Copyright © 2002 by the European Society of Cardiology.
Coronary anatomy predicts presence or absence of renal artery stenosis. A prospective study in patients undergoing cardiac catheterization for suspected coronary artery disease
a Krankenhaus der Barmherzigen Brüder, Teaching Hospital of the Karl Franzens University Graz, Department of Internal Medicine, Graz, Austria
b University Clinic Internal Medicine, Department Cardiology, Graz, Austria
revised May 28, 2002; accepted May 29, 2002
Abstract
Aims This study aimed to determine the prevalence of renal artery stenosis (RAS) and associated risk factors in patients undergoing cardiac catheterization for suspected coronary artery disease (CAD).
Methods One hundred and seventy-seven consecutive patients (62 females) with a serum creatinine concentration <2·0mg.dl–1 were studied. Abdominal aortography followed cardiac catheterization to screen for RAS.
Results In 110 patients (62%) CAD and in 19 patients (11%) significant RAS (luminal narrowing of 
50%) were detected, 12 of whom had high grade (70%) RAS, and two subjects had significant RAS without CAD. Patients with RAS were older (67±8 vs 61±11 years, mean±SD;P =0·004), had higher systolic blood pressure (150±15 vs 138±20mmHg;P =0·005), a lower glomerular filtration rate (GFR; 61±16 vs 80±22ml.min–1, P<0·001) and more often diabetes mellitus (69% vs 30%; P=0·004). In multivariate analysis a low GFR and the extent of CAD were independent predictors of RAS. The presence of >2 significant coronary lesions predicted RAS (sensitivity 0·84, specificity 0·77, positive predictive value 0·30, negative predictive value 0·98).
Conclusion Screening for RAS in patients with >2 diseased coronary segments has a high diagnostic yield, which is even greater in the presence of a reduced GFR, diabetes mellitus, and elevated systolic blood pressure.Copyright 2002 The European Society of Cardiology. Published by Elsevier Science Ltd. All rights reserved .
Key Words: Renal artery stenosis, coronary artery disease, cardiac catheterization, ROC analysis.
f1 Correspondence: Peter Kotanko, MD, Krankenhaus der Barmherzigen Brüder, Teaching Hospital of the Karl Franzens University Graz, Department of Internal Medicine, Marschallgasse 12, A-8020 Graz, Austria.
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