Bavry

Chrysochou

Cooper

Green

Hall

Hirsch

Kalra

Kane

Kumbhani

MacDowall

Marcantoni

Messina

Missouris

Pickering

Ritchie

Silva

Textor

Wheatley

Wright

Zeller

English

AIM: To determine whether the apparent benefit of revascularization of renal artery stenosis for "flash" pulmonary oedema extends to heart failure patients without a history of prior acute pulmonary oedema.METHODS: A prospective study of patients with renal artery stenosis and heart failure at a single centre between 1(st) January 1995 and 31(st) December 2010. Patients were divided into those with and without previous acute pulmonary oedema / decompensation. Survival analysis compared revascularization versus medical therapy in each group using Cox regression adjusted for age, eGFR, blood pressure, and co-morbidities.RESULTS: There were 152 patients: 59% male, 36% diabetic, age 70 ± 9 years, eGFR 29 ± 17 mL/min/1.73 m(2) . 52 had experienced previous acute pulmonary oedema (34%), whereas 100 had no previous acute pulmonary oedema (66%). The revascularization rate was 31% in both groups. For heart failure without previous acute pulmonary oedema, the hazard ratio for death after revascularization compared to medical therapy was 0.76 (0.58-0.99, p = 0.04). In heart failure with previous acute pulmonary enema, the hazard ratio was 0.73 (0.44-1.21, p = 0.22). For those without previous acute pulmonary oedema, the hazard ratio for heart failure hospitalization after revascularization compared to medical therapy was 1.00 (0.17-6.05, p = 1.00). In those with previous acute pulmonary oedema, it was 0.51 (0.08-3.30, p = 0.48).CONCLUSIONS: The benefit of revascularization in heart failure may extend beyond the current indication of acute pulmonary oedema. However, findings derive from an observational study.</p

Green, Darren

Ritchie, James P

Chrysochou, Constantina

Kalra, Philip A

The University of Manchester - Institutional Repository

Revascularization of Atherosclerotic Renal Artery Stenosis for Chronic Heart Failure Versus Acute Pulmonary Oedema

Darren Green

James P Ritchie

Constantina Chrysochou

Philip A Kalra

Crossref

Nephrology

Revascularization of atherosclerotic renal artery stenosis for chronic heart failure <i>versus</i>
 acute pulmonary oedema

https://pure.manchester.ac.uk/ws/files/53179188/10.1111nep.13038epdf.pdf

Revascularization of Atherosclerotic Renal Artery Stenosis for Chronic Heart Failure Versus Acute Pulmonary Oedema

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The University of Manchester - Institutional Repository

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