title: Low glomerular filtration rate is associated with high prevalence of vasospastic angina.
abstract: BACKGROUND
  Although chronic kidney disease is associated with a high prevalence of cardiovascular disease, the relationship between coronary artery spasm and renal dysfunction has not been elucidated.
  
  
  RESULTS
  We evaluated 139 patients with chest pain at rest who had no significant organic stenosis on coronary angiograms and who underwent coronary spasm provocation tests using acetylcholine or ergonovine. The results of the provocation tests revealed that 59 patients had vasospastic angina (VSA), and that 80 did not (non-VSA). We analyzed the association between VSA and renal dysfunction using the estimated glomerular filtration rate (eGFR). The eGFR was significantly lower in the VSA group than in the non-VSA group (P = 0.013). The patients were assigned to quartiles (Q) 1, 2, 3 and 4 based on eGFR (ml·min⁻¹·1.73 m²) < 64.1, 64.1-74.7, 74.8-85.0 and ≥ 85.1, respectively, in each of which the prevalence of VSA was 57%, 53%, 34% and 26%, respectively. The prevalence of VSA was significantly higher in Q1 than in Q4 (P = 0.008). Logistic regression analysis showed that the independent factors associated with the presence of VSA were a lower eGFR (P = 0.011) and male gender (P = 0.001).
  
  
  CONCLUSIONS
  Lower levels of eGFR in our study population were significantly and independently associated with a high prevalence of VSA, suggesting that a lower eGFR could be a risk factor for VSA.
authors.affiliation: Department of Cardiovascular Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
authors.forename: Seiji
authors.initials: S
authors.lastname: Koga
authors.forename: Satoshi
authors.initials: S
authors.lastname: Ikeda
authors.forename: Tomoo
authors.initials: T
authors.lastname: Nakata
authors.forename: Tomohiko
authors.initials: T
authors.lastname: Yasunaga
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Takeno
authors.forename: Yuji
authors.initials: Y
authors.lastname: Koide
authors.forename: Koji
authors.initials: K
authors.lastname: Maemura
mesh_terms: D000368:Aged; D000789:Angina, Unstable / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology*; D017023:Coronary Angiography; D003329:Coronary Vasospasm / Q000150:complications / Q000453:epidemiology* / Q000503:physiopathology*; D005260:Female; D005919:Glomerular Filtration Rate / Q000502:physiology*; D006801:Humans; D007668:Kidney / Q000503:physiopathology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors