Relative risk factors of patients with coronary heart disease combined with renal artery stenosis / 解放军医学杂志

ABSTRACT

Objective To investigate the risk factors of atherosclerotic renal artery stenosis (ARAS) in patients with coronary heart disease.Method Six hundred and seventy-seven patients with suspected or certainly diagnosed as coronary heart disease consecutively underwent selective coronary angiography and non-selective renal artery angiography during May to Sep.2016 in the Department of Cardiology of General Hospital of Shenyang Military Region.According to the degree of renal artery stenosis,the subjects were divided into renal artery normal group,renal artery slight stenosis group (renal artery stenosis ＜50％) and renal artery obvious stenosis group (renal artery stenosis ＞50％).Both univariate and multivariate logistic regression analysis were used to study the independent risk predictors of ARAS.Results By analysis of clinical data,it was found that age,systolic blood pressure,pulse pressure and creatinine level were higher in patients with different degrees of renal artery stenosis than in renal artery normal group (P＜0.05).There were significant differences in different degrees of renal artery stenosis groups in female,hypertension,left main coronary artery (P＜0.05).The proportion of coronary double vessel lesions was higher in renal artery slight stenosis group than in renal artery normal group (P＜0.05).Age,pulse pressure and creatinine level were significantly higher in renal artery obvious stenosis group than in the other two groups (P＜0.05).Peripheral vascular disease,left main coronary artery disease,single coronary artery and three vessel disease were significantly higher than that in other two groups (P＜0.05).The incidence of renal artery obvious stenosis was 18.9％ in patients with renal artery obvious stenosis,and was 16.7％ in renal arteries slight stenosis group.By univariate and multivariate Logistic regression analysis,age,female,peripheral vascular disease,and multivessel coronary artery disease were independent risk factors for ARAS.Conclusion Renal artery angiography should be routinely performed for patients with coronary artery disease undergoing coronary angiography to identify ARAS,especially for elderly and female patients associated with peripheral vascular disease.