HIGH-INCIDENCE OF RENAL-ARTERY STENOSIS IN PATIENTS WITH CORONARY-ARTERY DISEASE

The incidence of renal artery stenosis (RAS) in patients with coronary artery disease (CAD) has not been well documented. Over a 9-month per iod, 196 patients who underwent coronary angiography because of clinic ally suspected CAD had routine nonselective renal cine or digital subt raction angiography. There were 68 females and 128 males with a mean a ge of 63 years (range 35-85). Angiographically significant CAD was pre sent in 152 patients (78%). Of the total patient cohort, 29 patients ( 15%) had mild RAS (<50%), and 36 patients (18%) had significant RAS (g reater-than-or-equal-to 50%). In patients with normal coronary arterie s, only three patients (7%) had RAS. Thirty-three patients (92%) with severe RAS also had CAD. Of these 33 patients, 45% had hypertension, 3 0% had hyperlipidemia, 24% had diabetes mellitus, 24% had renal insuff iciency (creatinine greater-than-or-equal-to 1.5), and 51% were smoker s. In addition, it was noted that 20 of these patients (61%) had two o r more of the above-listed clinical parameters. However, univariate an alysis using the chi-square test revealed that only CAD (22% P<0.03) a nd renal insufficiency (29% P<0.15) were reliable clinical predictors of RAS. In conclusion, RAS is a frequent finding in patients with CAD, particularly when renal insufficiency is also present. (C) 1994 Wiley -Liss, Inc.