[Prevalence of renal artery stenosis in patients undergoing cardiac catheterization: when should abdominal aortography be performed? Results in 467 patients].
OBJECTIVE
To define a subgroup of patients at increased risk of renal artery stenosis (RAS) in a population of patients undergoing cardiac catheterization.


METHODS
A total of 467 patients (mean age of 64 Years +/-11) underwent cardiac catheterization and aortography Results were evaluated to detect correlations between the presence or absence of RAS and clinical and biological parameters.


RESULTS
A total of 42 (9%) patients had a renal artery stenosis. Univariate analysis defined parameters correlated with the presence of RAS: systolic blood pressure (p=0.03), pulse pressure (p=0.005), age (p<0.0001), creatinine clearance (p<0.0001), 2-vessel (p=0.028) and 3-vessel (p=0.037) coronary artery diseases. Multivariate analysis showed that the presence of RAS correlated to creatinine clearance (p=0.02) and 2-vessel coronary artery disease. A creatinine clearance between 30 and 60 ml/min and multi-vessel coronary artery disease defined a subgroup at increased risk of RAS with sensitivity, specificity, positive and negative predictive values of: 47.6, 90.1, 32.3 and 94.6%. The prevalence of renal artery stenosis was 5.2% when both parameters were absent.


CONCLUSIONS
Patients with mild renal insufficiency and multi-vessel coronary artery disease defined a subgroup of patients at increased risk of RAS (32.5%) that may benefit from abdominal aortography performed at the time of cardiac catheterization.
Leandri
M
M
Services de Radiologie.
Lipiecki
J
J
Lipiecka
E
E
Hamzaoui
A
A
Amonchot
A
A
Mansour
M
M
Albuisson
E
E
Citron
B
B
Ponsonnaille
J
J
Boyer
L
L
D000368:Aged; D000704:Analysis of Variance; D001027:Aortography / Q000592:standards* / Q000706:statistics & numerical data; D001794:Blood Pressure; D006328:Cardiac Catheterization; D015897:Comorbidity; D017023:Coronary Angiography; D003327:Coronary Disease / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology; D003404:Creatinine / Q000378:metabolism; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008657:Metabolic Clearance Rate; D008875:Middle Aged; D018579:Patient Selection; D015995:Prevalence; D011446:Prospective Studies; D012078:Renal Artery Obstruction / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology / Q000378:metabolism; D051437:Renal Insufficiency / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology / Q000378:metabolism; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D013599:Systole
D003404:Creatinine