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Renal artery stenosis predicts coronary artery disease in patients with hypertension

Macedo, Thiago A ; Pedrosa, Rodrigo P ; Costa-Hong, Valeria ; Kajita, Luiz J ; Morais, Gustavo R ; De Lima, Jose J G ; Drager, Luciano F ; Bortolotto, Luiz A Aikawa, Elena

PloS one, 2013-03, Vol.8 (3), p.e58635-e58635 [Periódico revisado por pares]

United States: Public Library of Science

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Título:
Renal artery stenosis predicts coronary artery disease in patients with hypertension
Autor: Macedo, Thiago A ; Pedrosa, Rodrigo P ; Costa-Hong, Valeria ; Kajita, Luiz J ; Morais, Gustavo R ; De Lima, Jose J G ; Drager, Luciano F ; Bortolotto, Luiz A
Aikawa, Elena
Assuntos: Angina ; Angina pectoris ; Angiography ; Arteriography ; Cardiology ; Cardiovascular disease ; Catheters ; Cholesterol ; Coronary artery ; Coronary artery disease ; Coronary Artery Disease - complications ; Coronary Artery Disease - diagnosis ; Coronary heart disease ; Coronary vessels ; Diabetes ; Family medical history ; Female ; Flow velocity ; Heart ; Heart diseases ; Hospitals ; Humans ; Hypertension ; Hypertension - complications ; Intubation ; Ischemia ; Kidney - blood supply ; Laboratories ; Male ; Medical diagnosis ; Medical imaging ; Medical research ; Medicine ; Medicine, Experimental ; Middle Aged ; Patients ; Regression analysis ; Renal artery ; Renal artery obstruction ; Renal Artery Obstruction - complications ; Renal Artery Obstruction - diagnostic imaging ; Scintigraphy ; Stenosis ; Task forces
É parte de: PloS one, 2013-03, Vol.8 (3), p.e58635-e58635
Notas: ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 23
Competing Interests: The authors have declared that no competing interests exist.
Conceived and designed the experiments: TAM RPP VCH LJK GRM JJGL LFD LAB. Performed the experiments: TAM RPP VCH LJK GRM JJGL LFD LAB. Analyzed the data: TAM RPP VCH LFD LAB. Contributed reagents/materials/analysis tools: TAM RPP VCH LJK GRM JJGL LFD LAB. Wrote the paper: TAM RPP JJGL LFD LAB.
Descrição: 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.
Editor: United States: Public Library of Science
Idioma: Inglês

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Renal artery stenosis predicts coronary artery disease in patients with hypertension

Macedo, Thiago A ; Pedrosa, Rodrigo P ; Costa-Hong, Valeria ; Kajita, Luiz J ; Morais, Gustavo R ; De Lima, Jose J G ; Drager, Luciano F ; Bortolotto, Luiz A Aikawa, Elena

United States: Public Library of Science

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