Naslov
Frequency and clinical characteristics of renal artery stenosis in patients with coronary artery disease undergoing cardiac catheterization

Autori
Straume Bah, Ida

Vrsta, podvrsta i kategorija rada
Ocjenski radovi, diplomski rad, diplomski

Fakultet
Medicinski fakultet

Mjesto
Split

Datum
26.07

Godina
2022

Stranica
68

Mentor
Borovac, Josip Anđelo

Ključne riječi
renal artery stenosis ; stable coronary artery disease ; chronic coronary syndrome ; RAS ; diagnostic angiography ; catheterisation ; multi vessel disease ; coronary disease ; comorbidities

Sažetak
Objectives: The aims of this study were to determine the incidence of renal artery stenosis (RAS) in patients undergoing diagnostic coronary angiography for stable coronary artery disease (CAD) or suspected coronary artery disease. Additionally, to investigate the influence of risk factors and certain clinical characteristics on the risk of finding significant RAS during diagnostic coronary angiography. Patients and methods: Systematic review and quantitative meta- analysis included a total of 28 observational cohort studies that were primarily designed to determine the prevalence and risk factors for RAS in patients with coronary artery disease. The main outcomes of interest were the mean incidence of significant, severe, and bilateral RAS in the previously described population, statistically adjusted for individual study size. The second objective was to investigate the potential association of established cardiovascular risk factors, comorbidities, and angiographic parameters of the severity of coronary disease with the frequency of RAS. Relative risk (RR) with 95% confidence interval (95% CI) was used as the main outcome measure, and a random effect model and the Mantel-Haenszel statistical algorithm were used for meta-analysis. Results: The average frequency of RAS in the mentioned population was 13, 82% (95% CI 10, 69-17, 27%), 6, 46% (95% CI 4, 36-8, 95%) and 4, 03% (95% CI 2, 58-5, 78%) for significant, severe and bilateral RAS. Chronic kidney disease was associated with almost 3-fold higher relative risk for RAS (RR 2, 80, 95% CI 2, 03-3, 38), followed by peripheral artery disease (RR 2, 46, 95% CI 1, 85-3, 27), left-main artery disease (RR 1, 86, 95% CI 1, 30- 2, 67) and three-vessel disease (RR 1, 56, 95% CI 1, 28-1, 90). Of the classic risk factors for cardiovascular disease, arterial hypertension (RR 1, 33, 95% CI 1, 22- 1, 45), diabetes (RR 1, 22, 95% CI 1, 09-1, 37) and dyslipidemia (RR 1, 12, 95% CI 1, 06-1, 19) were significant associated with a higher relative risk for significant RAS. Smoking was not significantly associated with a higher risk of RAS (RR 1, 02, 95% CI 0, 94-1, 12). Female gender was associated with a 33% higher relative risk for RAS compared to the male gender (RR 1, 33, 95% CI 1, 07-1, 66). Finally, patients with RAS were significantly older that those without RAS (+4, 6 years of age, 95% CI 3, 50-5, 02). Conclusion: This study showed that significant RAS is present in nearly 14 out of 100 patients undergoing routine cardiac catheterization for coronary artery disease. Variables that were significantly associated with a higher risk of finding RAS were older age, female sex, chronic kidney disease, peripheral artery disease, diabetes mellitus, arterial hypertension, and dyslipidemia. Of the angiographic variables, RAS was found to be significantly more frequent in patients with left-main disease and three-vessel disease.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

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