Abstract
Background
Chronic kidney disease (CKD) is highly prevalent in patients with coronary artery
disease (CAD) and is an independent risk factor for adverse cardiovascular disease
(CVD) and all-cause mortality in patients with acute coronary syndromes. SYNTAX score
(SXscore) can predict the outcomes of patients undergoing percutaneous coronary intervention.
However, the association between kidney function and SXscore has not been previously
reported.
Methods
The estimated glomerular filtration rate (eGFR) and SXscore were retrospectively collected
in 2262 patients with established CAD undergoing coronary angiography at Peking University
Third Hospital from March 2005 to September 2010. Ordinal logistic regression and
Pearson and partial correlation were used to analyze the association between eGFR
and SXscore.
Results
Patients with renal dysfunction were older, more likely to be female, and have a history
of hypertension and diabetes. The unadjusted correlation coefficient of eGFR and SXscore
was −0.125 (P < 0.001).This remained significant after adjustment for age, sex, hypertension, diabetes,
hyperlipidemia, or current smoking (r = −0.075, P = 0.019). Ordinal logistic regression showed that age, gender, diabetes, and eGFR
exerted independent influences on SXscore.
Conclusions
Kidney function was an independent predictor of SXscore in patients with established
CAD. This helps explain the increased risk of cardiovascular disease events and mortality
in patients with renal dysfunction. Further prospective multicentre studies are needed
to confirm this finding.
Résumé
Introduction
La maladie rénale chronique (MRC) est très répandue chez les patients ayant une maladie
coronarienne (MC). De plus, elle est un facteur de risque indépendant des maladies
cardiovasculaires (MCV) indésirables et de la mortalité de toute origine chez les
patients ayant des syndromes coronariens aigus. Le score SYNTAX peut prédire les résultats
des patients subissant une intervention coronarienne percutanée. Cependant, le lien
entre la fonction rénale et le score SYNTAX n'a pas été rapporté antérieurement.
Méthodes
Le taux de filtration glomérulaire estimé (TFGe) et le score SYNTAX étaient collectés
rétrospectivement chez 2 262 patients avec une MC établie ayant subi une coronarographie
au Peking University Third Hospital de mars 2005 à septembre 2010. La régression logistique ordinale, la corrélation
de Pearson et la corrélation partielle ont été utilisées pour analyser le lien entre
le TFGe et le score SYNTAX.
Résultats
Les patients avec une dysfonction rénale étaient plus vieux, plus susceptibles d'être
des femmes, et avaient des antécédents d'hypertension et de diabète. Le coefficient
de corrélation non ajusté du TFGe et du score SYNTAX était de −0,125 (P < 0,001). Cela demeurait significatif après l'ajustement sur l'âge, le sexe, l'hypertension,
le diabète, l'hyperlipidémie ou le tabagisme présent (r = −0,075, P = 0,019). La régression logistique ordinale montrait que l'âge, le genre, le diabète
et le TFGe exerçaient des influences indépendantes sur le score SYNTAX.
Conclusions
La fonction rénale était un prédicteur indépendant du score SYNTAX chez les patients
avec une MC établie. Cela aide à la compréhension de l'augmentation du risque d'événements
de maladies cardiovasculaires et de mortalité chez les patients avec une dysfonction
rénale. D'autres études multicentriques prospectives sont nécessaires pour confirmer
cette découverte.
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Article info
Publication history
Published online: July 26, 2011
Accepted:
April 7,
2011
Received:
February 14,
2011
Footnotes
See page 771 for disclosure information.
Identification
Copyright
© 2011 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.
