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

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67 Scopus citations

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

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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    Cohen, M. G., Andrés Pascua, J., Garcia-Ben, M., Rojas-Matas, C. A., Gabay, J. M., Berrocal, D. H., Tan, W. A., Stouffer, G. A., Montoya, M., Fernandez, A. D., Halac, M. E., & 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