title: Mildly decreased glomerular filtration rate is associated with poor coronary collateral circulation in patients with coronary artery disease.
abstract: BACKGROUND
  The aim of this study was to evaluate the association between mildly decreased glomerular filtration rate (GFR) and coronary collateral circulation (CCC).
  
  
  OBJECTIVE
  There would be an association between mildly decreased GFR and CCC.
  
  
  METHODS
  Patients who had an occlusion in at least 1 major coronary artery were included in this study. Patients with severely and moderately decreased GFR were excluded. Patient data were obtained from their files. To classify CCC, we used the Rentrop classification. Patients were classified as having poor CCC (Rentrop grades 0 to 1) or good CCC (Rentrop grades 2 to 3). We used the Modification of Diet in Renal Disease (MDRD) equation to calculate GFR. Mildly decreased GFR was defined as 60 mL/min per 1.73 m(2) ≥ eGFR ≤89 mL/min per 1.73 m(2) according to the MDRD definition. Multivariate logistic regression analysis was performed to determine independent variables.
  
  
  RESULTS
  The study group consisted of 299 patients. Ninety-three patients had poor CCC and 206 patients had good CCC. The frequency of mildly decreased GFR was higher in the poor CCC group than in the good CCC group (P<0.001). Also, the frequency of diabetes and dyslipidemia, and the plasma high sensitive C-reactive protein levels, were higher in the poor CCC group (P = 0.003, P = 0.018, P<0.001, respectively). Logistic regression analysis revealed that eGFR is an independent predictor of CCC (B = 1.68; odds ratio = 5.4; P<0.001; 95% confidence interval, 3.1-9.4).
  
  
  CONCLUSIONS
  We found that CCC was worse in patients with mildly decreased GFR compared to patients with normal GFR in patients with coronary artery disease.
authors: Department of Cardiology, Faculty of Medicine, Gaziosmanpasa University, Tokat, Turkey. drhkadi@gmail.com
authors: Hasan
authors: H
authors: Kadi
authors: Koksal
authors: K
authors: Ceyhan
authors: Erkan
authors: E
authors: Sogut
authors: Fatih
authors: F
authors: Koc
authors: Atac
authors: A
authors: Celik
authors: Orhan
authors: O
authors: Onalan
authors: Semsettin
authors: S
authors: Sahin
mesh_terms: D000328:Adult; D000368:Aged; D016009:Chi-Square Distribution; D003097:Collateral Circulation; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology; D003326:Coronary Circulation; D003430:Cross-Sectional Studies; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007668:Kidney / Q000503:physiopathology*; D007674:Kidney Diseases / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D014421:Turkey