Impact of incidental renal artery stenosis on long-term mortality in patients with peripheral arterial disease undergoing vascular procedure

Introduction: The most common cause of the peripheral arterial disease (PAD) is atherosclerosis. PAD is associated with other atherosclerotic diseases such as renal artery stenosis (RAS). Life expectancy decreases in patients with RAS, especially those whose stenosis is above 60% but has not reached the stage of chronic kidney failure. This study aims to determine the prevalence of RAS in PAD patients, the relationship between angiographic scoring system (ANGIO Score), history of hypertension, and diabetes mellitus with the degree of RAS. Method: This research was a cross-sectional study conducted at Cipto Mangunkusumo Hospital from February to May 2019. Patients with a diagnosis of lower extremity PAD and had been assessed with CT angiography examination, were included in this study. The degree of RAS and ANGIO Score were calculated. Sampling was done by the total sampling method. Results Most patients were women 33 (50.8%), while men were 32 (49.2%). 90.8% of the patients had diabetes, while 61.5% of the sample had hypertension. Grade 1 RAS was the most found. There was no correlation between ANGIO Score on age, sex, and diabetes mellitus, but there was a significant relationship with hypertension. There was a relationship between RAS with age and hypertension, but there was no relationship with diabetes mellitus and gender. ANGIO Score and RAS had a significant relationship (p <0.001). Conclusion: There was a relationship between the ANGIO Score and the severity of RAS. The cut-off score of 9 for the ANGIO Score had a sensitivity of 85.7% and a specificity of 61.4% for predicting RAS. Keywords: peripheral arterial disease, angiographic scoring system, renal artery stenosis, CT angiography

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Prevalence and risk factors for renal artery stenosis and chronic kidney disease in Japanese patients with peripheral arterial disease

Hypertension Research ◽

10.1038/hr.2010.93 ◽

2010 ◽

Vol 33 (9) ◽

pp. 911-915 ◽

Cited By ~ 12

Author(s):

Michiko Endo ◽

Hisao Kumakura ◽

Hiroyoshi Kanai ◽

Yoshihiro Araki ◽

Shu Kasama ◽

...

Keyword(s):

Risk Factors ◽

Chronic Kidney Disease ◽

Kidney Disease ◽

Peripheral Arterial Disease ◽

Renal Artery ◽

Renal Artery Stenosis ◽

Japanese Patients ◽

Arterial Disease ◽

Artery Stenosis ◽

Peripheral Arterial

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Site and Burden of Lower Limb Atherosclerosis Predicts Long-term Mortality in a Cohort of Patients With Peripheral Arterial Disease

European Journal of Vascular and Endovascular Surgery ◽

10.1016/j.ejvs.2018.07.020 ◽

2018 ◽

Vol 56 (6) ◽

pp. 849-856 ◽

Cited By ~ 3

Author(s):

Paul J.W. Tern ◽

Izabela Kujawiak ◽

Pratyasha Saha ◽

Thomas B. Berrett ◽

Mohammed M. Chowdhury ◽

...

Keyword(s):

Peripheral Arterial Disease ◽

Lower Limb ◽

Arterial Disease ◽

Peripheral Arterial ◽

Long Term Mortality

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ANALYSIS OF CONCOMITANT MULTI-SYSTEMIC ATHEROSCLEROSIS; STUDY FOR CAROTID ARTERY STENOSIS, PERIPHERAL ARTERIAL DISEASE OF LOWER LIMBS, RENAL ARTERY STENOSIS AND CORONARY ARTERY DISEASE

Journal of the American College of Cardiology ◽

10.1016/s0735-1097(12)61424-7 ◽

2012 ◽

Vol 59 (13) ◽

pp. E1423

Author(s):

Yoichi Imori ◽

Takeshi Akasaka ◽

Satoshi Takeshita ◽

Shigeru Saito

Keyword(s):

Coronary Artery Disease ◽

Coronary Artery ◽

Carotid Artery ◽

Peripheral Arterial Disease ◽

Renal Artery ◽

Arterial Disease ◽

Artery Stenosis ◽

Lower Limbs ◽

Artery Disease ◽

Peripheral Arterial

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A Prognostic Risk Index for Long-term Mortality in Patients With Peripheral Arterial Disease

Archives of Internal Medicine ◽

10.1001/archinte.167.22.2482 ◽

2007 ◽

Vol 167 (22) ◽

pp. 2482 ◽

Cited By ~ 49

Author(s):

Harm H. H. Feringa

Keyword(s):

Peripheral Arterial Disease ◽

Risk Index ◽

Arterial Disease ◽

Peripheral Arterial ◽

Long Term Mortality

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Long-term mortality after renal artery stenting in patients with severe atherosclerotic renal artery stenosis and high-risk clinical manifestations

American Journal of Hypertension ◽

10.1093/ajh/hpab027 ◽

2021 ◽

Author(s):

M I Dregoesc ◽

S D Bolboacă ◽

P M Doroltan ◽

M Istrate ◽

M C Marc ◽

...

Keyword(s):

Blood Pressure ◽

High Risk ◽

Renal Artery ◽

Renal Artery Stenosis ◽

Clinical Manifestations ◽

Artery Stenosis ◽

Uncontrolled Hypertension ◽

Renal Artery Stenting ◽

Long Term Mortality

Abstract Background Atherosclerotic renal artery stenosis is a risk factor for cardiovascular death. Observational studies support the benefit of renal revascularization on outcomes in selected patients with high-risk clinical manifestations. In this context, we evaluated the factors associated with long-term mortality after renal artery stenting in patients with severe renal artery stenosis, impaired kidney function and/or uncontrolled hypertension. Methods The medical records of patients undergoing renal artery stenting between 2004 and 2014 were extracted. Blood pressure and creatinine were recorded at baseline, 24 hours post-stenting and in the one month to one year interval that followed revascularization. Long-term follow-up was performed in March 2020. Results The cohort consisted of 65 patients. Median follow-up was 120 months. In the first year after stenting, less patients had chronic kidney disease (CKD) class 3b – 5 as compared to baseline (35.3 vs. 56.9%, p=0.01). The number of patients with controlled blood pressure after revascularization increased with 69.2% (p<0.001). Long-term all-cause mortality reached 44.6%. Age (OR 1.1; 95%CI 1.0–1.2; p=0.01), male gender (OR 7.9; 95%CI 1.9 – 43.5; p=0.008), post-stenting CKD class 3b-5 (OR 5.8; 95%CI 1.5–27.9; p=0.01), and post-revascularization uncontrolled hypertension (OR 8.9; 95%CI 1.7–63.5; p=0.01) were associated with long-term mortality independent of diabetes mellitus and coronary artery disease. Conclusion Improved CKD class and blood pressure were recorded in the first year after renal artery stenting in patients with severe renal artery stenosis and high-risk clinical manifestations. The lack of improvement in kidney function and blood pressure was independently associated with long-term mortality.

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Initial Diastolic Dysfunction is a Powerful Predictor of 5-year Mortality in Peripheral Arterial Disease Patients undergoing Percutaneous Transluminal Angioplasty

10.21203/rs.3.rs-41677/v1 ◽

2020 ◽

Author(s):

Kyung-Hee Kim ◽

Seung Woon Rha ◽

Byoung Geol Choi ◽

Jae-Kyung Byun ◽

Woohyeun Kim ◽

...

Keyword(s):

Peripheral Arterial Disease ◽

Percutaneous Transluminal Angioplasty ◽

Independent Predictor ◽

Arterial Disease ◽

Transluminal Angioplasty ◽

Total Death ◽

Peripheral Arterial ◽

Percutaneous Transluminal ◽

Long Term Mortality

Abstract Background Peripheral arterial disease (PAD) and heart failure share common risks and are associated with increased morbidity and mortality. However, it is unknown whether cardiac function can be an independent predictor of long-term mortality in patients with PAD. Methods In total, 902 patients who underwent percutaneous transluminal angioplasty for PAD were enrolled. The patients were categorized into three groups according to the left ventricular ejection fraction (LVEF): reduced EF (< 40%, n = 62); mid-range EF (40–49%, n = 76); and preserved EF (≥ 50%, n = 764). Echocardiographic (EF, ratio of mitral inflow velocity to annular velocity E/eʹ ≥ 15, and others) and clinical parameters were tested using stepwise logistic regression analysis to determine independent predictors of 5-year mortality. Results A higher proportion of patients with reduced EF had ischemic heart disease than those with preserved EF (77.4% vs. 56.8%, p < 0.001). Up to 5 years, patients with reduced EF and mid-range EF showed a higher incidence of total death than those with normal EF. However, there was no difference in the incidence of myocardial infarction, stroke, and revascularization among the three groups. After multivariable adjustment, the ratio of E/eʹ ≥ 15 was the only strong predictor of total mortality (hazard ratio, 6.14; 95% confidence interval, 3.7–10.1;p < 0.01). Conclusion Patients with PAD and reduced EF undergoing PTA had a higher incidence of total death during the 5-year follow-up. Initial tissue Doppler E/eʹ ≥ 15, a non-invasive estimate of left atrial filling pressure, was the only independent predictor of long-term mortality.

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