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Catheter Cardiovasc Interv. 2014 Mar 1;83(4):603-9. doi: 10.1002/ccd.25263. Epub 2013 Nov 9.

Blood pressure response to renal artery stenting in 901 patients from five prospective multicenter FDA-approved trials.

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1
The Institute for Heart, Vascular and Stroke Care, Massachusetts General Hospital, Boston, Massachusetts.

Abstract

BACKGROUND:

Renal artery stent revascularization is commonly used for renovascular hypertension. Clinical predictors associated with blood pressure (BP) improvement after renal artery stent revascularization are not well understood.

METHODS:

Patient-level data from 901 patients in five prospective multicenter Food and Drug Administration-approved investigational device exemption studies of renal artery stent revascularization was pooled. BP response was defined as reduction of systolic BP (SBP) by >10 mm Hg. Stent patency was defined within each study. Associations of BP reduction were determined by logistic regression.

RESULTS:

Of 901 patients, complete outcome information was available in 527. Of these, 212/527 (40%) were male, mean age was 63 ± 13 years, 196/544 (36%) were diabetic and 504/527 (96%) had a SBP ≥ 140 mm Hg or DBP ≥ 90 mm Hg at baseline. Compared to baseline, 9-month systolic (164 ± 21 mm Hg vs. 146 ± 22 mm Hg, P < 0.0001) and diastolic (79 ± 13 mm Hg vs. 76 ± 12 mm Hg, P < 0.0001) BP declined significantly. Nine-month stent patency was 90% (305/339). In a univariate analysis, baseline SBP >150 mm Hg (OR = 4.09, CI = 2.74-6.12, P < 0.0001) was positively associated with BP response following renal artery stent revascularization. In a multivariable analysis, baseline SBP remained associated with a positive BP response (OR = 1.76, CI = 1.53-2.03, P < 0.0001).

CONCLUSIONS:

In the largest pooled dataset of patients treated with renal artery stent revascularization, SBP and DBP were significantly lower at 9-months. Elevated baseline SBP (>150 mm Hg) was strongly associated with BP reduction after the procedure.

KEYWORDS:

ANPE- angiography, peripheral/renal; HTN-hypertension; RADI-renal artery disease; RADI-renal artery disease intervention

Comment in

PMID:
24307609
DOI:
10.1002/ccd.25263
[Indexed for MEDLINE]

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