Biomarkers for Predicting Improved Outcomes With Renal Artery Stenting
This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.
See related article, pp 1145–1152
The CORAL study (Cardiovascular Outcomes With Renal Artery Lesions) was an important, prospective, randomized-controlled trial that conclusively demonstrated the lack of clinical benefit of renal artery stent placement compared with optimal medical therapy alone on both renal and cardiovascular outcomes.1 Yet, is this the case in every patient? However, in this cohort of 931 participants, there might be signals as to which patients might benefit from renal artery stenting. Murphy et al2 provide interesting new data in their article suggesting that a urinary albumin excretion ≤the median value of 22 0.5 mg/g was predictive of significantly better event-free survival from the primary composite outcome of renal and cardiovascular events with stenting as compared with those with levels of microalbuminuria above the median.
How can one interpret these results? The authors hypothesize that there is biological plausibility in that elevated levels of microalbuminuria indicate the presence of much more advanced systemic endothelial disease and increased likelihood of adverse cardiovascular outcomes. Thus, although all patients with renal artery disease deserve …