Determinants of coronary artery disease in nondiabetic hemodialysis patients: a matched case-control study.
OBJECTIVE
The aim of this matched case-control study was to evaluate the determinants of coronary artery disease (CAD) other than conventional risk factors in nondiabetic hemodialysis (HD) patients.


METHODS
Among 312 consecutive patients on regular HD, 26 nondiabetic patients with angiographically defined coronary artery disease (20 men, 6 women; mean age 57.0 +/- 13 years) constituted the case group (group 1). A subject group of the same gender, smoking status, and hypertension with similar ages and body mass indexes who had normal electrocardiography and myocardial perfusion scintigraphy served as controls (20 men, 6 women; mean age 54.1+/-12 years, group 2). Demographics, high sensitivity C-reactive protein (hs-CRP), erythrocytes dimentation rate (ESR), hematocrit-corrected ESR, beta-2 microglobulin, cardiac troponin I, parathyroid hormone, albumin, calcium (Ca), phosphorus (P), Ca x P, and lipid profiles were compared between the groups.


RESULTS
Patients in group 1 had higher hs-CRP and troponin I (18.0+/-12 vs. 7.2+/-5 mg/L, p < 0.001; 0.36+/-0.16 vs. 0.22+/-0.05 ng/mL, p < 0.001, respectively) and lower HDL cholesterol levels than group 2 (37.0+/-10 mg/dL vs. 46.3+/-17 mg/dL, p = 0.02). Backwards stepwise logistic regression analysis revealed that high hs-CRP and troponin I levels (p = 0.03 and p = 0.01) and low HDL cholesterol levels (p = 0.02) were independently related with CAD.


CONCLUSIONS
According to these results, in nondiabetic patients on regular hemodialysis, high hs-CRP, troponin I levels and low HDL-cholesterol were the determinants of CAD.
Zumrutdal
Aysegul
A
Department of Nephrology, Baskent University Faculty of Medicine, Ankara, Turkey. azumrutdal@yahoo.com
Baltali
Mehmet
M
Micozkadioglu
Hasan
H
Torun
Dilek
D
Sezer
Siren
S
Ozdemir
F Nurhan
FN
Haberal
Mehmet
M
D000328:Adult; D000368:Aged; D002097:C-Reactive Protein / Q000378:metabolism*; D016022:Case-Control Studies; D008076:Cholesterol, HDL / Q000097:blood*; D003324:Coronary Artery Disease / Q000097:blood* / Q000175:diagnosis / Q000209:etiology; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D019210:Troponin I / Q000097:blood*
D008076:Cholesterol, HDL; D019210:Troponin I; D002097:C-Reactive Protein