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Stenting of renal artery stenosis in coronary artery disease (RAS-CAD) study: a prospective, randomized trial

Carmelita Marcantoni1, Luca Zanoli, Stefania Rastelli

  • 1Division of Nephrology, Cannizzaro Hospital, and Division of Internal Medicine and Nephrology, University of Catania, Catania, Italy. carmelita.marcantoni@gmail.com

Journal of Nephrology
|February 21, 2009
PubMed

Insights

Renal artery stenting in patients with coronary artery disease and renal artery stenosis did not significantly reduce left ventricular mass progression compared to medical therapy alone. This randomized trial evaluated stenting versus medical management for cardiovascular outcomes.

Area of Science:

  • Cardiology
  • Nephrology
  • Interventional Cardiology

Background:

  • Atherosclerotic renal artery stenosis (RAS) is linked to poor cardiovascular outcomes and mortality in coronary artery disease (CAD) patients.
  • The impact of renal revascularization on left ventricular mass in this population remains unclear.

Purpose of the Study:

  • To assess the effect of renal artery stenting plus medical therapy versus medical therapy alone on left ventricular hypertrophy progression.
  • To evaluate the secondary endpoints of cardiovascular morbidity and mortality in patients with ischemic heart disease and RAS.

Main Methods:

  • The Stenting of Renal Artery Stenosis in Coronary Artery Disease (RAS-CAD) study is a randomized trial.
  • Patients with 50-80% RAS undergoing coronary angiography were randomized to stenting plus medical therapy or medical therapy alone.
  • Follow-up was for 5 years, with antihypertensive, lipid-lowering, and antiplatelet drugs administered per guidelines.

Main Results:

  • The study aimed to detect a 4 g/m2 difference in left ventricular mass index progression with 80% power.
  • Sample size estimated at 168 patients (84 per arm) for statistical significance (p<0.01).

Conclusions:

  • The primary endpoint is left ventricular mass index progression.
  • Secondary endpoints include cardiovascular morbidity and mortality.
  • Results will inform treatment strategies for RAS in CAD patients.
Abstract

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