title: Cardiac events in hypertensive patients with renal artery stenosis treated with renal angioplasty or drug therapy: meta-analysis of randomized trials.
abstract: BACKGROUND
  Cardiac outcome in patients with atherosclerotic renal artery stenosis (ARAS) undergoing percutaneous transluminal renal angioplasty (PTRA) or medical therapy is not yet completely clear. The aim of this study was to perform a meta-analysis of randomized controlled trials to compare the effect of PTRA and medical therapy on nonfatal myocardial infarction in patients with ARAS.
  
  
  METHODS
  We searched for articles reporting cardiovascular outcome, including nonfatal myocardial infarction, in patients with renal artery stenosis randomized to PTRA with/without stenting or medical therapy.
  
  
  RESULTS
  Five studies were identified. The pooled population consisted of 1,159 subjects who experienced 56 nonfatal myocardial infarctions. When compared with medical therapy, the overall relative risk (RR) was 0.85 (95% confidence interval (CI) 0.51-1.42), P = 0.55, for PTRA. There was no significant difference between PTRA and medical therapy according to procedural characteristics (with/without stent placement), mean serum creatinine at follow-up (higher or lower than 2.0 mg/dl), and maximum follow-up length (> or <2 years).
  
  
  CONCLUSIONS
  In patients with ARAS and hypertension, there is a lack of evidence supporting the superiority of PTRA over medical therapy in prevention of nonfatal myocardial infarction. Awaiting for results of ongoing trials, our data and previous data suggest that PTRA and drug therapy have a similar impact on cardiovascular risk reduction in patients with renal artery stenosis and hypertension.
authors.affiliation: Dipartimento di Medicina e Scienze dell'Invecchiamento, Università "Gabriele d'Annunzio", Chieti, Italy. pierdomenico@unich.it
authors.forename: Sante D
authors.initials: SD
authors.lastname: Pierdomenico
authors.forename: Anna M
authors.initials: AM
authors.lastname: Pierdomenico
authors.forename: Chiara
authors.initials: C
authors.lastname: Cuccurullo
authors.forename: Mariantonietta
authors.initials: M
authors.lastname: Mancini
authors.forename: Silvio
authors.initials: S
authors.lastname: Di Carlo
authors.forename: Franco
authors.initials: F
authors.lastname: Cuccurullo
mesh_terms: D000368:Aged; D017130:Angioplasty; D002318:Cardiovascular Diseases / Q000209:etiology; D003404:Creatinine / Q000097:blood; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000517:prevention & control*; D012077:Renal Artery / Q000601:surgery; D012078:Renal Artery Obstruction / Q000150:complications / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D015607:Stents
chemical_list: D003404:Creatinine