The 'chicken little' of renal stent trials: The CORAL trial in perspective

摘要

No, "the sky is not falling" after the release of the results of CORAL (Cardiovascular Outcomes in Renal Atherosclerotic Lesions) (1). There is absolutely no justification for the "Chicken Little" hysteria portending the demise of renal artery stenting (2). The CORAL study did not support a preference for renal stenting as the initial treatment for presumed atherosclerotic renovascular hypertension, but neither do the current American College of Cardiology and American Heart Association guidelines (3). These guidelines recommend renal artery stenting as a reasonable option for patients with one of the following: an atherosclerotic severe renal artery stenosis (>70% angiographic diameter renal artery stenosis or 50% to 70% stenosis with hemodynamic confirmation of lesion severity) associated with 1) resistant or uncontrolled hypertension and the failure of 3 antihypertensive drugs, 1 of which is a diuretic agent, and 2) hypertension and intolerance to medication.