Abstract 13734: Impact of Percutaneous Transluminal Renal Angioplasty on Clinical Outcomes in Patients with Renal Artery Stenosis: an Update Meta-analysis and Meta-regression
Aims: Percutaneous transluminal renal angioplasty (PTRA) in patients with renal artery stenosis (RAS) has been investigated in multiple clinical trials but the benefit on clinical outcomes remains unclear. We assessed the clinical impact of efficacy of PTRA for RAS by an update meta-analysis and meta-regression analysis.
Methods and Results: MEDLINE, EMBASE, and Cochran Library database were queried all relevant randomized controlled trials comparing PTRA with medical therapy alone in patients with RAS. A total of 2221 patients were enrolled in this meta-analysis. There were no significant efficacies of PTRA on all-cause death, cardiac death, renal death, progressive renal insufficiency, heart failure, myocardial infarction, stroke, changes in systolic blood pressure from baseline, and a serum creatinine level at end of follow-up (Figure). The mean number of anti-hypertensive medications at the end of follow-up was significantly lower in the PTRA arm than in the medical therapy arm (risk ratio -0.26 [-0.36 to -0.15]) (Figure). In addition, this sole beneficial efficacy of PTRA was associated with higher systolic or diastolic blood pressure at baseline (Coefficient 0.041, P < 0.01; Coefficient 0.043, P = 0.03) (Figure).
Conclusion: The present meta-analysis confirms that PTRA for RAS did not improve almost clinical outcomes but significantly reduces the number of anti-hypertensive medications at the end of follow-up. This efficacy emphasizes PTRA in RAS patients with higher systolic blood pressure at baseline.
Author Disclosures: S. Nakamura: None. H. Takano: None. Y. Kuobota: None. K. Asai: None. W. Shimizu: None.
- © 2014 by American Heart Association, Inc.