Associations of antiplatelet therapy and beta blockade with patient outcomes in atherosclerotic renovascular disease

Randomized trials have shown a neutral effect of percutaneous revascularization compared with optimal medical therapy in patients with atherosclerotic renovascular disease (ARVD). However, there are few data to define what constitutes optimal medical therapy. We present a retrospective analysis of 529 ARVD patients. Separate analyses were performed comparing outcomes in patients prescribed/not prescribed beta blocker and antiplatelet agents. Analyses were adjusted for effects of baseline covariates on probability of treatment and on clinical outcome. Over a median follow-up period of 3.8 years, antiplatelet therapy was associated with a reduced risk for death (relative risk, 0.52 [95% confidence interval {CI}: 0.31-0.89]; P = .02). Beta blocker therapy was associated with a reduced for death (relative risk, 0.45 [95% CI: 0.21-0.97]; P = .04) and nonfatal cardiovascular events (relative risk, 0.74 [95% CI: 0.60-0.90]; P = .003). Although limited by small patient numbers, this study suggests that in ARVD, treatment with antiplatelet therapy and beta blockade may associate with a prognostic benefit.