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 protoc...
| Main Authors: | , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2022-04-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.121.024421 |
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| author | Mark Reinhard Karoline Schousboe Ulrik B. Andersen Niels Henrik Buus Jesper Moesgaard Rantanen Jesper Nørgaard Bech Hossein Mohit Mafi Sten Langfeldt Arindam Bharadwaz Arne Hørlyck Mogens Kærsgaard Jensen Jørgen Jeppesen Michael Hecht Olsen Ib Abildgaard Jacobsen Bo Martin Bibby Kent Lodberg Christensen |
| author_facet | Mark Reinhard Karoline Schousboe Ulrik B. Andersen Niels Henrik Buus Jesper Moesgaard Rantanen Jesper Nørgaard Bech Hossein Mohit Mafi Sten Langfeldt Arindam Bharadwaz Arne Hørlyck Mogens Kærsgaard Jensen Jørgen Jeppesen Michael Hecht Olsen Ib Abildgaard Jacobsen Bo Martin Bibby Kent Lodberg Christensen |
| author_sort | Mark Reinhard |
| collection | DOAJ |
| description | 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 months 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. |
| first_indexed | 2024-04-09T18:46:53Z |
| format | Article |
| id | doaj.art-103325a684914322bb27105fb47256c1 |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-04-09T18:46:53Z |
| publishDate | 2022-04-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-103325a684914322bb27105fb47256c12023-04-10T11:57:33ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802022-04-0111710.1161/JAHA.121.024421Renal Artery Stenting in Consecutive High‐Risk Patients With Atherosclerotic Renovascular Disease: A Prospective 2‐Center Cohort StudyMark Reinhard0Karoline Schousboe1Ulrik B. Andersen2Niels Henrik Buus3Jesper Moesgaard Rantanen4Jesper Nørgaard Bech5Hossein Mohit Mafi6Sten Langfeldt7Arindam Bharadwaz8Arne Hørlyck9Mogens Kærsgaard Jensen10Jørgen Jeppesen11Michael Hecht Olsen12Ib Abildgaard Jacobsen13Bo Martin Bibby14Kent Lodberg Christensen15Department of Renal Medicine and The Clinic of Hypertension Aarhus University Hospital DenmarkDepartment of Endocrinology/Steno Diabetes Center Odense and The Clinic of Hypertension Odense University Hospital DenmarkDepartment of Clinical Physiology and Nuclear Medicine Rigshospitalet, GlostrupUniversity of Copenhagen Glostrup DenmarkDepartment of Renal Medicine and The Clinic of Hypertension Aarhus University Hospital DenmarkDepartment of Nephrology Aalborg University Hospital DenmarkDepartment of Medicine University Clinic in Nephrology and HypertensionGodstrup Regional Hospital DenmarkDepartment of Radiology Aarhus University Hospital Aarhus N DenmarkDepartment of Radiology Aarhus University Hospital Aarhus N DenmarkDepartment of Radiology Aarhus University Hospital Aarhus N DenmarkDepartment of Radiology Aarhus University Hospital Aarhus N DenmarkDepartment of Vascular Surgery Aarhus University Hospital Aarhus N DenmarkDepartment of Medicine Amager Hvidovre Hospital GlostrupUniversity of Copenhagen Glostrup DenmarkDepartment of Internal Medicine Holbaek Hospital DenmarkDepartment of Endocrinology/Steno Diabetes Center Odense and The Clinic of Hypertension Odense University Hospital DenmarkDepartment of Biostatistics Aarhus University DenmarkDepartment of Clinical Medicine Aarhus University DenmarkBackground 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 months 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.https://www.ahajournals.org/doi/10.1161/JAHA.121.024421atherosclerotic renal artery stenosisatherosclerotic renovascular diseaseflash pulmonary edemarapid loss of kidney functionrenal revascularizationresistant hypertension |
| spellingShingle | Mark Reinhard Karoline Schousboe Ulrik B. Andersen Niels Henrik Buus Jesper Moesgaard Rantanen Jesper Nørgaard Bech Hossein Mohit Mafi Sten Langfeldt Arindam Bharadwaz Arne Hørlyck Mogens Kærsgaard Jensen Jørgen Jeppesen Michael Hecht Olsen Ib Abildgaard Jacobsen Bo Martin Bibby Kent Lodberg Christensen Renal Artery Stenting in Consecutive High‐Risk Patients With Atherosclerotic Renovascular Disease: A Prospective 2‐Center Cohort Study Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease atherosclerotic renal artery stenosis atherosclerotic renovascular disease flash pulmonary edema rapid loss of kidney function renal revascularization resistant hypertension |
| title | Renal Artery Stenting in Consecutive High‐Risk Patients With Atherosclerotic Renovascular Disease: A Prospective 2‐Center Cohort Study |
| title_full | Renal Artery Stenting in Consecutive High‐Risk Patients With Atherosclerotic Renovascular Disease: A Prospective 2‐Center Cohort Study |
| title_fullStr | Renal Artery Stenting in Consecutive High‐Risk Patients With Atherosclerotic Renovascular Disease: A Prospective 2‐Center Cohort Study |
| title_full_unstemmed | Renal Artery Stenting in Consecutive High‐Risk Patients With Atherosclerotic Renovascular Disease: A Prospective 2‐Center Cohort Study |
| title_short | Renal Artery Stenting in Consecutive High‐Risk Patients With Atherosclerotic Renovascular Disease: A Prospective 2‐Center Cohort Study |
| title_sort | renal artery stenting in consecutive high risk patients with atherosclerotic renovascular disease a prospective 2 center cohort study |
| topic | atherosclerotic renal artery stenosis atherosclerotic renovascular disease flash pulmonary edema rapid loss of kidney function renal revascularization resistant hypertension |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.121.024421 |
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