title: Atherosclerosis within the non-neoplastic margin of partial nephrectomy specimens: implications for medical management.
abstract: OBJECTIVE
  To describe the frequency and severity of atherosclerosis contained within the non-neoplastic tissue of partial nephrectomy (PN) specimens.
  
  
  METHODS
  Archived open PN specimens were evaluated for histological evidence of atherosclerosis. Clinically significant atherosclerosis was defined as arterial luminal narrowing of >25% due to fibrointimal thickening. Histological findings were correlated with clinical data including history of major medical comorbidities and preoperative statin use.
  
  
  RESULTS
  The study cohort was comprised of 114 patients (71 men and 43 women). The mean age at the time of surgery was 59.3 years, and 69 (60.5%) patients had a history of at least one major medical comorbidity including hypertension (54.5%), diabetes (16.7%) and coronary artery disease (12.3%). Clinically significant atherosclerosis was observed in 29 (25.4%) patients. These individuals were older (p = 0.001), and three times more likely to have greater than one major medical comorbidity (p = 0.002). In addition, only 17 (58.6%) were prescribed a statin at the time of surgery.
  
  
  CONCLUSIONS
  Atherosclerosis is frequently observed in the non-neoplastic tissue of PN specimens. Patients found to have atherosclerosis can potentially benefit from intensive lifestyle modification and medical therapy with lipid-lowering medications. These measures would likely have the greatest clinical impact on those patients without an existing history of major medical comorbidities.
authors.affiliation: James Buchanan Brady Urological Institute, Johns Hopkins Medical Institutions, 1800 Orleans Street, Marburg 134, Baltimore, MD, 21287, USA, mgorin1@jhmi.edu.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Gorin
authors.forename: Michael
authors.initials: M
authors.lastname: Garcia-Roig
authors.forename: Monica
authors.initials: M
authors.lastname: Garcia-Buitrago
authors.forename: Carlos
authors.initials: C
authors.lastname: Parra-Herran
authors.forename: Merce
authors.initials: M
authors.lastname: Jorda
authors.forename: Gaetano
authors.initials: G
authors.lastname: Ciancio
mesh_terms: D000368:Aged; D050197:Atherosclerosis / Q000175:diagnosis* / Q000453:epidemiology* / Q000517:prevention & control; D015897:Comorbidity; D003324:Coronary Artery Disease / Q000150:complications / Q000453:epidemiology; D048909:Diabetes Complications / Q000150:complications / Q000453:epidemiology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000453:epidemiology; D000960:Hypolipidemic Agents / Q000627:therapeutic use; D007668:Kidney / Q000098:blood supply* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods*; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index
chemical_list: D000960:Hypolipidemic Agents