Document Detail


Long-term follow-up of patients with atherosclerotic renal artery disease.
MedLine Citation:
PMID:  23321402     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Atherosclerotic renal artery stenosis (ARAS) is a predictor of increased morbidity and mortality. However, whether ARAS itself accelerates the arteriosclerotic process or whether ARAS is solely the consequence of atherosclerosis is unclear. We imaged renal arteries of 1561 hypertensive patients undergoing coronary angiography and followed this cohort for 9 years (range, 2.4-15.1 years; median, 31.2 months, interquartile range, 13.4/52.9 months). All patients received aspirin, renin-angiotensin system blockade, statins, and beta blockade as indicated. One hundred seventy-one patients had ARAS >50% diameter stenosis and 126 patients an arteriosclerotic plaque (ARAP) without significant stenosis. Blood pressures were not different in ARAS, ARAP, and non-ARAS patients. After adjustment for cardiovascular risk factors by propensity scores and matched pair analysis, ARAS patients had a lower ejection fraction and more coronary artery disease (CAD) than non-ARAS patients. The same was true for brain natriuretic peptide values, troponin I, and highly sensitive C-reative protein. Over 9 years, more ARAS patients died of any cause (34% vs 23%; P < .05). The prevalence of CAD in ARAP patients was higher than in non-ARAS patients and lower than in ARAS patients. The mortality of the ARAP patients at 9 years was 37%, not different from the ARAS patients. Atherosclerotic renal artery disease appears to be a marker for the severity of atherosclerosis rather than a causative factor for atherosclerosis progression.
Authors:
Erdal Safak; Caroline Wilke; Wolfgang Derer; Andreas Busjahn; Michael Gross; Martin Moeckel; Dominik N Mueller; Friedrich C Luft; Ralf Dechend
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of the American Society of Hypertension : JASH     Volume:  7     ISSN:  1878-7436     ISO Abbreviation:  J Am Soc Hypertens     Publication Date:    2013 Jan-Feb
Date Detail:
Created Date:  2013-01-16     Completed Date:  2013-07-09     Revised Date:  2013-09-23    
Medline Journal Info:
Nlm Unique ID:  101312518     Medline TA:  J Am Soc Hypertens     Country:  United States    
Other Details:
Languages:  eng     Pagination:  24-31     Citation Subset:  IM    
Copyright Information:
Copyright © 2013 American Society of Hypertension. Published by Elsevier Inc. All rights reserved.
Affiliation:
Department of Cardiology, Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, Germany. erdal.safak@charite.de
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MeSH Terms
Descriptor/Qualifier:
Aged
Angiography
Atherosclerosis / mortality*,  physiopathology,  radiography
Blood Pressure / physiology
Comorbidity
Coronary Angiography
Coronary Artery Disease / mortality,  physiopathology,  radiography
Disease Progression
Female
Follow-Up Studies
Humans
Hypertension, Renal / mortality*,  physiopathology,  radiography
Male
Middle Aged
Prevalence
Renal Artery Obstruction / mortality*,  physiopathology,  radiography
Risk Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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