Impact of simultaneous renal artery and coronary artery stenting on cardiac and renal function in patients with renal artery stenosis and coronary artery disease
10.3760/cma.j.issn.0253-3758.2014.01.005
- VernacularTitle:同期冠状动脉和肾动脉支架术对心肾功能的影响
- Author:
Haojian DONG
1
;
Yujing MO
;
Yuan LIU
;
Jianfang LUO
;
Yingling ZHOU
;
Wenhui HUANG
Author Information
1. 广东省心血管病研究所广东省人民医院心内科广东省医学科学院
- Keywords:
Coronary disease;
Renal artery obstruction;
Stents
- From:
Chinese Journal of Cardiology
2014;42(1):19-24
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the impact of simultaneous percutaneous transluminal renal artery stenting (PTRAS) and percutaneous coronary artery interventions (PCI) on cardiac and renal function in patients with renal artery stenosis (RAS) and coronary artery disease (CAD),and explore the factors affecting the long-term prognosis.Methods This retrospective cohort study enrolled 169 patients with RAS and CAD from January 2006 to January 2010,149 patients were intervened with PTRAS and PCI simultaneously (combined group) and the remaining 20 patients were treated with PCI (PCI group).All patients were followed up for at least 2 years.Clinical data including blood pressure,estimated glomerular filtration rate (eGFR),echocardiography and major adverse events were obtained.Results The average stenotic ratio of the left and right renal artery in PCI group were significantly lower than those in combined group (both P ＜ 0.01).After 2 years,there was a significant decrease in systolic blood pressure compared to baseline level in the combined group (P ＜ 0.01).In the PCI group,both systolic blood pressure and diastolic blood pressure were significantly lower during follow-up than at the baseline level(both P ＜ 0.01).Echocardiography examination showed that left ventricular mass index (LVMI) during follow up was significantly lower than the baseline value in both groups,and the reduction extent in the combined group was larger than in PCI group(-55.6 g/m2 vs.-12.8 g/m2,P ＜ 0.01).In the combined group,the eGFR value decreased from (44.7 ± 17.4) ml · min-1 · 1.73 m-2 to (41.7 ± 18.9) ml · min-1 · 1.73 m-2 (P ＜ 0.01).eGFR level remained unchanged in PCI group(P ＞ 0.05).Multivariate Cox regression analysis demonstrated that baseline renal dysfunction was not significantly related to the long-term adverse prognosis in combined group (HR =0.986,P ＞ 0.05).Conclusions Simultaneous PTRAS and PCI are safe and effective for treating patients with RAS and CAD.Simultaneous PTRAS and PCI are beneficial on controlling blood pressure and reducing left ventricular mass index but has no impact on renal function change.
