Angiographic Characteristics of Renal Arterial Disease over the Spectrum of Coronary Artery Disease

Abstract

Background/Aim: The angiographic characteristics of renal artery stenoses (RAS) in patients with coronary artery disease (CAD) have not been yet fully investigated. We sought to evaluate the angiographic characteristics of RAS in patients with CAD. Methods: The medical records of consecutive patients who underwentcoronary angiography in a single public institution over a 12-month period were evaluated. The patients who underwent coincident diagnostic renal angiography to evaluate renal vessels on the basis of clinical criteria and who had at least one-vessel CAD were analyzed. Moderate (50–70%) to severe (70–100%) arterial stenoses were noted as significant angiographic findings. The types of stenosis (ostial, true renal, mixed) and presence and location of calcium were recorded. Results: Angiographically significant RAS were reported in 40 (19.5%) of 205 consecutive patients (mean age 67.1 ± 12.8 years, mean serum creatinine concentration 2.1 ± 0.5 mg/dl, mean glomerular filtration rate 52 ± 13 ml/min) for a total of 55 lesions. The RAS severity was moderate in 30.9% (17/55), severe in 69.1% (38/55), ostial in 27.2% (15/55), true renal in 10.9% (6/55), and mixed in 61.8% (34/55) of the patients. The mean lesion length was 16 ± 1.8 mm. Patients with ≧3-vessel CAD had a statistically significantly higher prevalence of mixed calcified RAS (18/24, 75%). Logistic regression analyses revealed ≧3-vessel CAD (odds ratio 9.917, p = 0.002), age >65 years (odds ratio 3.817, p = 0.036), and ≧3 risk factors (odds ratio 2.8, p = 0.048) as independent predictors of RAS. Conclusion: RAS in multivessel CAD patients seems to have a peculiar angiographic pattern, such as a higher prevalence of mixed calcified lesions and poststenotic enlargement, that should be taken in account when dealing with RAS.