Vascular function and mild renal impairment in stable coronary artery disease.
OBJECTIVE
In patients with coronary artery disease, the concomitant presence of renal function impairment is associated with decreased survival. We aimed to assess whether in coronary artery diseased patients renal function impairment is associated with systemic vascular function, functional parameters of the renin-angiotensin system, or inflammation as potential mediators for cardiovascular risk.


RESULTS
We studied 125 patients, 87% male, with a mean age of 62.2+/-8.2 years; 72% had 3-vessel disease, and mean renal function was 74+/-13 mL/min per 1.73 m2. Internal thoracic artery rings were sampled during coronary bypass surgery and used for in vitro vascular measurements. We could not establish an association between endothelium-dependent vasorelaxation (response to methacholine) and renal function. In addition, vascular response to potassium chloride, phenylephrine, and angiotensin II were not associated with renal function. Finally, serum angiotensin-converting enzyme (ACE) activity, usage of ACE inhibitors, C-reactive protein, and soluble intercellular adhesion molecule 1 were not related to renal function.


CONCLUSIONS
In coronary artery disease patients, mild renal function impairment is not associated with systemic vasomotor responsiveness, inflammation, or functional systemic parameters of the renin-angiotensin system. The relation between systemic endothelial dysfunction and mild renal insufficiency might be more complicated than previously thought.
van der Harst
Pim
P
Department of Cardiology, Medical Center Groningen, University of Groningen, The Netherlands. p.van.der.harst@thorax.umcg.nl
Smilde
Tom D J
TD
Buikema
Hendrik
H
Voors
Adriaan A
AA
Navis
Gerjan
G
van Veldhuisen
Dirk J
DJ
van Gilst
Wiek H
WH
D000368:Aged; D015415:Biomarkers; D003324:Coronary Artery Disease / Q000453:epidemiology* / Q000503:physiopathology*; D003404:Creatinine / Q000097:blood; D004730:Endothelium, Vascular / Q000503:physiopathology*; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D066298:In Vitro Techniques; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D051437:Renal Insufficiency / Q000453:epidemiology* / Q000503:physiopathology*; D012084:Renin-Angiotensin System / Q000502:physiology; D012307:Risk Factors; D012720:Severity of Illness Index; D017678:Sex Distribution; D013895:Thoracic Arteries / Q000502:physiology; D014662:Vasoconstrictor Agents / Q000494:pharmacology; D014664:Vasodilation / Q000187:drug effects / Q000502:physiology
D015415:Biomarkers; D014662:Vasoconstrictor Agents; D003404:Creatinine