A simple prediction rule for significant renal artery stenosis in patients undergoing cardiac catheterization
Background: Renal artery stenosis (RAS) is a potentially reversible cause of hypertension and renal insufficiency and is associated with poor prognosis. Methods: We aimed to identify simple predictors of significant RAS among patients undergoing coronary angiography. Prospective data were collected...
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todo:paper_00028703_v150_n6_p1204_Cohen2023-10-03T13:54:37Z A simple prediction rule for significant renal artery stenosis in patients undergoing cardiac catheterization Cohen, M.G. Andrés Pascua, J. Garcia-Ben, M. Rojas-Matas, C.A. Gabay, J.M. Berrocal, D.H. Tan, W.A. Stouffer, G.A. Montoya, M. Fernandez, A.D. Halac, M.E. Grinfeld, L.R. creatinine abdominal angiography adult aged angiocardiography aortography article controlled study coronary artery bypass graft coronary artery disease diagnostic accuracy female heart catheterization human hypertension kidney artery stenosis major clinical study male multivariate analysis peripheral vascular disease prediction prevalence priority journal prospective study scoring system Adult Aged Argentina Blood Pressure Cholesterol Coronary Angiography Coronary Disease Female Germany Heart Catheterization Humans Male Middle Aged Multivariate Analysis Peripheral Vascular Diseases Regression Analysis Renal Artery Obstruction Background: Renal artery stenosis (RAS) is a potentially reversible cause of hypertension and renal insufficiency and is associated with poor prognosis. Methods: We aimed to identify simple predictors of significant RAS among patients undergoing coronary angiography. Prospective data were collected on 843 consecutive patients who underwent cardiac catheterization and abdominal aortography. Stenoses ≥75% were considered significant. Multivariable logistic regression was used to assess the relationship between baseline characteristics and coronary anatomy with significant RAS. A simple risk score was derived from the model. Results: The prevalence of RAS ≥75% was 11.7%. Independent predictors of significant RAS were older age, higher creatinine levels, peripheral vascular disease, number of cardiovascular drugs, hypertension, female sex, and 3-vessel coronary artery disease or previous coronary artery bypass graft. The concordance index of the model was 0.802. These variables were used to develop a simple predictive score of significant RAS for patients undergoing cardiac catheterization. The prevalence of RAS increased stepwise with increasing score values: 0.6% for a score ≤5, 1.5% for 6 to 7, 6.1% for 8 to 9, 12.2% for 10 to 11, 18.7% for 12 to 14, 35.7% for 15 to 17, and 62.1% for ≥18 (P < .001). Approximately one third of the patients had a score ≥11, which yielded a sensitivity of 76% and a specificity of 71%. Conclusions: Renal artery stenosis is a relatively common finding among patients referred for coronary angiography. A simple score can predict the presence of significant RAS among patients referred for cardiac catheterization. © 2005, Mosby, Inc. All rights reserved. Fil:Garcia-Ben, M. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales; Argentina. JOUR info:eu-repo/semantics/openAccess http://creativecommons.org/licenses/by/2.5/ar http://hdl.handle.net/20.500.12110/paper_00028703_v150_n6_p1204_Cohen |
| institution |
Universidad de Buenos Aires |
| institution_str |
I-28 |
| repository_str |
R-134 |
| collection |
Biblioteca Digital - Facultad de Ciencias Exactas y Naturales (UBA) |
| topic |
creatinine abdominal angiography adult aged angiocardiography aortography article controlled study coronary artery bypass graft coronary artery disease diagnostic accuracy female heart catheterization human hypertension kidney artery stenosis major clinical study male multivariate analysis peripheral vascular disease prediction prevalence priority journal prospective study scoring system Adult Aged Argentina Blood Pressure Cholesterol Coronary Angiography Coronary Disease Female Germany Heart Catheterization Humans Male Middle Aged Multivariate Analysis Peripheral Vascular Diseases Regression Analysis Renal Artery Obstruction |
| spellingShingle |
creatinine abdominal angiography adult aged angiocardiography aortography article controlled study coronary artery bypass graft coronary artery disease diagnostic accuracy female heart catheterization human hypertension kidney artery stenosis major clinical study male multivariate analysis peripheral vascular disease prediction prevalence priority journal prospective study scoring system Adult Aged Argentina Blood Pressure Cholesterol Coronary Angiography Coronary Disease Female Germany Heart Catheterization Humans Male Middle Aged Multivariate Analysis Peripheral Vascular Diseases Regression Analysis Renal Artery Obstruction Cohen, M.G. Andrés Pascua, J. Garcia-Ben, M. Rojas-Matas, C.A. Gabay, J.M. Berrocal, D.H. Tan, W.A. Stouffer, G.A. Montoya, M. Fernandez, A.D. Halac, M.E. Grinfeld, L.R. A simple prediction rule for significant renal artery stenosis in patients undergoing cardiac catheterization |
| topic_facet |
creatinine abdominal angiography adult aged angiocardiography aortography article controlled study coronary artery bypass graft coronary artery disease diagnostic accuracy female heart catheterization human hypertension kidney artery stenosis major clinical study male multivariate analysis peripheral vascular disease prediction prevalence priority journal prospective study scoring system Adult Aged Argentina Blood Pressure Cholesterol Coronary Angiography Coronary Disease Female Germany Heart Catheterization Humans Male Middle Aged Multivariate Analysis Peripheral Vascular Diseases Regression Analysis Renal Artery Obstruction |
| description |
Background: Renal artery stenosis (RAS) is a potentially reversible cause of hypertension and renal insufficiency and is associated with poor prognosis. Methods: We aimed to identify simple predictors of significant RAS among patients undergoing coronary angiography. Prospective data were collected on 843 consecutive patients who underwent cardiac catheterization and abdominal aortography. Stenoses ≥75% were considered significant. Multivariable logistic regression was used to assess the relationship between baseline characteristics and coronary anatomy with significant RAS. A simple risk score was derived from the model. Results: The prevalence of RAS ≥75% was 11.7%. Independent predictors of significant RAS were older age, higher creatinine levels, peripheral vascular disease, number of cardiovascular drugs, hypertension, female sex, and 3-vessel coronary artery disease or previous coronary artery bypass graft. The concordance index of the model was 0.802. These variables were used to develop a simple predictive score of significant RAS for patients undergoing cardiac catheterization. The prevalence of RAS increased stepwise with increasing score values: 0.6% for a score ≤5, 1.5% for 6 to 7, 6.1% for 8 to 9, 12.2% for 10 to 11, 18.7% for 12 to 14, 35.7% for 15 to 17, and 62.1% for ≥18 (P < .001). Approximately one third of the patients had a score ≥11, which yielded a sensitivity of 76% and a specificity of 71%. Conclusions: Renal artery stenosis is a relatively common finding among patients referred for coronary angiography. A simple score can predict the presence of significant RAS among patients referred for cardiac catheterization. © 2005, Mosby, Inc. All rights reserved. |
| format |
JOUR |
| author |
Cohen, M.G. Andrés Pascua, J. Garcia-Ben, M. Rojas-Matas, C.A. Gabay, J.M. Berrocal, D.H. Tan, W.A. Stouffer, G.A. Montoya, M. Fernandez, A.D. Halac, M.E. Grinfeld, L.R. |
| author_facet |
Cohen, M.G. Andrés Pascua, J. Garcia-Ben, M. Rojas-Matas, C.A. Gabay, J.M. Berrocal, D.H. Tan, W.A. Stouffer, G.A. Montoya, M. Fernandez, A.D. Halac, M.E. Grinfeld, L.R. |
| author_sort |
Cohen, M.G. |
| title |
A simple prediction rule for significant renal artery stenosis in patients undergoing cardiac catheterization |
| title_short |
A simple prediction rule for significant renal artery stenosis in patients undergoing cardiac catheterization |
| title_full |
A simple prediction rule for significant renal artery stenosis in patients undergoing cardiac catheterization |
| title_fullStr |
A simple prediction rule for significant renal artery stenosis in patients undergoing cardiac catheterization |
| title_full_unstemmed |
A simple prediction rule for significant renal artery stenosis in patients undergoing cardiac catheterization |
| title_sort |
simple prediction rule for significant renal artery stenosis in patients undergoing cardiac catheterization |
| url |
http://hdl.handle.net/20.500.12110/paper_00028703_v150_n6_p1204_Cohen |
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