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Does a Reduction in the Glomerular Filtration Rate Increase the Overall Severity of Coronary Artery Stenosis?
Junichi Nishida1, Nobuaki Kokubu, Mina Kawamukai
1Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Japan.
Insights
Reduced kidney function, indicated by estimated glomerular filtration rate (eGFR), is a significant but minor factor in coronary artery stenosis severity, particularly in men. This finding highlights a link between kidney health and heart disease progression.
Area of Science:
- Cardiology
- Nephrology
- Public Health
Background:
- Chronic kidney disease (CKD) is a known risk factor for coronary events.
- The specific impact of reduced kidney function on coronary artery stenosis severity requires further clarification using large-scale data.
Purpose of the Study:
- To investigate the association between reduced estimated glomerular filtration rate (eGFR) and the overall severity of coronary artery stenosis.
- To analyze this relationship in a large cohort undergoing coronary angiography.
Main Methods:
- 1,150 patients with suspected stable angina pectoris underwent coronary angiography.
- Coronary artery stenosis severity was quantified using the Gensini score (GS), with logarithmic values (log-GS) used for statistical analysis.
- Multivariate regression analysis was employed to identify independent explanatory variables for log-GS.
Main Results:
- The log-GS was significantly higher in men than in women.
- In men, age, smoking, eGFR, HDL-cholesterol, and HbA1c were independent predictors of log-GS, with eGFR explaining 1.2% of the variation.
- eGFR was not a significant explanatory variable in women, though the sex difference in the eGFR-log-GS relationship was not statistically significant.
Conclusions:
- Reduced eGFR is a significant, albeit minor, determinant of coronary artery stenosis severity in both men and potentially women.
- This study underscores the importance of considering kidney function in the assessment of coronary artery disease.
Objective:
Chronic kidney disease is a risk factor of coronary events, however, its impact on coronary artery stenosis has not yet been clarified with the use of a large database. We examined the association between a reduced glomerular filtration rate (GFR) and the overall severity of coronary stenosis.
Methods:
We enrolled 1,150 patients [mean age, 68±12 (SD) years; 66.6% men] who consecutively underwent coronary angiography for suspected stable angina pectoris. The overall severity of stenosis in the coronary arteries was assessed by the Gensini score (GS), and its logarithmic values (log-GS) were used for statistical analyses since the GS does not follow a normal distribution.
Results:
The log-GS was significantly larger in men than in women (2.5±1.5 vs. 1.9±1.7), while the estimated GFR (eGFR) and comorbidities were comparable between both sexes. A multivariate regression analysis indicated that age, smoking, eGFR, HDL-cholesterol and HbA1c were independent explanatory variables of the log-GS in men, although the eGFR explained only 1.2% of the log-GS variation. In women, the eGFR was not included in the significant explanatory variables shown by the multivariate analysis. However, the sex difference in the regression for the eGFR-log-GS relationship was not statistically significant.
Conclusion:
A reduced eGFR is a significant, but minor, determinant of the overall severity of coronary artery stenosis in men and potentially women.
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