Prevalence of renal artery stenosis in high-risk veterans referred to cardiac catheterization.
OBJECTIVE
The prevalence of atherosclerotic renal artery stenosis (RAS) varies depending on patient selection with no specific guidelines on indications for selective renal angiography in patients referred for coronary angiography. The goal of this study is to determine the prevalence and predictors of renal artery stenosis in hypertensive veterans referred for coronary angiography.


METHODS
Prospective study.


METHODS
Tertiary care veterans' administration facility in the USA.


METHODS
A total of 90 veterans referred for coronary angiography with an initial ascending aortic pressure > 135 mmHg.


METHODS
Selective renal angiography was performed following coronary angiography.


RESULTS
We found that 28% of the patients had single RAS (> or = 50% stenosis), while 16% had single RAS > or = 70% stenosis, 10% had bilateral RAS >or = 50% and 6% had bilateral RAS > or = 70%. Significant positive univariate predictors of RAS (> or = 50%) were age, peripheral vascular disease (PVD), creatinine level (Cr) and myocardial infarction. Significant multivariate predictors of RAS (> or = 50%) were age > 65 years [relative risk (RR), 3.6; 95% confidence interval (CI), (1.2-10.6)], PVD [RR 3.2, 95% CI (1.1-9.1)] and Cr > 1 mg/dl [RR 4.9, 95% CI (1.53-15.9)]. No complications related to renal angiography were noted.


CONCLUSIONS
Selective renal angiography during routine coronary angiography in hypertensive veterans with coronary artery disease is safe and uncovers RAS in many older patients with PVD and renal insufficiency.
Aqel
Raed A
RA
Birmingham's Veterans Affair Medical Center, Division of Cardiovascular Disease, Birmingham, Alabama 35233, USA. raqel@cardio.com.uab.edu
Zoghbi
Gilbert J
GJ
Baldwin
Shawn A
SA
Auda
Wael S
WS
Calhoun
David A
DA
Coffey
Christopher S
CS
Perry
Gilbert J
GJ
Iskandrian
Ami E
AE
D000368:Aged; D000792:Angiography; D006328:Cardiac Catheterization / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D015995:Prevalence; D012017:Referral and Consultation; D012078:Renal Artery Obstruction / Q000175:diagnosis* / Q000453:epidemiology*; D012307:Risk Factors; D014728:Veterans / Q000706:statistics & numerical data*