A simple prediction rule for significant renal artery stenosis in patients undergoing cardiac catheterization

Mauricio G Cohen, J. Andrés Pascua, Marta Garcia-Ben, Carlos A. Rojas-Matas, Jose M. Gabay, Daniel H. Berrocal, Walter A. Tan, George A. Stouffer, Mario Montoya, Alejandro D. Fernandez, Marcelo E. Halac, Liliana R. Grinfeld

Research output: Contribution to journalArticle

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Abstract

Background: Renal artery stenosis (RAS) is a potentially reversible cause of hypertension and renal insufficiency and is associated with poor prognosis. Methods: We aimed to identify simple predictors of significant RAS among patients undergoing coronary angiography. Prospective data were collected on 843 consecutive patients who underwent cardiac catheterization and abdominal aortography. Stenoses ≥75% were considered significant. Multivariable logistic regression was used to assess the relationship between baseline characteristics and coronary anatomy with significant RAS. A simple risk score was derived from the model. Results: The prevalence of RAS ≥75% was 11.7%. Independent predictors of significant RAS were older age, higher creatinine levels, peripheral vascular disease, number of cardiovascular drugs, hypertension, female sex, and 3-vessel coronary artery disease or previous coronary artery bypass graft. The concordance index of the model was 0.802. These variables were used to develop a simple predictive score of significant RAS for patients undergoing cardiac catheterization. The prevalence of RAS increased stepwise with increasing score values: 0.6% for a score ≤5, 1.5% for 6 to 7, 6.1% for 8 to 9, 12.2% for 10 to 11, 18.7% for 12 to 14, 35.7% for 15 to 17, and 62.1% for ≥18 (P < .001). Approximately one third of the patients had a score ≥11, which yielded a sensitivity of 76% and a specificity of 71%. Conclusions: Renal artery stenosis is a relatively common finding among patients referred for coronary angiography. A simple score can predict the presence of significant RAS among patients referred for cardiac catheterization.

Original languageEnglish
Pages (from-to)1204-1211
Number of pages8
JournalAmerican Heart Journal
Volume150
Issue number6
DOIs
StatePublished - Dec 1 2005
Externally publishedYes

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Renal Artery Obstruction
Cardiac Catheterization
Coronary Angiography
Hypertension
Cardiovascular Agents
Aortography
Peripheral Vascular Diseases
Coronary Artery Bypass
Renal Insufficiency
Coronary Artery Disease
Creatinine
Anatomy
Pathologic Constriction
Logistic Models
Transplants

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Cohen, M. G., Andrés Pascua, J., Garcia-Ben, M., Rojas-Matas, C. A., Gabay, J. M., Berrocal, D. H., ... Grinfeld, L. R. (2005). A simple prediction rule for significant renal artery stenosis in patients undergoing cardiac catheterization. American Heart Journal, 150(6), 1204-1211. https://doi.org/10.1016/j.ahj.2005.02.019

A simple prediction rule for significant renal artery stenosis in patients undergoing cardiac catheterization. / Cohen, Mauricio G; Andrés Pascua, J.; Garcia-Ben, Marta; Rojas-Matas, Carlos A.; Gabay, Jose M.; Berrocal, Daniel H.; Tan, Walter A.; Stouffer, George A.; Montoya, Mario; Fernandez, Alejandro D.; Halac, Marcelo E.; Grinfeld, Liliana R.

In: American Heart Journal, Vol. 150, No. 6, 01.12.2005, p. 1204-1211.

Research output: Contribution to journalArticle

Cohen, MG, Andrés Pascua, J, Garcia-Ben, M, Rojas-Matas, CA, Gabay, JM, Berrocal, DH, Tan, WA, Stouffer, GA, Montoya, M, Fernandez, AD, Halac, ME & Grinfeld, LR 2005, 'A simple prediction rule for significant renal artery stenosis in patients undergoing cardiac catheterization', American Heart Journal, vol. 150, no. 6, pp. 1204-1211. https://doi.org/10.1016/j.ahj.2005.02.019
Cohen, Mauricio G ; Andrés Pascua, J. ; Garcia-Ben, Marta ; Rojas-Matas, Carlos A. ; Gabay, Jose M. ; Berrocal, Daniel H. ; Tan, Walter A. ; Stouffer, George A. ; Montoya, Mario ; Fernandez, Alejandro D. ; Halac, Marcelo E. ; Grinfeld, Liliana R. / A simple prediction rule for significant renal artery stenosis in patients undergoing cardiac catheterization. In: American Heart Journal. 2005 ; Vol. 150, No. 6. pp. 1204-1211.
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abstract = "Background: Renal artery stenosis (RAS) is a potentially reversible cause of hypertension and renal insufficiency and is associated with poor prognosis. Methods: We aimed to identify simple predictors of significant RAS among patients undergoing coronary angiography. Prospective data were collected on 843 consecutive patients who underwent cardiac catheterization and abdominal aortography. Stenoses ≥75{\%} were considered significant. Multivariable logistic regression was used to assess the relationship between baseline characteristics and coronary anatomy with significant RAS. A simple risk score was derived from the model. Results: The prevalence of RAS ≥75{\%} was 11.7{\%}. Independent predictors of significant RAS were older age, higher creatinine levels, peripheral vascular disease, number of cardiovascular drugs, hypertension, female sex, and 3-vessel coronary artery disease or previous coronary artery bypass graft. The concordance index of the model was 0.802. These variables were used to develop a simple predictive score of significant RAS for patients undergoing cardiac catheterization. The prevalence of RAS increased stepwise with increasing score values: 0.6{\%} for a score ≤5, 1.5{\%} for 6 to 7, 6.1{\%} for 8 to 9, 12.2{\%} for 10 to 11, 18.7{\%} for 12 to 14, 35.7{\%} for 15 to 17, and 62.1{\%} for ≥18 (P < .001). Approximately one third of the patients had a score ≥11, which yielded a sensitivity of 76{\%} and a specificity of 71{\%}. Conclusions: Renal artery stenosis is a relatively common finding among patients referred for coronary angiography. A simple score can predict the presence of significant RAS among patients referred for cardiac catheterization.",
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AU - Andrés Pascua, J.

AU - Garcia-Ben, Marta

AU - Rojas-Matas, Carlos A.

AU - Gabay, Jose M.

AU - Berrocal, Daniel H.

AU - Tan, Walter A.

AU - Stouffer, George A.

AU - Montoya, Mario

AU - Fernandez, Alejandro D.

AU - Halac, Marcelo E.

AU - Grinfeld, Liliana R.

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N2 - Background: Renal artery stenosis (RAS) is a potentially reversible cause of hypertension and renal insufficiency and is associated with poor prognosis. Methods: We aimed to identify simple predictors of significant RAS among patients undergoing coronary angiography. Prospective data were collected on 843 consecutive patients who underwent cardiac catheterization and abdominal aortography. Stenoses ≥75% were considered significant. Multivariable logistic regression was used to assess the relationship between baseline characteristics and coronary anatomy with significant RAS. A simple risk score was derived from the model. Results: The prevalence of RAS ≥75% was 11.7%. Independent predictors of significant RAS were older age, higher creatinine levels, peripheral vascular disease, number of cardiovascular drugs, hypertension, female sex, and 3-vessel coronary artery disease or previous coronary artery bypass graft. The concordance index of the model was 0.802. These variables were used to develop a simple predictive score of significant RAS for patients undergoing cardiac catheterization. The prevalence of RAS increased stepwise with increasing score values: 0.6% for a score ≤5, 1.5% for 6 to 7, 6.1% for 8 to 9, 12.2% for 10 to 11, 18.7% for 12 to 14, 35.7% for 15 to 17, and 62.1% for ≥18 (P < .001). Approximately one third of the patients had a score ≥11, which yielded a sensitivity of 76% and a specificity of 71%. Conclusions: Renal artery stenosis is a relatively common finding among patients referred for coronary angiography. A simple score can predict the presence of significant RAS among patients referred for cardiac catheterization.

AB - Background: Renal artery stenosis (RAS) is a potentially reversible cause of hypertension and renal insufficiency and is associated with poor prognosis. Methods: We aimed to identify simple predictors of significant RAS among patients undergoing coronary angiography. Prospective data were collected on 843 consecutive patients who underwent cardiac catheterization and abdominal aortography. Stenoses ≥75% were considered significant. Multivariable logistic regression was used to assess the relationship between baseline characteristics and coronary anatomy with significant RAS. A simple risk score was derived from the model. Results: The prevalence of RAS ≥75% was 11.7%. Independent predictors of significant RAS were older age, higher creatinine levels, peripheral vascular disease, number of cardiovascular drugs, hypertension, female sex, and 3-vessel coronary artery disease or previous coronary artery bypass graft. The concordance index of the model was 0.802. These variables were used to develop a simple predictive score of significant RAS for patients undergoing cardiac catheterization. The prevalence of RAS increased stepwise with increasing score values: 0.6% for a score ≤5, 1.5% for 6 to 7, 6.1% for 8 to 9, 12.2% for 10 to 11, 18.7% for 12 to 14, 35.7% for 15 to 17, and 62.1% for ≥18 (P < .001). Approximately one third of the patients had a score ≥11, which yielded a sensitivity of 76% and a specificity of 71%. Conclusions: Renal artery stenosis is a relatively common finding among patients referred for coronary angiography. A simple score can predict the presence of significant RAS among patients referred for cardiac catheterization.

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