Document Detail


Relationship between coronary and renal artery disease and associated risk factors in hypertensive and diabetic patients undergoing coronary angiography.
MedLine Citation:
PMID:  19110812     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIMS: Performing simultaneous renal angiography in patients undergoing coronary angiography for suspected coronary artery disease (CAD) is suitable for those who have a high probability for renal artery stenosis (RAS), thus better recognition of all potential candidates could have paramount importance. METHODS AND RESULTS: In a cross sectional study, 260 consecutive hypertensive and/or diabetic patients (135 males, 125 females with average age of 57.1 and 57.2 years respectively) underwent simultaneous coronary and renal angiography. RAS was identified in 55 patients (21.2%). Significant RAS (> 50%) was present in 37 patients (14.2%). Female sex (P=0.01), older age (62.1+/-10 vs 56.3+/-8.9 years, p=0.001), higher serum creatinine level (1.3+/-0.69 vs 0.98+/-0.35 mg/dl p=0.017), reduced estimated glomerular filtration rate (eGFR) (58.6+/-25.4 vs 81.8+/-28.1 ml/min/1.73 m2, p< 0.001), increased levels of intra-arterial systolic blood pressure (169.8+/-31.1 vs 155.1+/-28.4 mmHg, p=0.004) and pulse pressure (90.9+/-26.2 vs 77.5+/-21.9, p=<0.001) during catheterisation, history of hypertension alone (p=0.007) or accompanied with diabetes mellitus (DM) (p=0.014) and multi vessel CAD (> 2 vessels, p=0.002) were associated with significant RAS in univariate analysis and normal coronary arteries was a strong negative predictive factor (negative predictive value=95%). There was no significant relationship between involved location of coronary arteries, history of DM alone, history of dyslipidaemia and smoking with RAS. In multivariate model, female sex [odds ratio (OR) 0.3; 95% confidence interval (CI) 0.12-0.80, P=0.016], multivessel CAD (OR 1.88; 95% CI 1.25-2.83, P=0.002) and reduced eGFR (OR 0.96; 95% CI 0.95-0.99, P=0.002) were independent predictors of RAS. CONCLUSIONS: Considering the limitations of non-invasive techniques, it seems worthwhile from both diagnostic and prognostic standpoints to perform simultaneous renal angiography following coronary angiography in patients with multivessel CAD, especially if other mentioned risk predictors are also present.
Authors:
Seyed Hashem Danesh Sani; Mehdi Hasanzadeh; Arash Gholoobi; Hedieh Alimi; Habib allah Esmaily; Mehrnoosh Gifani
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology     Volume:  4     ISSN:  1774-024X     ISO Abbreviation:  -     Publication Date:  2008 Nov 
Date Detail:
Created Date:  2008-12-29     Completed Date:  2009-02-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101251040     Medline TA:  EuroIntervention     Country:  France    
Other Details:
Languages:  eng     Pagination:  373-7     Citation Subset:  IM    
Affiliation:
Department of Cardiology, Emam Reza Educational Hospital, Mashhad University of Medical Sciences (MUMS), Mashhad, Iran.
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MeSH Terms
Descriptor/Qualifier:
Aged
Coronary Angiography / statistics & numerical data*
Coronary Artery Disease / epidemiology*,  radiography
Cross-Sectional Studies
Diabetic Angiopathies / epidemiology*
Female
Humans
Hypertension, Renal / epidemiology*
Male
Middle Aged
Prevalence
Renal Artery Obstruction / epidemiology*
Risk Factors

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