Prevalence and Predictors of Renal Artery Stenosis in Patients with Type 2 Diabetes and Coronary Artery Disease Undergoing Coronary Angiography
Journal Title: INTERNATIONAL JOURNAL OF SCIENTIFIC STUDY - Year 2017, Vol 5, Issue 1
Abstract
Background: Atherosclerotic renal artery stenosis (RAS) is a major comorbid and independent risk factor for cardiovascular diseases. The presence of diabetes mellitus (DM) an independent predictive factor for RAS has been controversial. Many studies evaluated the risk of RAS in patients with DM as a subgroup analysis rather than a study population. We evaluated the prevalence of RAS specifically in patients with Type 2 DM and coronary artery disease (CAD). Methods: The diabetic patients with CAD undergoing coronary angiography (CAG) and renal angiography were planned after completion of the CAG. The renal arteries were selectively cannulated with judkins right catheter, and renal angiogram was completed. In difficult cases, nonselective renal angiogram was done using pigtail catheter. Significant RAS was defined as decrease of at least 50% in luminal diameter. Results: A total of 50 patients with angiographically proven CAD were studied. There were 30 men (60%) and 20 women (40%) with a mean age of 54.4 years (range 36-75). Patients had segment elevation myocardial infarction (STEMI) (n = 15), unstable angina/non-STEMI (n = 15), CSA (n = 20) 0.12 (24%) patients were smokers, 24 (48%) patients had hypertension, 20 (40%) patients had hyperlipidemia and 7 (14%) patients were receiving insulin treatment. Among 50 patients, 8 (16%) had a significant RAS, of which one had bilateral involvement. The prevalence of RAS was 2%, 4%, and 10% for single vessel disease, 2 vessel disease, left main coronary artery, and triple vessel disease, respectively. RAS was more prevalent in age >60, females, patients with coexistent hypertension (HT). Conclusion: We, therefore, find that screening of RAS should be a part in diabetic patients with multivessel disease and coexistent HT. It is necessary to detect atherosclerotic RAS to save renal function, prevent complication by timely intervention limitation.
Authors and Affiliations
R Sankar
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