Frequency of coronary artery disease in patients with renal artery stenosis without clinical manifestations of coronary insufficiency.
Atherosclerotic renal artery stenosis (RAS) and coronary artery disease (CAD) arise from the same multiple risk factors. The purpose of this study was to assess the frequency of previously undiagnosed CAD in patients with angiographically confirmed RAS, by conducting coronary arteriography in the same setting. Of 57 consecutive patients referred for renal arteriography on clinical grounds during a 14-month period, 28 had no RAS and 6 had RAS, but previously documented CAD. Of the remainder 23 patients, 17 (74%; CI 56%-92%) had both RAS and CAD (7 single vessel, 4 two-vessel, and 7 multivessel disease). The clinical characteristics, such as age, blood pressure (BP) levels, signs of heart failure, were no different between those with and without CAD, although the 4 diabetic patients, the 4 patients with fundoscopic findings of grade III retinopathy, 11 of 14 with peripheral arterial disease, and 7 of 8 patients with prior stroke belonged in the CAD group. None developed complications as a result of the two consecutive procedures. The data suggest that in patients with RAS the frequency of silent CAD is high and cannot be predicted on clinical grounds alone, therefore coronary angiography should be routinely recommended in the same setting.
Cardoso de Carvalho
Fábio
F
Section of Cardiology, Department of Internal Medicine, Botucatu Medical School, Universidade Estadual Paulista, São Paulo, Brazil.
Bregagnollo
Edson
E
Santos Silva
Vanessa
V
Brunie
Andréa
A
da Silva Franco
Roberto Jorge
RJ
Martin
Luis Cuadrado
LC
Gavras
Irene
I
Gavras
Haralambos
H
D000368:Aged; D000792:Angiography; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012078:Renal Artery Obstruction / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D012307:Risk Factors