The AR ratio was found to be high in severe CKD patients, especially haemodialysis patients, but not in mild and moderate CKD patients. This increased AR ratio in severe CKD patients may affect the prognosis in patients who already have an increased risk for cardiovascular complications.

IntroductionThe aim of this study was to investigate the relationships between survival and related features in patients with chronic kidney disease undergoing cardiac catheterization and coronary angiography.Material and methodsThree hundred and seven consecutive patients with an estimated glomerular filtration rate (e-GFR) less than 60 ml/min/1.73 m2 undergoing coronary angiography were enrolled in the study. The study population was pursued with a median follow-up duration of 41.5 months.ResultsIn the Cox proportional hazards regression model, age (HR = 1.047, 95% CI: 1.011–1.084, p = 0.01), contrast media volume (HR = 1.004, 95% CI: 1.001–1.007, p = 0.008), angiotensin II receptor blocker (ARB) use (HR = 0.485, 95% CI: 0.261–0.901, p = 0.02), and e-GFR (HR = 0.978, 95% CI: 0.940–1.016, p = 0.04) were found to be independent predictors of long-term all-cause mortality. The survival analysis showed that the long-term all-cause mortality rate was higher in patients using contrast media volume greater than 140 ml compared to patients given less than or equal to 140 ml during the coronary angiography (3.6% vs. 11.6% log-rank, p = 0.001).ConclusionsIn patients with chronic kidney disease undergoing cardiac catheterization, age, contrast media volume, e-GFR and low ARB use were found to be independent predictors of long-term all-cause mortality. Contrast media volume used > 140 ml was independently associated with long-term all-cause mortality compared to less than or equal to 140 ml during cardiac catheterization.

Objectives In this study, we evaluated and compared the level of myocardial ischaemia caused by cardiac syndrome X (CSX) and coronary slow flow (CSF) with single photon emission computed tomography myocardial perfusion imaging (SPECT-MPI), and determined if changes in the level of myocardial ischaemia exist in CSF and CSX cases according to thrombolysis in myocardial infarction frame count (TFC). Materials and methods The study population consisted of 66 patients with CSF and 78 angiographically normal patients (36 of them with CSX and 42 of them healthy controls). The coronary flow rates of all patients were documented using TFC. Subsequently, all patients were evaluated with SPECT-MPI and categorized into the following groups according to their results: patients with CSF, patients with CSX, and patients with normal coronary arteries. Finally, we investigated whether a relationship existed between the SPECT-MPI and TFC results from these three groups. Results All ischaemia scores for MPI were significantly higher in the CSF group than in the CSX and control groups (P < 0.05). TFC was significantly associated with the severity of ischaemia in the CSF patients. There was a significant positive correlation between the summon difference score (SDS) and mean TFC value (P < 0.05) as well as between the SDS and each individual coronary TFC value in the CSF patients (P < 0.05). The number of vessels involved in CSF was positively correlated with the SDS. Conclusion CSF is associated with more severe myocardial ischaemia than CSX. The level of myocardial ischaemia on SPECT-MPI was correlated with the TFC and the number of affected coronary vessels in patients with CSF. These results suggest that CSF is a more serious clinical entity than CSX, and that the clinical severity of CSF appears to increase as the coronary flow rate decreases.

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THE RELATIONSHIP BETWEEN CORONARY SLOW FLOW AND MYOCARDIAL ISCHAEMIA EVALUATED WITH TIMI FRAME COUNT AND MYOCARDIAL PERFUSION SCINTIGRAPHY ABSTRACT Aim: Coronary slow flow (CSF) is known as a form or early stage of common atherosclerotic disease. Myocardial perfusion scintigraphy (MPS) is a valuable technique in the diagnosis of coronary artery disease and prediction of prognosis. The aim of this study was to investigate the relationship between the myocardial defect score and ischaemia in patients with CSF. Method: A total of 169 patients who applied with the complaint of angina pectoris and underwent SPECT as a non-invasive test followed by coronary angiography were included in this retrospective study. 10 patient was excluded from the study for various reasons. The study population comprised 91 (58%) determined with CSF and no obstructive stricture in the coronary arteries and 68 (42%) with normal flow. The mean age of the patients was 56±12 years. The scores obtained from Quantitative Perfusion SPECT (QPS) and Quantitative Gated SPECT (QGS) software were used in the myocardial perfusion evaluation. The TIMI frame counts were compared with the myocardial defect and ischaemia scores. The TIMI frame count method was used in the determination of CSF. In patients with slow flow in the circumflex (Cx) coronary artery, the stress total perfusion defect Cx (sTPD-Cx) was found to be 0.1 (range, 0.0-1.3), and in those with normal flow, it was 0.0 (range, 0.0-0.28) (p=0.002). The stress score Cx (sscore-Cx) was found to be 1.0 (range, 0.0-3.0) in patients with slow flow and 0.0 (range, 0.0-2.0) in those with normal flow (p=0.031). A linear correlation was determined between the Cx TIMI frame count and the sTPD-Cx and sscore-Cx values (r=0.207, p=0.009; r=0.159, p=0.045). No relationship was found between slow flow and the defect and ischemia scores in other myocardial regions. Conclusion: In patients with slow flow in the Cx coronary artery, the sTPD-Cx and the sscore-Cx values were found to be significantly high. Although at a weak level, a linear correlation was found between the Cx TIMI frame count and the sTPD-Cx and the sscore-Cx values. Key Words: Coronary slow flow, TIMI frame count, myocardial perfusion scintigraphy