title: Long-Term Outcomes and Causes of Death in Patients With Renovascular Disease Undergoing Renal Artery Stenting.
abstract: Renovascular disease (RVD) can lead to hypertension and chronic kidney disease (CKD). Patients with advanced peripheral arterial disease (PAD) have a 5-year mortality of ∼30%. Rate and causes of death in patients with significant RVD, who share similar risk factors with patients having PAD, are not well defined. We assessed consecutive patients with RVD who underwent renal artery stenting at our institution over 6 years. Specific causes of death were ascertained, and the probability of survival was estimated. Cox models were fit to identify predictors of outcomes. We identified 281 patients with RVD who underwent renal stenting. Follow-up was available for all patients (median 5.1 years). All-cause mortality was 24.2% at 5 years and 33.7% at 7 years (compounded annualized death rate: 5.5%). Of the 68 deaths, 36 (52.9%) were cardiovascular (13.2% acute myocardial infarction, 13.2% stroke, 11.8% sudden death, and 10.3% congestive heart failure) and 32 (47.1%) deaths had noncardiovascular causes. In patients with RVD undergoing stenting, cardiovascular events are the most common causes of death. Compared to patients with advanced PAD, RVD may have a lower 5-year mortality.
authors.affiliation: Division of Cardiovascular Medicine, Gill Heart Institute, University of Kentucky and the Veterans Affairs Medical Center, Lexington, KY, USA.
authors.forename: Eric L
authors.initials: EL
authors.lastname: Wallace
authors.affiliation: Department of Internal Medicine, University of Kentucky, Lexington, KY, USA.
authors.forename: Ediz
authors.initials: E
authors.lastname: Tasan
authors.affiliation: Department of Internal Medicine, University of Kentucky, Lexington, KY, USA.
authors.forename: Bryon S
authors.initials: BS
authors.lastname: Cook
authors.affiliation: College of Public Health, University of Kentucky, Lexington, KY, USA.
authors.forename: Richard
authors.initials: R
authors.lastname: Charnigo
authors.affiliation: Division of Cardiovascular Medicine, Gill Heart Institute, University of Kentucky and the Veterans Affairs Medical Center, Lexington, KY, USA.
authors.forename: Ahmed K
authors.initials: AK
authors.lastname: Abdel-Latif
authors.affiliation: Division of Cardiovascular Medicine, Gill Heart Institute, University of Kentucky and the Veterans Affairs Medical Center, Lexington, KY, USA khaled.ziada@uky.edu.
authors.forename: Khaled M
authors.initials: KM
authors.lastname: Ziada
mesh_terms: D000368:Aged; D002423:Cause of Death; D016757:Death, Sudden, Cardiac / Q000453:epidemiology; D057510:Endovascular Procedures / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D005260:Female; D006333:Heart Failure / Q000401:mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D007629:Kentucky / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000401:mortality; D016016:Proportional Hazards Models; D012078:Renal Artery Obstruction / Q000000981:diagnostic imaging / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D012307:Risk Factors; D015607:Stents; D020521:Stroke / Q000401:mortality; D013997:Time Factors; D016896:Treatment Outcome
keywords: cardiovascular mortality; myocardial infarction; peripheral arterial disease; renovascular disease; stroke