred to renal angiography. Eighty-two consecutive patients with high clinical risk suggesting the presence of RAS systematically underwent renal angiography and coronary angiography during the same procedure. Significant arterial stenosis was defined by an obstruction ≥ 70% to both renal and coronary territories. Significant CAD was present in 32/82 (39%) and significant RAS in 32/82 (39%) patients. Both CAD and RAS were present in 25.6% from the 82 patients. Patients with severe CAD were older (63 ± 12 vs. 56 ± 13 years; p = 0.03) and had more angina (41 vs. 16%; p = 0.013) compared to patients without severe CAD. Significant RAS was associated with an increased frequency of severe CAD compared to patients without significant RAS (66% vs. 22%, respectively; p<0.001). Myocardial scintigraphy showed ischemia in 21.8% of the patients with CAD. Binary logistic regression analysis showed that RAS ≥ 70% was independently associated with CAD ≥ 70% (OR: 11.48; 95% CI 3.2-40.2; p<0.001), even in patients without angina (OR: 13.48; 95%CI 2.6-12.1; p<0.001). Even considering a small number of patients with significant RAS, we conclude that in hypertensive patients referred to renal angiography, RAS ≥ 70% may be a strong predictor of severe CAD, independently of angina, and dual investigation should be considered.
format	article
author	Thiago A Macedo Rodrigo P Pedrosa Valeria Costa-Hong Luiz J Kajita Gustavo R Morais Jose J G De Lima Luciano F Drager Luiz A Bortolotto
author_facet	Thiago A Macedo Rodrigo P Pedrosa Valeria Costa-Hong Luiz J Kajita Gustavo R Morais Jose J G De Lima Luciano F Drager Luiz A Bortolotto
author_sort	Thiago A Macedo
title	Renal artery stenosis predicts coronary artery disease in patients with hypertension.
title_short	Renal artery stenosis predicts coronary artery disease in patients with hypertension.
title_full	Renal artery stenosis predicts coronary artery disease in patients with hypertension.
title_fullStr	Renal artery stenosis predicts coronary artery disease in patients with hypertension.
title_full_unstemmed	Renal artery stenosis predicts coronary artery disease in patients with hypertension.
title_sort	renal artery stenosis predicts coronary artery disease in patients with hypertension.
publisher	Public Library of Science (PLoS)
publishDate	2013
url	https://doaj.org/article/2ff1642f52324870a335c9f882060d9b
work_keys_str_mv	AT thiagoamacedo renalarterystenosispredictscoronaryarterydiseaseinpatientswithhypertension AT rodrigoppedrosa renalarterystenosispredictscoronaryarterydiseaseinpatientswithhypertension AT valeriacostahong renalarterystenosispredictscoronaryarterydiseaseinpatientswithhypertension AT luizjkajita renalarterystenosispredictscoronaryarterydiseaseinpatientswithhypertension AT gustavormorais renalarterystenosispredictscoronaryarterydiseaseinpatientswithhypertension AT josejgdelima renalarterystenosispredictscoronaryarterydiseaseinpatientswithhypertension AT lucianofdrager renalarterystenosispredictscoronaryarterydiseaseinpatientswithhypertension AT luizabortolotto renalarterystenosispredictscoronaryarterydiseaseinpatientswithhypertension
_version_	1718422809032523776

Renal artery stenosis predicts coronary artery disease in patients with hypertension.

Ejemplares similares