Renal artery revascularization improves heart failure control in patients with atherosclerotic renal artery stenosis.
Nephrol Dial Transplant
; 25(3): 813-20, 2010 Mar.
Article
em En
| MEDLINE
| ID: mdl-19666661
ABSTRACT
BACKGROUND:
Renal artery stenosis (RAS) impacts the pathogenesis and control of heart failure (HF) and may further contribute to increased cardiovascular morbidity and mortality in HF patients. However, the long-term effects of renal artery revascularization on cardiovascular outcomes in HF patients are not well studied.METHODS:
The prevalence of HF and its effects on all-cause mortality were studied in 163 consecutive patients with systemic hypertension and chronic kidney disease (serum creatinine >2 mg/dL) who underwent percutaneous transluminal renal angioplasty (PTRA) with stenting for atherosclerotic RAS. In addition, in 100 patients with RAS and coexistent HF, we compared the impact of medical treatment (n = 50) versus PTRA (n = 50) on clinical outcomes.RESULTS:
HF (predominantly normal ejection fraction) was present in 50/163 (31%) patients with systemic hypertension and chronic kidney disease (serum creatinine >2 mg/ dL) undergoing PTRA for RAS and represented the major predictor of all-cause mortality in these patients. When compared with sex-matched RAS and HF patients treated medically, PTRA with stenting was associated with a significant decrease in the New York Heart Association Functional Class (1.9 +/- 0.8 versus 2.6 +/- 1.0, P < 0.04) and a 5-fold reduction in the number of hospitalizations. However, renal artery revascularization did not impact mortality.CONCLUSION:
HF was present in one-third of patients with renal dysfunction and atherosclerotic RAS who were referred for PTRA. The presence of HF was associated with a significantly increased risk of death after PTRA with stenting. Renal artery revascularization resulted in improved HF control and a reduction in HF hospitalizations.
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Base de dados:
MEDLINE
Assunto principal:
Artéria Renal
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Obstrução da Artéria Renal
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Stents
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Angioplastia com Balão
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Aterosclerose
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Insuficiência Cardíaca
Idioma:
En
Ano de publicação:
2010
Tipo de documento:
Article