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ASTRAL

ASTRAL. Baseline creatinine, 2.02 mg/dl; glomerular filtration rate, 40 ml/min; mean stenosis, 76%; antihypertensive medications, 2.8 per patient 93% of revascularized patients received a stent

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ASTRAL

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  1. ASTRAL Baseline creatinine, 2.02 mg/dl; glomerular filtration rate, 40 ml/min; mean stenosis, 76%; antihypertensive medications, 2.8 per patient 93% of revascularized patients received a stent At follow-up, no difference in creatinine, blood pressure, time to first renal event, or mortality (p = NS for all outcomes) Trial design:Patients with significant renal artery stenosis were randomized to angioplasty and/or stenting plus medical therapy (n = 403) or medical therapy alone (n = 403) and followed for 27 months. Results (p = 0.46) (p = 0.96) 36.0 35.0 26.3 25.6 % All-cause mortality CV event Conclusions • Renal artery revascularization is not superior to medical therapy alone • Renal artery stenting does not reduce creatinine, blood pressure, time to first renal event, adverse cardiac events, or mortality Renal stenting (n = 403) Medical therapy (n = 403) The ASTRAL Investigators. NEJM 2009;361:1953-62

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