Renal Artery Stenting in Consecutive High-Risk Patients With Atherosclerotic Renovascular Disease : A Prospective 2-Center Cohort Study
Background The aim of this study was to prospectively evaluate the effects of renal artery stenting in consecutive patients with severe atherosclerotic renal artery stenosis and high-risk clinical presentations as defined in a national protocol developed in 2015. Methods and Results Since the protocol was initiated, 102 patients have been referred for revascularization according to the following high-risk criteria: severe renal artery stenosis (≥70%) with true resistant hypertension, rapidly declining kidney function, or recurrent heart failure/sudden pulmonary edema. At baseline, the mean 24-hour ambulatory systolic blood pressure was 166.2 mm Hg (95% CI, 162.0-170.4), the defined daily dose of antihypertensive medication was 6.5 (95% CI, 5.8-7.3), and the estimated glomerular filtration rate was 41.1 mL/min per 1.73m2 (95% CI, 36.6-45.6). In 96 patients with available 3-month follow-up data, mean 24-hour ambulatory systolic blood pressure decreased by 19.6 mm Hg (95% CI, 15.4-23.8; P<0.001), the defined daily dose of antihypertensive medication was reduced by 52% (95% CI, 41%-62%; P<0.001), and estimated glomerular filtration rate increased by 7.8 mL/min per 1.73m2 (95% CI, 4.5-11.1; P<0.001). All changes persisted after 24 month follow-up. Among 17 patients with a history of hospitalization for acute decompensated heart failure, 14 patients had no new episodes after successful revascularization. Conclusions In this prospective cohort study, we observed a reduction in blood pressure and antihypertensive medication, an increase in estimated glomerular filtration rate, and a decrease in new hospital admissions attributable to heart failure/sudden pulmonary edema after renal artery stenting. Registration URL: https://clinicaltrials.gov. Identifier: NCT02770066.
| Errataetall: |
CommentIn: J Am Heart Assoc. 2022 Sep 6;11(17):e025901. - PMID 35975740 |
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:11 |
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| Enthalten in: |
Journal of the American Heart Association - 11(2022), 7 vom: 05. Apr., Seite e024421 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Reinhard, Mark [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Completed 07.04.2022 Date Revised 18.04.2023 published: Print-Electronic ClinicalTrials.gov: NCT02770066 CommentIn: J Am Heart Assoc. 2022 Sep 6;11(17):e025901. - PMID 35975740 Citation Status MEDLINE |
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| doi: |
10.1161/JAHA.121.024421 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM338530010 |
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| 100 | 1 | |a Reinhard, Mark |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Renal Artery Stenting in Consecutive High-Risk Patients With Atherosclerotic Renovascular Disease |b A Prospective 2-Center Cohort Study |
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| 500 | |a published: Print-Electronic | ||
| 500 | |a ClinicalTrials.gov: NCT02770066 | ||
| 500 | |a CommentIn: J Am Heart Assoc. 2022 Sep 6;11(17):e025901. - PMID 35975740 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Background The aim of this study was to prospectively evaluate the effects of renal artery stenting in consecutive patients with severe atherosclerotic renal artery stenosis and high-risk clinical presentations as defined in a national protocol developed in 2015. Methods and Results Since the protocol was initiated, 102 patients have been referred for revascularization according to the following high-risk criteria: severe renal artery stenosis (≥70%) with true resistant hypertension, rapidly declining kidney function, or recurrent heart failure/sudden pulmonary edema. At baseline, the mean 24-hour ambulatory systolic blood pressure was 166.2 mm Hg (95% CI, 162.0-170.4), the defined daily dose of antihypertensive medication was 6.5 (95% CI, 5.8-7.3), and the estimated glomerular filtration rate was 41.1 mL/min per 1.73m2 (95% CI, 36.6-45.6). In 96 patients with available 3-month follow-up data, mean 24-hour ambulatory systolic blood pressure decreased by 19.6 mm Hg (95% CI, 15.4-23.8; P<0.001), the defined daily dose of antihypertensive medication was reduced by 52% (95% CI, 41%-62%; P<0.001), and estimated glomerular filtration rate increased by 7.8 mL/min per 1.73m2 (95% CI, 4.5-11.1; P<0.001). All changes persisted after 24 month follow-up. Among 17 patients with a history of hospitalization for acute decompensated heart failure, 14 patients had no new episodes after successful revascularization. Conclusions In this prospective cohort study, we observed a reduction in blood pressure and antihypertensive medication, an increase in estimated glomerular filtration rate, and a decrease in new hospital admissions attributable to heart failure/sudden pulmonary edema after renal artery stenting. Registration URL: https://clinicaltrials.gov. Identifier: NCT02770066 | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a atherosclerotic renal artery stenosis | |
| 650 | 4 | |a atherosclerotic renovascular disease | |
| 650 | 4 | |a flash pulmonary edema | |
| 650 | 4 | |a rapid loss of kidney function | |
| 650 | 4 | |a renal revascularization | |
| 650 | 4 | |a resistant hypertension | |
| 650 | 7 | |a Antihypertensive Agents |2 NLM | |
| 700 | 1 | |a Schousboe, Karoline |e verfasserin |4 aut | |
| 700 | 1 | |a Andersen, Ulrik B |e verfasserin |4 aut | |
| 700 | 1 | |a Buus, Niels Henrik |e verfasserin |4 aut | |
| 700 | 1 | |a Rantanen, Jesper Moesgaard |e verfasserin |4 aut | |
| 700 | 1 | |a Bech, Jesper Nørgaard |e verfasserin |4 aut | |
| 700 | 1 | |a Mafi, Hossein Mohit |e verfasserin |4 aut | |
| 700 | 1 | |a Langfeldt, Sten |e verfasserin |4 aut | |
| 700 | 1 | |a Bharadwaz, Arindam |e verfasserin |4 aut | |
| 700 | 1 | |a Hørlyck, Arne |e verfasserin |4 aut | |
| 700 | 1 | |a Jensen, Mogens Kærsgaard |e verfasserin |4 aut | |
| 700 | 1 | |a Jeppesen, Jørgen |e verfasserin |4 aut | |
| 700 | 1 | |a Olsen, Michael Hecht |e verfasserin |4 aut | |
| 700 | 1 | |a Jacobsen, Ib Abildgaard |e verfasserin |4 aut | |
| 700 | 1 | |a Bibby, Bo Martin |e verfasserin |4 aut | |
| 700 | 1 | |a Christensen, Kent Lodberg |e verfasserin |4 aut | |
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