title: Effect of renal artery stenting on left ventricular mass: a randomized clinical trial.
abstract: BACKGROUND
  Whether renal revascularization reduces left ventricular hypertrophy in patients with coronary artery disease is uncertain.
  
  
  METHODS
  Randomized clinical trial testing the effect of renal artery stenting versus medical therapy on left ventricular hypertrophy progression in patients affected by ischemic heart disease and renal artery stenosis.
  
  
  METHODS
  Incident patients with ischemic heart disease undergoing cardiac catheterization with renal artery stenosis >50%-≤80%.
  
  
  METHODS
  Revascularization plus standard medical therapy versus medical therapy alone.
  
  
  RESULTS
  Primary end point was change in echocardiographic left ventricular mass index (LVMI).
  
  
  METHODS
  Clinical and echocardiographic studies were performed at baseline and after 1 year.
  
  
  RESULTS
  84 patients were randomly assigned: 43 to revascularization plus standard medical therapy and 41 to medical therapy alone. At baseline, clinical characteristics were similar in the 2 study groups. After 1 year, there was no statistically significant difference between longitudinal change in the medical therapy group versus that in the medical therapy plus revascularization group for LVMI (2.1; 95% CI, -6.1 to 10.3 g/m(2)), blood pressure (systolic, -0.2 [95% CI, -9.1 to 8.8 mm Hg]; diastolic, -3.3 [95% CI, -8.4 to 1.8 mm Hg]), or estimated glomerular filtration rate (1.5; 95% CI, -5.8 to 8.9 mL/min/1.73 m(2)). The number of major cardiovascular events was similar in the 2 groups (revascularization plus standard medical therapy [fatal, n = 2; nonfatal, n = 11] and medical therapy alone [fatal, n = 2; nonfatal, n = 11]).
  
  
  CONCLUSIONS
  Patients with very severe renal artery stenosis were excluded from the study.
  
  
  CONCLUSIONS
  Our study was unable to detect a clinically significant benefit of renal revascularization on LVMI in patients with coronary artery disease and renal artery stenosis of 50%-80%.
authors.affiliation: Division of Nephrology, Cannizzaro Hospital, Catania, Italy. marcantoni.carmelita@gmail.com
authors.forename: Carmelita
authors.initials: C
authors.lastname: Marcantoni
authors.forename: Luca
authors.initials: L
authors.lastname: Zanoli
authors.forename: Stefania
authors.initials: S
authors.lastname: Rastelli
authors.forename: Giovanni
authors.initials: G
authors.lastname: Tripepi
authors.forename: Massimo
authors.initials: M
authors.lastname: Matalone
authors.forename: Sarah
authors.initials: S
authors.lastname: Mangiafico
authors.forename: Davide
authors.initials: D
authors.lastname: Capodanno
authors.forename: Salvatore
authors.initials: S
authors.lastname: Scandura
authors.forename: Domenico
authors.initials: D
authors.lastname: Di Landro
authors.forename: Corrado
authors.initials: C
authors.lastname: Tamburino
authors.forename: Carmine
authors.initials: C
authors.lastname: Zoccali
authors.forename: Pietro
authors.initials: P
authors.lastname: Castellino
mesh_terms: D000368:Aged; D000800:Angioplasty, Balloon; D015897:Comorbidity; D018450:Disease Progression; D005260:Female; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000453:epidemiology*; D012078:Renal Artery Obstruction / Q000453:epidemiology* / Q000628:therapy*; D015607:Stents