OBJECTIVE: We aimed to elucidate the relationship between mild-to-moderate renal impairment and the development of coronary collateral vessels (CCV) in patients with acute coronary syndrome (ACS). METHODS: We enrolled 461 patients with ACS who underwent coronary angiography for the first time. The development of CCV was assessed with the Rentrop score. Kidney function was classified according to the estimated glomerular filtration rate (eGFR). The Gensini score was used to show the extent of atherosclerosis. RESULTS: The mean eGFR value was 89.9 ± 24.3 U/l for patients with no development of collaterals and 82.7 ± 20.5 for patients who had CCV. The mean age was 59 ± 11 years and 349 patients (75.7 %) were male. Rentrop classifications 1-2-3 (presence of CCV) were determined in 222 (48.1 %) patients. The presence of CCV was significantly associated with low levels of eGFR (p = 0.001), increased serum creatinine levels (p = 0.034), high levels of serum albumin (0.036), and the Gensini score (p < 0.001). Multivariate analysis showed that the Gensini score was an independent predictor of the presence of CCV (OR = 1.090, 95 % CI: 1.032-1.151, p = 0.002). CONCLUSION: We suggest that the association between mild-to-moderate renal impairment and the presence of CCV may be explained by increased myocardial ischemia and severe CAD.
OBJECTIVE: We aimed to elucidate the relationship between mild-to-moderate renal impairment and the development of coronary collateral vessels (CCV) in patients with acute coronary syndrome (ACS). METHODS: We enrolled 461 patients with ACS who underwent coronary angiography for the first time. The development of CCV was assessed with the Rentrop score. Kidney function was classified according to the estimated glomerular filtration rate (eGFR). The Gensini score was used to show the extent of atherosclerosis. RESULTS: The mean eGFR value was 89.9 ± 24.3 U/l for patients with no development of collaterals and 82.7 ± 20.5 for patients who had CCV. The mean age was 59 ± 11 years and 349 patients (75.7 %) were male. Rentrop classifications 1-2-3 (presence of CCV) were determined in 222 (48.1 %) patients. The presence of CCV was significantly associated with low levels of eGFR (p = 0.001), increased serum creatinine levels (p = 0.034), high levels of serum albumin (0.036), and the Gensini score (p < 0.001). Multivariate analysis showed that the Gensini score was an independent predictor of the presence of CCV (OR = 1.090, 95 % CI: 1.032-1.151, p = 0.002). CONCLUSION: We suggest that the association between mild-to-moderate renal impairment and the presence of CCV may be explained by increased myocardial ischemia and severe CAD.
Authors: Frank Stam; Coen van Guldener; Annemarie Becker; Jacqueline M Dekker; Robert J Heine; Lex M Bouter; Coen D A Stehouwer Journal: J Am Soc Nephrol Date: 2005-12-28 Impact factor: 10.121
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Authors: P Elsman; A W J van 't Hof; M J de Boer; J C A Hoorntje; H Suryapranata; J H E Dambrink; F Zijlstra Journal: Eur Heart J Date: 2004-05 Impact factor: 29.983
Authors: Mahboob Rahman; Sara Pressel; Barry R Davis; Chuke Nwachuku; Jackson T Wright; Paul K Whelton; Joshua Barzilay; Vecihi Batuman; John H Eckfeldt; Michael A Farber; Stanley Franklin; Mario Henriquez; Nelson Kopyt; Gail T Louis; Mohammad Saklayen; Carole Stanford; Candace Walworth; Harry Ward; Thomas Wiegmann Journal: Ann Intern Med Date: 2006-02-07 Impact factor: 25.391