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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Detalles Bibliográficos
Autores principales: 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.
Formato: JOUR
Materias:
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
Acceso en línea:http://hdl.handle.net/20.500.12110/paper_00028703_v150_n6_p1204_Cohen
Aporte de:
Biblioteca Digital - Facultad de Ciencias Exactas y Naturales (UBA) de Universidad de Buenos Aires
Descripción
Sumario: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.

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