Glomerular hyperfiltration: An independent risk factor and predictor of advanced coronary artery disease (original) (raw)
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Angiology, 2013
We aimed to elucidate the relationship between mild to moderate renal impairements and burden of atherosclerosis in patients with acute coronary syndrome (ACS). A total of 380 patients with ACS were included in the study. Gensini and SYNTAX scores were also calculated. Kidney function was classified based on estimated glomerular filtration rate (eGFR) into stage 1: eGFR >90, stage 2: 60 to 89, and stage 3: 30 to 60 mL/min per 1.73 m2. Gensini and SYNTAX scores were higher in stages 2 and 3 than in stage 1. Also, the number of diseased vessels, number of critical lesions (>50 and 70%), left main disease, and number of total occlusion vessels were higher in stages 2 and 3 than in stage 1. Multivariate linear regression analysis demonstrated that a decreased eGFR was an independent risk factor for SYNTAX and Gensini scores together with age and male gender.
International Urology and Nephrology, 2012
Purpose Chronic kidney disease is independently associated with an increased risk of cardiovascular events; however, the relationship between the glomerular filtration rate (GFR) and coronary artery disease (CAD) in patients undergoing coronary angiography has yet to be fully elucidated. Methods This retrospective study enrolled a total of 7968 patients who underwent diagnostic coronary artery catheterization [mean age = 54.8 ± 10.6 years, 74.4% males] and did not have any previous history of coronary revascularization, diabetes mellitus, hypertension, end-stage renal disease treated by dialysis or renal transplantation, and were not taking diuretics or drugs acting on renin angiotensin system. The severity of CAD was defined as the number of coronary arteries with a luminal stenosis C50% on the angiogram, and the GFR was calculated using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI). Results There were 2133 (26.8%) patients with GFR C 90 ml/min/1.73 m 2 , 4574 (57.4%) patients with 60 B GFR \ 90 ml/min/1.73 m 2 , 1073 (13.5%) with 45 B GFR \ 60 ml/min/1.73 m 2 and 181 (2.3%) with 15 \ GFR \ 45 ml/min/1.73 m 2 . After adjustment for traditional cardiovascular risk factors (age, sex, dyslipidemia, low to high-density lipoprotein ratio, smoking status, and family history), the GFR showed a significant association with the severity of CAD and remained a significant predictor of CAD (Odds Ratio raised from 1.1 in patients with 60 B GFR \ 90 ml/min/1.73 m 2 to 1.8 in patients with 15 \ GFR \ 45 ml/min/1.73 m 2 ). Conclusions A reduced kidney function, even mildly, is significantly associated with CAD severity, independently of other traditional CAD risk factors.
Estimated Glomerular Filtration Rate and Mortality among Patients with Coronary Heart Disease
PloS one, 2016
The association between estimated glomerular filtration rate (eGFR) and the risk of mortality among patients with coronary heart disease (CHD) is complex and still unclear. The aim of this study was to evaluate the effect of eGFR on the risk prediction of all-cause and cardiovascular disease (CVD) mortality with a long follow-up period among patients with CHD in China. We conducted a prospective cohort study of 3276 Chinese patients with CHD. Cox proportional hazards regression models were used to estimate the association of different levels of eGFR with the risks of mortality. During a mean follow-up period of 4.9 years, 293 deaths were identified. The multivariable-adjusted hazard ratios associated with different levels of eGFR (≥90 [reference group], 60-89, 30-59, 15-29 ml/min per 1.73m2) at baseline were 1.00, 1.28 (95% confidence interval [CI], 0.87-1.88), 1.96 (95% CI, 1.31-2.94), and 3.91 (95% CI, 2.15-7.13) (P <0.001) for all-cause mortality, and 1.00, 1.26 (95% CI, 0.78-...
ijdo, 2020
Objective: Chronic kidney disease (CKD) and diabetes mellitus can influence coronary artery disease (CAD) independently. The aim of this study was to evaluate the association of glomerular filtration rate (GFR) and CAD in type 2 diabetic patients (T2DM). Materials and Methods: This cross sectional study evaluated 3624 T2DM patients with clinical presentation of CAD whose documents were registered in angiography center of Shahid Mohammadi Hospital in Bandar Abbas, Iran during 18 months. GFR was measured by MDRD method and divided into 5 subgroups: GFR< 15, 15≤ GFR< 30, 30≤ GFR< 60, 60≤ GFR< 90 and GFR≥ 90. Then the association of 5 subgroups of GFR with coronary angioplasty in T2DM patients was evaluated. T-test was used to compare the mean of quantitative variables, and chi-squared test for qualitative variables. Using SPSS- 22 the collected data were analyzed and P-value< 0.05 was significant. Results: Among 3624 T2DM patients, 36% had GFR< 60 (ml/min/1.73m2).The ...
Background: Chronic kidney disease is independently associated with cardiovascular disease (CVD) events in high-risk populations according to several studies. However, findings from community-based population studies are insufficient. We studied the relationship between estimated glomerular filtration rate (eGFR) and risk of coronary artery disease (CAD) events in patients attending Zagazig University Hospital, Sharqiya governorate, Egypt. Methods: A total of 800 subjects aged P60 years admitted to Internal Medicine Department or attended medicine outpatient clinic were included in this study. Careful history and full clinical examinations were done to assess the risk factors of CAD. Serum creatinine, lipid profile and serum glucose were measured. Estimated eGFR was evaluated by creatinine based MDRD formula. According to eGFR, patients were divided into 2 groups: group 1 with eGFR P 60 mL/min/1.73 m 2 and Group 2 with eGFR < 60 mL/min/1.73 m (between 40 and 60 mL/min/1.73 m). Results: 410 patients were found to have eGFR P 60 mL/min/1.73 m 2 , while 390 patients were found to have eGFR < 60 mL/min/1.73 m 2. eGFR was lower in patients with CAD (62 ± 13 mL/min/1.73 m 2) in comparison with patients without CAD (76 ± 11 mL/min/1.73 m 2) (P 6 0.001). Older age, hypertension, Diabetes and Low HDL are highly significant risk factors for CAD in those patients (P 0.001). Conclusions: Reduced eGFR is a significant risk factor for CAD events in older patients. Monitoring of eGFR may have a pivotal role in early detection and management of CAD in those types of patients.