European Journal of Biomedical and Pharmaceutical Sciences

PREVALENCE AND RISK PROFILE OF ATHEROSCLEROTIC RENAL ARTERY STENOSIS IN RELATION TO ATHEROSCLEROTIC CORONARY ARTERY DISEASE.

*Dr. Santanu De, Dr. K.S. Poddar, Dr. Angshumitra Bandyopadhyay, Dr. Sahid Imam Mallick, Dr. Ashraful Haque, Dr. Arindam Basu, Dr. Aurion Kar and Dr. (Prof) Kajal Ganguly

ABSTRACT

Background: Associations between patient demographic characteristics, coronary disease burden, extracoronary atherosclerosis, putative manifestations of RAS and the prevalence of RAS have not been prospectively and rigorously examined, particularly in Indian context, most importantly in this part of the subcontinent. Objectives: To determine the prevalence of atherosclerotic renal artery stenosis (ARAS) in patients with obstructive coronary artery disease during cardiac catheterization and to study the association of common atherosclerosis risk factors and other variables (if any), with ARAS. Methods: The observational study was done in the department of Cardiology, NRS Medical College, Kolkata, India over the period of one year. A total of 304 subjects were screened for renal artery stenosis by renal angiography among all patients whom we suspected atherosclerotic renal artery stenosis (ARAS) and who were undergoing non-emergent diagnostic cardiac catheterization for cardiac indication, at our hospital. The clinical characteristics of patients were compared using simple statistical methods. Correlation of atherosclerotic coronary artery disease, renal artery stenosis was evaluated and laboratory findings were analyzed once the complete data was available. Results: Among subjects with significant CAD, renal angiogram showed 4.61% had significant bilateral ARAS, 4.61% had unilateral RAS, 6.91% had insignificant RAS and 83.88% patients’ revealed normal renal artery. It is evident that smoking is the only factor conclusively associated with ARAS. However, HTN has also shown a trend of association in our study and most of ARAS were present in subjects with multiple risk factors (≥2). Conclusion: Pre-test likelihood for the presence of significant ARAS is particularly high in elderly patients, with multi atherosclerotic risk factors, with reduced glomerular filtration rate and with multi vessel coronary artery disease.

Keywords: Atherosclerosis, Renal artery stenosis, Coronary artery disease.