{
    "abstract": "Although renal artery stenosis (RAS) and heart failure (HF) have been linked, the incidence and predictors of HF among patients with RAS are not well described.\nPost hoc analysis of the Cardiovascular Outcomes in Renal Atherosclerotic Lesions (CORAL) multicenter, open-label, randomized controlled trial (RCT).\nPatients with atherosclerotic RAS and elevated blood pressure, chronic kidney disease, or both, and without a history of HF at enrollment.\nMedical therapy alone versus medical therapy plus renal artery stenting.\nIncident HF events.\nThis analysis included 808 participants enrolled in the CORAL trial without evidence of baseline HF. During a median follow-up of 4.8 years, 54 participants (6.7%) developed incident HF. HF incidence rates did not differ by randomized intervention (HR, 0.84; 95% confidence interval [CI], 0.49-1.43 for stent arm with medical arm as reference). Baseline diabetes (subdistribution hazard ratio (sHR), 2.07; 95% CI, 1.20-3.58), albuminuria (sHR, 1.12 per doubling of urinary albumin-creatinine ratio, 95% CI, 1.02-1.24), lower eGFR (sHR, 0.78 per 10\u00a0mL/min/1.73\u00a0m\nThis is a post hoc analysis of a RCT. The number of HF events is small.\nIn patients with RAS, rates of incident HF did not differ between participants randomized to optimal medical therapy alone versus optimal medical therapy plus renal artery stenting. The presence of diabetes, PVD, and worse kidney health at baseline were associated with future HF events.\nRenal artery stenosis has been linked with heart failure. The CORAL randomized controlled trial has the largest study population of participants with renal artery stenosis. In this analysis, we assessed the incidence and predictors of heart failure in CORAL. We found similar rates of incident heart failure among participants randomized to medical therapy alone vs. medical therapy plus renal artery stent. We identified independent predictors of incident heart failure among people with renal artery stenosis include PAD, diabetes, albuminuria, and lower baseline eGFR. In addition, eGFR declined prior to heart failure events.",
    "authors": [
        {
            "affiliation": "Division of Cardiovascular Medicine, University of Toledo College of Medicine and Life Sciences, Toledo, OH.\nDepartment of Medicine, University of Toledo College of Medicine and Life Sciences, Toledo, OH.",
            "firstname": "Rajesh",
            "initials": "R",
            "lastname": "Gupta"
        },
        {
            "affiliation": "Kidney Health Research Collaborative, San Francisco Veterans Affairs Healthcare System and University of California, San Francisco, CA.",
            "firstname": "Michelle M",
            "initials": "MM",
            "lastname": "Estrella"
        },
        {
            "affiliation": "Kidney Health Research Collaborative, San Francisco Veterans Affairs Healthcare System and University of California, San Francisco, CA.",
            "firstname": "Rebecca",
            "initials": "R",
            "lastname": "Scherzer"
        },
        {
            "affiliation": "Department of Medicine, University of Toledo College of Medicine and Life Sciences, Toledo, OH.",
            "firstname": "Pamela S",
            "initials": "PS",
            "lastname": "Brewster"
        },
        {
            "affiliation": "Department of Medicine, University of Toledo College of Medicine and Life Sciences, Toledo, OH.",
            "firstname": "Lance D",
            "initials": "LD",
            "lastname": "Dworkin"
        },
        {
            "affiliation": "Department of Medicine, University of Toledo College of Medicine and Life Sciences, Toledo, OH.",
            "firstname": "Hanh T",
            "initials": "HT",
            "lastname": "Nguyen"
        },
        {
            "affiliation": "Department of Medicine, University of Toledo College of Medicine and Life Sciences, Toledo, OH.",
            "firstname": "Yanmei",
            "initials": "Y",
            "lastname": "Xie"
        },
        {
            "affiliation": "Nephrology Section, Veterans Affairs San Diego Healthcare System and Division of Nephrology-Hypertension, University of California, San Diego, CA.",
            "firstname": "Joachim H",
            "initials": "JH",
            "lastname": "Ix"
        },
        {
            "affiliation": "Kidney Health Research Collaborative, San Francisco Veterans Affairs Healthcare System and University of California, San Francisco, CA.",
            "firstname": "Michael G",
            "initials": "MG",
            "lastname": "Shlipak"
        },
        {
            "affiliation": "Summa Therapeutics, LLC, Cambridge, MA.",
            "firstname": "Timothy P",
            "initials": "TP",
            "lastname": "Murphy"
        },
        {
            "affiliation": "Beth Israel Deaconess Medical Center and Baim Institute for Clinical Research, Boston, MA.",
            "firstname": "Donald E",
            "initials": "DE",
            "lastname": "Cutlip"
        },
        {
            "affiliation": "Cardiovascular Division, Stanford University, Stanford, CA.",
            "firstname": "Eldrin F",
            "initials": "EF",
            "lastname": "Lewis"
        },
        {
            "affiliation": "Division of Cardiovascular Medicine, University of Toledo College of Medicine and Life Sciences, Toledo, OH.",
            "firstname": "Christopher J",
            "initials": "CJ",
            "lastname": "Cooper"
        }
    ],
    "conclusions": null,
    "copyrights": "\u00a9 2024 The Authors.\n\u00a9 2024 The Authors.",
    "doi": "10.1016/j.xkme.2024.100948",
    "journal": "Kidney medicine",
    "keywords": [
        "Albuminuria",
        "cardiorenal syndrome",
        "heart failure",
        "renal artery stenosis"
    ],
    "methods": null,
    "publication_date": "2025-02-03",
    "pubmed_id": "39895851\n15120819\n23122491\n35078371\n2900930\n10749962\n19907042\n24245566\n22989293\n9800739\n22508558\n26481745\n17631082\n36261106\n34554658\n0\n9147598\n26551272\n27225988\n27647847\n37558088\n35855557\n33502090\n16549646\n23457117",
    "results": "This analysis included 808 participants enrolled in the CORAL trial without evidence of baseline HF. During a median follow-up of 4.8 years, 54 participants (6.7%) developed incident HF. HF incidence rates did not differ by randomized intervention (HR, 0.84; 95% confidence interval [CI], 0.49-1.43 for stent arm with medical arm as reference). Baseline diabetes (subdistribution hazard ratio (sHR), 2.07; 95% CI, 1.20-3.58), albuminuria (sHR, 1.12 per doubling of urinary albumin-creatinine ratio, 95% CI, 1.02-1.24), lower eGFR (sHR, 0.78 per 10\u00a0mL/min/1.73\u00a0m",
    "title": "Incident Heart Failure in Atherosclerotic Renal Artery Stenosis: A Post Hoc Analysis of the CORAL Trial.",
    "xml": "<Element 'PubmedArticle' at 0x788505d8aac0>"
}