Authors’ response to “Is the routine screening for significant atherosclerotic renal artery stenosis during coronary angiography/intervention indispensable?”

Authors’ response to “Is the routine screening for significant atherosclerotic renal artery stenosis during coronary angiography/intervention indispensable?” first-author †E-mail:rjshenweifeng@yahoo.com.cn †E-mail:rjshenweifeng@yahoo.com.cn rjshenweifeng@yahoo.com.cn Department of Cardiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China Department of Cardiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China 1 We are grateful for the constructive comments given by Babic et al. ( 2013 2013 ) on our article recently published in the Journal of Zhejiang University-SCIENCE B (Biomedicine & Biotechnology) (Pu et al., 2012 2012 ). The aim of this study was to generate a logistic regression model to predict the presence of significant atherosclerotic renal artery stenosis (ARAS) defined as luminal diameter stenosis ≥70% of uni- or bilateral renal arteries using clinical, biochemical, and angiographic factors. Although others have used less severe stenosis criteria ( < 50% luminal diameter narrowing), we believe that renal intervention may be more likely considered for patients with significant ARAS. Likewise, since the mortality risk depends highly on the severity of ARAS, significant ARAS should not be mis-diagnosed during coronary intervention via transradial access (White and Olin, 2009 2009 ). We agree with Babic et al. ( 2013 2013 ) that our regression model may be applied in a particular circumstance, and some patients without all risk factors as indicated in our regression model could be suspected for the presence of significant ARAS. The classification of significant coronary artery disease as the angiographic percent stenosis ≥70% at the site of coronary artery lesions is to some extent arbitrary. However, within the range of angiographically significant coronary artery disease including lesions of ≥70%, this criterion of stenosis severity has been correlated with physiologic significance, has relevance to commonly applied angiographic standards, and is widely accepted clinical practice (Scanlon et al., 1999 1999 ). In this study, patients with 0-vessel disease were those without significant coronary disease, including normal coronary artery and mild to moderate coronary stenosis. References S Babic , D Nezic , D Radak . Is the routine screening for significant atherosclerotic renal artery stenosis during coronary angiography/intervention indispensable? . J Zhejiang Univ-Sci B (Biomed & Biotechnol) , 2013 . 14 ( 1 ): 83 - 84 . DOI: 10.1631/jzus.B1200240 http://doi.org/10.1631/jzus.B1200240 . Is the routine screening for significant atherosclerotic renal artery stenosis during coronary angiography/intervention indispensable? LJ Pu , Y Shen , RY Zhang , Q Zhang , L Lu , FH Ding , J Hu , ZK Yang , WF Shen . Screening for significant atherosclerotic renal artery stenosis with a regression model in patients undergoing transradial coronary angiography/intervention . J Zhejiang Univ-Sci B (Biomed & Biotechnol) , 2012 . 13 ( 8 ): 631 - 637 . 22843183 DOI: 10.1631/jzus.B1201003 http://doi.org/10.1631/jzus.B1201003 . Screening for significant atherosclerotic renal artery stenosis with a regression model in patients undergoing transradial coronary angiography/intervention PJ Scanlon , DP Faxon , AM Audet , B Carabello , GJ Dehmer , KA Eagle , RD Legako , DF Leon , JA Murray , SE Nissen , 等 . ACC/AHA guidelines for coronary angiography. A report of the American college of cardiology/American heart association task force on practice guidelines (committee on coronary angiography). Developed in collaboration with the society for cardiac angiography and interventions . J Am Coll Cardiol , 1999 . 33 ( 6 ): 1756 - 1824 . 10334456 . ACC/AHA guidelines for coronary angiography. A report of the American college of cardiology/American heart association task force on practice guidelines (committee on coronary angiography). Developed in collaboration with the society for cardiac angiography and interventions CJ White , JW Olin . Diagnosis and management of atherosclerotic renal artery stenosis: improving patient selection and outcomes . Nat Clin Pract Cardiovasc Med , 2009 . 6 ( 3 ): 176 - 190 . 19234498 DOI: 10.1038/ncpcardio1448 http://doi.org/10.1038/ncpcardio1448 . Diagnosis and management of atherosclerotic renal artery stenosis: improving patient selection and outcomes 10.1631/jzus.B12r0240 2022-01-05 Copyright © Zhejiang University and Springer-Verlag Berlin Heidelberg 2013 2013 Journal of Zhejiang University-SCIENCE B (Biomedicine and Biotechnology) 01 14