Clinical significance of low-grade renal artery stenosis

Autor: H. M. E. Kruis, D. G. Dechering, Ahmet Adiyaman, Cornelis T. Postma, Th. Thien
Rok vydání: 2010
Předmět:
Zdroj: Journal of Internal Medicine, 267, 3, pp. 305-15
Journal of Internal Medicine, 267, 305-15
ISSN: 0954-6820
Popis: Contains fulltext : 88895.pdf (Publisher’s version ) (Closed access) BACKGROUND: Patients with a renal artery stenosis (RAS) >50% carry an increased risk for future cardiovascular (CV) events. Experimental literature on this topic suggests that this might as well be true for subjects with lower-grade RAS. METHODS: Recruitment in this longitudinal cohort study was conducted from 1982 to 2002 in a Dutch University Hospital. Included in this study were 301 hypertensive patients clinically suspected of having RAS. Study participants were radiologically classified as having no, a low-grade ( or =50%) RAS. A predetermined composite CV end-point was defined as one of the following: myocardial infarction or 'objectified' angina pectoris, ischaemic stroke or death from any CV cause. Other end-points were the occurrence of CV complications, all-cause plus CV mortality and decline in renal function. RESULTS: During a median follow-up of 8.2 years, the incidence of the composite end-point totalled 79 events. After full adjustment in Cox models, a significant risk increase in high-grade [hazard ratio (HR) 2.81; P = 0.002] and low-grade RAS (HR 2.32; P = 0.038) was observed. Other end-points did not differ significantly between study groups. CONCLUSION: Hypertensive subjects with RAS of any extent, compared with hypertensives without RAS, carry a substantially increased risk for future CV events. Therefore, even in patients with low-grade RAS, aggressive pharmacological treatment strategies should be adopted as a preventive measure. 01 maart 2010
Databáze: OpenAIRE
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