Coronary heart disease extension as a predictor of atherosclerotic renal artery stenosis.
BACKGROUND
Although the association of renal artery stenosis with coronary artery disease is well established, the best cutoff of diseased coronary vessels predicting atherosclerotic narrowing of renal artery remains still undefined.


METHODS
In 109 consecutive patients (78/31 M/F) submitted to elective coronary angiography because of effort angina, renal angiography was also performed in the same session. We considered only renal artery stenosis > or =60% to be of clinical relevance.


RESULTS
Coronary artery stenosis was present in 87 patients (80%), while significant narrowing of renal arteries was found in 42 patients (39%). On univariate analysis, the odds ratio (OR) of renal artery stenosis associated with 1 stenotic coronary vessel was 1.76 (95% confidence interval [95% CI], 1.34-2.33, p<0.001). This estimate was confirmed in a multiple logistic regression model adjusting for a series of potential confounders (OR=1.83, 95% CI, 1.34-2.48, p<0.001). On receiver operating characteristic curve analysis (area under the curve: 0.74 +/- 0.05, p<0.001), the presence of 3 diseased coronary vessels provided the best cutoff for the diagnosis of concomitant renal artery stenosis (positive predictive value: 63%; negative predictive value: 76%).


CONCLUSIONS
There is a strong parallelism between the number of diseased coronary vessels and the occurrence of renal vascular disease. The presence of 3 diseased coronary vessels may corroborate the decision of performing renal angiography in patients with ischemic heart disease.
Stancanelli
Benedetta
B
Unit of Internal Medicine and Hypertension Centre, University of Catania, Azienda Ospedaliera di Ragusa, Piazza Caduti di Nassirya 1, Ragusa, Italy.
Maugeri
Egle
E
Nicosia
Antonino
A
Ferrante
Francesco
F
Tripepi
Giovanni
G
Zoccali
Carmine
C
Malatino
Lorenzo S
LS
D000368:Aged; D050197:Atherosclerosis / Q000150:complications*; D003324:Coronary Artery Disease / Q000150:complications* / Q000473:pathology; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D016017:Odds Ratio; D011237:Predictive Value of Tests; D012372:ROC Curve; D012078:Renal Artery Obstruction / Q000150:complications* / Q000175:diagnosis