title: Long-term follow-up of patients with atherosclerotic renal artery disease.
abstract: Atherosclerotic renal artery stenosis (ARAS) is a predictor of increased morbidity and mortality. However, whether ARAS itself accelerates the arteriosclerotic process or whether ARAS is solely the consequence of atherosclerosis is unclear. We imaged renal arteries of 1561 hypertensive patients undergoing coronary angiography and followed this cohort for 9 years (range, 2.4-15.1 years; median, 31.2 months, interquartile range, 13.4/52.9 months). All patients received aspirin, renin-angiotensin system blockade, statins, and beta blockade as indicated. One hundred seventy-one patients had ARAS >50% diameter stenosis and 126 patients an arteriosclerotic plaque (ARAP) without significant stenosis. Blood pressures were not different in ARAS, ARAP, and non-ARAS patients. After adjustment for cardiovascular risk factors by propensity scores and matched pair analysis, ARAS patients had a lower ejection fraction and more coronary artery disease (CAD) than non-ARAS patients. The same was true for brain natriuretic peptide values, troponin I, and highly sensitive C-reative protein. Over 9 years, more ARAS patients died of any cause (34% vs 23%; P < .05). The prevalence of CAD in ARAP patients was higher than in non-ARAS patients and lower than in ARAS patients. The mortality of the ARAP patients at 9 years was 37%, not different from the ARAS patients. Atherosclerotic renal artery disease appears to be a marker for the severity of atherosclerosis rather than a causative factor for atherosclerosis progression.
authors: Department of Cardiology, Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, Germany. erdal.safak@charite.de
authors: Erdal
authors: E
authors: Safak
authors: Caroline
authors: C
authors: Wilke
authors: Wolfgang
authors: W
authors: Derer
authors: Andreas
authors: A
authors: Busjahn
authors: Michael
authors: M
authors: Gross
authors: Martin
authors: M
authors: Moeckel
authors: Dominik N
authors: DN
authors: Mueller
authors: Friedrich C
authors: FC
authors: Luft
authors: Ralf
authors: R
authors: Dechend
mesh_terms: D000368:Aged; D000792:Angiography; D050197:Atherosclerosis / Q000000981:diagnostic imaging / Q000401:mortality* / Q000503:physiopathology; D001794:Blood Pressure / Q000502:physiology; D015897:Comorbidity; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000401:mortality / Q000503:physiopathology; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006977:Hypertension, Renal / Q000000981:diagnostic imaging / Q000401:mortality* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012078:Renal Artery Obstruction / Q000000981:diagnostic imaging / Q000401:mortality* / Q000503:physiopathology; D012307:Risk Factors