title: [Impact of simultaneous renal artery and coronary artery stenting on cardiac and renal function in patients with renal artery stenosis and coronary artery disease].
abstract: OBJECTIVE
  To investigate the impact of simultaneous percutaneous transluminal renal artery stenting (PTRAS) and percutaneous coronary artery interventions (PCI) on cardiac and renal function in patients with renal artery stenosis (RAS) and coronary artery disease (CAD), and explore the factors affecting the long-term prognosis.
  
  
  METHODS
  This retrospective cohort study enrolled 169 patients with RAS and CAD from January 2006 to January 2010, 149 patients were intervened with PTRAS and PCI simultaneously (combined group) and the remaining 20 patients were treated with PCI (PCI group). All patients were followed up for at least 2 years. Clinical data including blood pressure, estimated glomerular filtration rate (eGFR), echocardiography and major adverse events were obtained.
  
  
  RESULTS
  The average stenotic ratio of the left and right renal artery in PCI group were significantly lower than those in combined group (both P < 0.01). After 2 years, there was a significant decrease in systolic blood pressure compared to baseline level in the combined group (P < 0.01). In the PCI group, both systolic blood pressure and diastolic blood pressure were significantly lower during follow-up than at the baseline level (both P < 0.01) . Echocardiography examination showed that left ventricular mass index (LVMI) during follow up was significantly lower than the baseline value in both groups, and the reduction extent in the combined group was larger than in PCI group (-55.6 g/m(2) vs.-12.8 g/m(2), P < 0.01) . In the combined group, the eGFR value decreased from (44.7 ± 17.4) ml×min(-1)×1.73 m(-2) to (41.7 ± 18.9) ml×min(-1)×1.73 m(-2) (P < 0.01). eGFR level remained unchanged in PCI group (P > 0.05). Multivariate Cox regression analysis demonstrated that baseline renal dysfunction was not significantly related to the long-term adverse prognosis in combined group (HR = 0.986, P > 0.05).
  
  
  CONCLUSIONS
  Simultaneous PTRAS and PCI are safe and effective for treating patients with RAS and CAD. Simultaneous PTRAS and PCI are beneficial on controlling blood pressure and reducing left ventricular mass index but has no impact on renal function change.
authors.affiliation: Department of Cardiology, Guangdong General Hospital, Guangdong Cardiovascular Institute, Guangzhou 510100, China.
authors.forename: Haojian
authors.initials: H
authors.lastname: Dong
authors.affiliation: Department of Cardiology, Guangdong General Hospital, Guangdong Cardiovascular Institute, Guangzhou 510100, China.
authors.forename: Yujing
authors.initials: Y
authors.lastname: Mo
authors.affiliation: Department of Cardiology, Guangdong General Hospital, Guangdong Cardiovascular Institute, Guangzhou 510100, China.
authors.forename: Yuan
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Department of Cardiology, Guangdong General Hospital, Guangdong Cardiovascular Institute, Guangzhou 510100, China.
authors.forename: Jianfang
authors.initials: J
authors.lastname: Luo
authors.affiliation: Department of Cardiology, Guangdong General Hospital, Guangdong Cardiovascular Institute, Guangzhou 510100, China.
authors.forename: Yingling
authors.initials: Y
authors.lastname: Zhou
authors.affiliation: Department of Cardiology, Guangdong General Hospital, Guangdong Cardiovascular Institute, Guangzhou 510100, China. Email: syhwh@21cn.com.
authors.forename: Wenhui
authors.initials: W
authors.lastname: Huang
mesh_terms: D000368:Aged; D003324:Coronary Artery Disease / Q000628:therapy*; D003331:Coronary Vessels / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D006321:Heart / Q000503:physiopathology; D006801:Humans; D007668:Kidney / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012077:Renal Artery / Q000473:pathology*; D012078:Renal Artery Obstruction / Q000628:therapy*; D012189:Retrospective Studies; D015607:Stents