title: The association of glomerular filtration rate and erectile dysfunction with severity of coronary artery disease in patients presenting with chest pain.
abstract: BACKGROUND
  The most common cause of death in patients with chronic kidney disease is cardiovascular. Coexistence of reduced estimated glomerular filtration rate (eGFR) and erectile dysfunction (ED) may predate severe underlying coronary artery disease (CAD). The aim of this study was to evaluate the predictive value of presence and severity of ED and reduced estimated eGFR in the risk stratification of CAD in patients with chest pain.
  
  
  METHODS
  Two hundred and sixty-five consecutive male patients with chest pain were included. All patients underwent exercise stress test (EST), of whom those with positive EST underwent coronary angiography. eGFR was calculated and sexual health inventory for men (SHIM) form was applied to evaluate ED. The relation between SHIM scores, eGFR and the number of arteries with significant lesions was evaluated.
  
  
  RESULTS
  Of the 265 male patients, 105 had positive EST while the remaining 160 patients had negative EST. ED was present in 62 patients (38.8%) in the EST (-) group and in 64 patients (61%) in the EST (+) group (P = 0.000). In the EST (+) group, coronary angiography (CAG) revealed normal coronary anatomy or insignificant coronary lesions in 19 (18%), one-vessel disease in 45 (43%), two-vessel disease in 22 (21%) and three-vessel disease in 19 (18%) patients, respectively. The lowest ED prevalence (36.8%) was seen in patients who had normal coronary anatomy or insignificant coronary lesions while the highest prevalence was in those with three-vessel disease (89.5%). When eGFR were taken into account, there was a significant difference between the groups as well (107.2 ± 19.2 ml/min in the EST (-) group versus 94.1 ± 20.0 ml/min in the EST (+) group; P = 0.001).
  
  
  CONCLUSIONS
  The presence and severity of ED and reduced eGFR are associated with the severity of underlying CAD in patients presenting with chest pain, and they could be implemented in the risk stratification of these patients.
authors.affiliation: Meram School of Medicine, Nephrology Department, Selcuk University, 42090 Meram, Konya, Turkey. yalcinsolakmd@gmail.com
authors.forename: Yalcin
authors.initials: Y
authors.lastname: Solak
authors.forename: Hakan
authors.initials: H
authors.lastname: Akilli
authors.forename: Huseyin
authors.initials: H
authors.lastname: Atalay
authors.forename: Mehmet
authors.initials: M
authors.lastname: Kayrak
authors.forename: Hasan
authors.initials: H
authors.lastname: Gok
authors.forename: Suleyman
authors.initials: S
authors.lastname: Turk
mesh_terms: D000328:Adult; D000368:Aged; D000419:Albuminuria; D002637:Chest Pain; D002908:Chronic Disease; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D003404:Creatinine / Q000378:metabolism; D007172:Erectile Dysfunction / Q000150:complications*; D005080:Exercise Test; D005919:Glomerular Filtration Rate; D006801:Humans; D007674:Kidney Diseases / Q000150:complications / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment
chemical_list: D003404:Creatinine