title: Does a Reduction in the Glomerular Filtration Rate Increase the Overall Severity of Coronary Artery Stenosis?
abstract: OBJECTIVE
  Chronic kidney disease is a risk factor of coronary events, however, its impact on coronary artery stenosis has not yet been clarified with the use of a large database. We examined the association between a reduced glomerular filtration rate (GFR) and the overall severity of coronary stenosis.
  
  
  METHODS
  We enrolled 1,150 patients [mean age, 68±12 (SD) years; 66.6% men] who consecutively underwent coronary angiography for suspected stable angina pectoris. The overall severity of stenosis in the coronary arteries was assessed by the Gensini score (GS), and its logarithmic values (log-GS) were used for statistical analyses since the GS does not follow a normal distribution.
  
  
  RESULTS
  The log-GS was significantly larger in men than in women (2.5±1.5 vs. 1.9±1.7), while the estimated GFR (eGFR) and comorbidities were comparable between both sexes. A multivariate regression analysis indicated that age, smoking, eGFR, HDL-cholesterol and HbA1c were independent explanatory variables of the log-GS in men, although the eGFR explained only 1.2% of the log-GS variation. In women, the eGFR was not included in the significant explanatory variables shown by the multivariate analysis. However, the sex difference in the regression for the eGFR-log-GS relationship was not statistically significant.
  
  
  CONCLUSIONS
  A reduced eGFR is a significant, but minor, determinant of the overall severity of coronary artery stenosis in men and potentially women.
authors.affiliation: Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Japan.
authors.forename: Junichi
authors.initials: J
authors.lastname: Nishida
authors.forename: Nobuaki
authors.initials: N
authors.lastname: Kokubu
authors.forename: Mina
authors.initials: M
authors.lastname: Kawamukai
authors.forename: Akiyoshi
authors.initials: A
authors.lastname: Hashimoto
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Ohnishi
authors.forename: Hidemichi
authors.initials: H
authors.lastname: Kouzu
authors.forename: Yoshito
authors.initials: Y
authors.lastname: Ohnuma
authors.forename: Tohru
authors.initials: T
authors.lastname: Hasegawa
authors.forename: Akihito
authors.initials: A
authors.lastname: Tsuchida
authors.forename: Tetsuji
authors.initials: T
authors.lastname: Miura
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D060050:Angina, Stable / Q000000981:diagnostic imaging; D008076:Cholesterol, HDL; D015897:Comorbidity; D017023:Coronary Angiography; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000503:physiopathology*; D003331:Coronary Vessels / Q000000981:diagnostic imaging; D005260:Female; D005919:Glomerular Filtration Rate; D006446:Hemoglobin E / Q000031:analogs & derivatives; D006801:Humans; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012307:Risk Factors; D012720:Severity of Illness Index; D012737:Sex Factors; D012907:Smoking / Q000453:epidemiology; D006442:Glycated Hemoglobin
chemical_list: D008076:Cholesterol, HDL; D006446:Hemoglobin E; D008055:Lipids; C032271:glycated hemoglobin E; D006442:Glycated Hemoglobin