Prevalence of renal artery stenosis in patients undergoing cardiac catheterization

To investigate the prevalence of significant renalartery stenosis (RAS C50%), and to identify clinical predictorsfor significant RAS in patients with an elevated cardiovascularrisk, such as those affected by ischemic heartdisease. In patients with an elevated cardio-vascular risk,both atherosclerotic renovascular disease and coronaryartery disease (CAD) are likely to occur. Prospectively fromApril 2007 to March 2008, all consecutive patients withischemic heart disease undergoing non-emergent cardiaccatheterization were also evaluated for atherosclerotic RASby renal arteriography. A RAS C50% was considered assignificant. A total of 1,298 patients underwent cardiac andrenal angiography. Significant RAS was found in 70 out of1,298 patients (5.4%). The presence of peripheral vasculardisease, eGFR7 ml/min/1.73 m2, age[66 years, dyslipidemia,CAD severity and pulse pressure[52 mmHg wereindependent clinical predictors of significant RAS, andjointly produced a ROC AUC of 0.79 (95% CI 0.73–0.85,P.001). Based on these data, a prediction rule for significantRAS was developed, and it showed an adequatepredictive performance with 64% sensitivity and 82%specificity. In a large cohort of patients undergoing coronaryangiography, significantRASis a relatively rare comorbidity(5.4%). A model based on simple clinical variables may beuseful for the clinical identification of high CV risk patientswho may be suitable for renal arteriography at the time ofcardiac catheterization.Keywords RAS CAD Renal arteriographyIntroduction