Differential associations of renal function with coronary and peripheral atherosclerosis.
BACKGROUND
The aim of this study was to examine the impact of renal dysfunction on both coronary and peripheral atherosclerosis in patients with coronary artery disease (CAD) without severe renal impairment.


METHODS
One hundred and eighty-seven consecutive patients referred for elective coronary angiography were enrolled. Mean IMT and the presence of plaques were measured in the carotid and femoral arteries prior to angiography as markers of subclinical peripheral atherosclerosis. The severity of CAD was evaluated by the Gensini score. Glomerular filtration rate (GFR) was estimated by the MDRD formula.


RESULTS
Significant CAD (>50% stenosis) was identified in 139 patients. GFR independently correlated with the presence and severity of CAD with incremental value over that of IMT. Renal function was significantly but not independently correlated with carotid IMT in CAD patients. Femoral IMT and the presence of plaques did not show any significant correlations with GFR in patients with or without CAD.


CONCLUSIONS
Renal function is an important predictor of the presence and severity of angiographic CAD in patients without severe renal impairment with incremental value over traditional risk factors for CAD and IMT. The contrasting weak or no associations of GFR with IMT and the presence of plaques suggest that renal dysfunction may exert differential effects on the development of coronary and peripheral atherosclerosis.
Stamatelopoulos
Kimon S
KS
Department of Clinical Therapeutics, University of Athens, Alexandra Hospital, Athens, Greece. stamatelopoulosk@yahoo.gr
Lekakis
John P
JP
Tseke
Paraskevi
P
Ikonomidis
Ignatios
I
Kollias
George E
GE
Alevizaki
Maria
M
Kanakakis
Ioannis
I
Voidonikola
Paraskevi
P
Zakopoulos
Nikolaos
N
Papamichael
Christos M
CM
D000368:Aged; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000503:physiopathology; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000503:physiopathology; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging; D005919:Glomerular Filtration Rate; D006801:Humans; D007668:Kidney / Q000502:physiology; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D051437:Renal Insufficiency / Q000453:epidemiology* / Q000503:physiopathology; D012307:Risk Factors; D012720:Severity of Illness Index; D014463:Ultrasonography