Long-Term Outcomes and Causes of Death in Patients With Renovascular Disease Undergoing Renal Artery Stenting

Angiology. 2016 Aug;67(7):657-63. doi: 10.1177/0003319715609013. Epub 2015 Sep 30.

Abstract

Renovascular disease (RVD) can lead to hypertension and chronic kidney disease (CKD). Patients with advanced peripheral arterial disease (PAD) have a 5-year mortality of ∼30%. Rate and causes of death in patients with significant RVD, who share similar risk factors with patients having PAD, are not well defined. We assessed consecutive patients with RVD who underwent renal artery stenting at our institution over 6 years. Specific causes of death were ascertained, and the probability of survival was estimated. Cox models were fit to identify predictors of outcomes. We identified 281 patients with RVD who underwent renal stenting. Follow-up was available for all patients (median 5.1 years). All-cause mortality was 24.2% at 5 years and 33.7% at 7 years (compounded annualized death rate: 5.5%). Of the 68 deaths, 36 (52.9%) were cardiovascular (13.2% acute myocardial infarction, 13.2% stroke, 11.8% sudden death, and 10.3% congestive heart failure) and 32 (47.1%) deaths had noncardiovascular causes. In patients with RVD undergoing stenting, cardiovascular events are the most common causes of death. Compared to patients with advanced PAD, RVD may have a lower 5-year mortality.

Keywords: cardiovascular mortality; myocardial infarction; peripheral arterial disease; renovascular disease; stroke.

MeSH terms

  • Aged
  • Cause of Death
  • Death, Sudden, Cardiac / epidemiology
  • Endovascular Procedures / adverse effects
  • Endovascular Procedures / instrumentation*
  • Endovascular Procedures / mortality
  • Female
  • Heart Failure / mortality
  • Humans
  • Kaplan-Meier Estimate
  • Kentucky / epidemiology
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Myocardial Infarction / mortality
  • Proportional Hazards Models
  • Renal Artery Obstruction / diagnostic imaging
  • Renal Artery Obstruction / mortality
  • Renal Artery Obstruction / physiopathology
  • Renal Artery Obstruction / therapy*
  • Risk Factors
  • Stents*
  • Stroke / mortality
  • Time Factors
  • Treatment Outcome