Stenting of atherosclerotic renal artery disease fails to improve outcomes

Atherosclerotic renal-artery stenosis is common among patients with cardiovascular disease and the condition may contribute to hypertension. The impact of renal artery angioplasty or stenting on the risk of clinical events among patients with atherosclerotic renal disease remains poorly defined. In the Cardiovascular Outcomes in Renal Atherosclerotic Lesions (CORAL) study, 947 patients atherosclerotic renal-artery stenosis and hypertension and/or chronic kidney disease were randomized to medical therapy alone or medical therapy plus renal artery stenting. The primary composite end-point included cardiovascular and renal death, myocardial infarction, stroke and progressive renal failure. Over a median follow-up of 43 months, there was no difference in the rate of the composite outcome in patients treated with renal artery stenting compared with medical therapy alone (35.1% vs. 35.8%,; hazard ratio [HR], 0.94; 95% confidence interval [CI], 0.76 to 1.17; P=0.58). Further, individual components of the composite end-point were similar for both treatment groups.