title: Associations of antiplatelet therapy and beta blockade with patient outcomes in atherosclerotic renovascular disease.
abstract: Randomized trials have shown a neutral effect of percutaneous revascularization compared with optimal medical therapy in patients with atherosclerotic renovascular disease (ARVD). However, there are few data to define what constitutes optimal medical therapy. We present a retrospective analysis of 529 ARVD patients. Separate analyses were performed comparing outcomes in patients prescribed/not prescribed beta blocker and antiplatelet agents. Analyses were adjusted for effects of baseline covariates on probability of treatment and on clinical outcome. Over a median follow-up period of 3.8 years, antiplatelet therapy was associated with a reduced risk for death (relative risk, 0.52 [95% confidence interval {CI}: 0.31-0.89]; P = .02). Beta blocker therapy was associated with a reduced for death (relative risk, 0.45 [95% CI: 0.21-0.97]; P = .04) and nonfatal cardiovascular events (relative risk, 0.74 [95% CI: 0.60-0.90]; P = .003). Although limited by small patient numbers, this study suggests that in ARVD, treatment with antiplatelet therapy and beta blockade may associate with a prognostic benefit.
authors.affiliation: Vascular Research Group, Department of Renal Medicine, Salford Royal NHS Foundation Trust, Salford, United Kingdom.
authors.forename: James
authors.initials: J
authors.lastname: Ritchie
authors.affiliation: Vascular Research Group, Department of Renal Medicine, Salford Royal NHS Foundation Trust, Salford, United Kingdom.
authors.forename: Darren
authors.initials: D
authors.lastname: Green
authors.affiliation: Vascular Research Group, Department of Renal Medicine, Salford Royal NHS Foundation Trust, Salford, United Kingdom.
authors.forename: Helen V
authors.initials: HV
authors.lastname: Alderson
authors.affiliation: Vascular Research Group, Department of Renal Medicine, Salford Royal NHS Foundation Trust, Salford, United Kingdom.
authors.forename: Constantina
authors.initials: C
authors.lastname: Chrysochou
authors.affiliation: Vascular Research Group, Department of Renal Medicine, Salford Royal NHS Foundation Trust, Salford, United Kingdom.
authors.forename: Diana
authors.initials: D
authors.lastname: Vassallo
authors.affiliation: Vascular Research Group, Department of Renal Medicine, Salford Royal NHS Foundation Trust, Salford, United Kingdom.
authors.forename: Smeeta
authors.initials: S
authors.lastname: Sinha
authors.affiliation: Vascular Research Group, Department of Renal Medicine, Salford Royal NHS Foundation Trust, Salford, United Kingdom. Electronic address: Philip.kalra@srft.nhs.uk.
authors.forename: Philip A
authors.initials: PA
authors.lastname: Kalra
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D000368:Aged; D000369:Aged, 80 and over; D017130:Angioplasty; D057911:Angiotensin Receptor Antagonists / Q000627:therapeutic use; D050197:Atherosclerosis / Q000150:complications* / Q000188:drug therapy; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D006978:Hypertension, Renovascular / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D011379:Prognosis; D016032:Randomized Controlled Trials as Topic; D012077:Renal Artery / Q000601:surgery; D012078:Renal Artery Obstruction / Q000150:complications / Q000188:drug therapy* / Q000209:etiology; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome
chemical_list: D000319:Adrenergic beta-Antagonists; D057911:Angiotensin Receptor Antagonists; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D010975:Platelet Aggregation Inhibitors
keywords: Aspirin; beta blocker; mortality; renal artery stenosis