Low Glomerular Filtration Rate Is Associated With High Prevalence of Vasospastic Angina

Koga, Seiji; Ikeda, Satoshi; Nakata, Tomoo; Yasunaga, Tomohiko; Takeno, Masayoshi; Koide, Yuji; Maemura, Koji

doi:10.1253/circj.cj-10-0864

Cited by 12 publications

(20 citation statements)

References 32 publications

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“…These results suggest that CFR is associated with CKD in the patients without obstructive coronary artery disease and vasospasm. In addition, although it is recently reported that low GFR is associated with vasospastic angina 27) , all patients in this study were ruled out the possibility of vasospastic angina.…”

Section: Discussionmentioning

confidence: 91%

A Reduction of Coronary Flow Reserve Is Associated With Chronic Kidney Disease and Long-Term Cardio-Cerebrovascular Events in Patients With Non-Obstructive Coronary Artery Disease and Vasospasm

Sakamoto¹,

Iwaya²,

Owada³

et al. 2012

FJMS

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: Background : Coronary flow reserve (CFR) provides essential information about the coronary microvasculature. Chronic kidney disease (CKD) is a risk factor for cardio -cerebrovascular diseases. We hypothesized that low CFR is associated with CKD and long -term cardio -cerebrovascular events in the patients without obstructive coronary artery diseases and vasospasm. Method and Results : In this study, 73 patients suspected with coronary artery disease but had no epicardial coronary stenosis and vasospasm were enrolled. There were 13 CKD patients and CFR was measured using the Doppler flow wire methods in the left anterior descending artery. CFR was significantly lower in CKD group than non -CKD group (3.13±0.6 vs. 4.00±1.1, P= 0.007). From multivariate logistic regression analysis, the independent factor associated with the presence of CKD was only CFR (odds ratio 3.85, 95% confidence interval 1.27 -11.70, P=0.017). In the patients with low CFR (≤2.8), cardio -cerebrovascular events were more common than those with normal CFR (CFR >2.8). Besides, in the patients who had both low CFR and CKD, longterm cardio -cerebrovascular events were more likely to occur than those with normal CFR or non -CKD. Conclusions : Our data suggest that low CFR is associated with CKD and cardio -cerebrovascular events in the patients without coronary stenosis and vasospasm.

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Section: Discussionmentioning

confidence: 91%

A Reduction of Coronary Flow Reserve Is Associated With Chronic Kidney Disease and Long-Term Cardio-Cerebrovascular Events in Patients With Non-Obstructive Coronary Artery Disease and Vasospasm

Sakamoto¹,

Iwaya²,

Owada³

et al. 2012

FJMS

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“…It is well known that renal dysfunction is an important risk factor for CVD, especially in patients with advanced or end-stage renal disease. 5,6) Atherosclerosis and vascular damage might be accelerated by several factors, including high blood pressure, increased inflammatory processes, oxidative stress, and an activated renin-angiotensin system, resulting in clinically significant CVD. 6,19,20) However, there have been few studies on the association between renal dysfunction and VSA, which is considered the most important functional coronary disorder.…”

Section: Discussionmentioning

confidence: 99%

“…[2][3][4] Renal dysfunction is closely related to cardiovascular disease (CVD), especially in patients with advanced or end-stage chronic kidney disease (CKD). 5,6) However, recent studies suggested that early stage renal disease with normal ranges of estimated glomerular filtration rate (eGFR) or serum creatinine (Cr) is also associated with the early changes of atherosclerosis. [6][7][8] Moreover, the progression of atherosclerosis is significantly accelerated by mild renal dysfunction, resulting in an increased risk of CVD in patients with mild renal dysfunction.…”

mentioning

confidence: 99%

“…5,6) However, recent studies suggested that early stage renal disease with normal ranges of estimated glomerular filtration rate (eGFR) or serum creatinine (Cr) is also associated with the early changes of atherosclerosis. [6][7][8] Moreover, the progression of atherosclerosis is significantly accelerated by mild renal dysfunction, resulting in an increased risk of CVD in patients with mild renal dysfunction. 7,8) Although several markers have been introduced for early detection of mild renal dysfunction, cystatin-C is known to be a more sensitive predictor than eGFR or Cr.…”

mentioning

confidence: 99%

“…8,11) The early changes and progression of atherosclerosis might contribute to both the pathologies of VSA and mild renal dysfunction. [6][7][8] However, there are few reports on the interactions between mild renal dysfunction indicated by cystatin-C and VSA. Recently, a Japanese group suggested that elevated cystatin-C level could predict the prevalence of VSA, but they did not present the associations between the level of cystatin-C and clinical or angiographic characteristics of VSA.…”

mentioning

confidence: 99%

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Impact of Cystatin-C Level on the Prevalence and Angiographic Characteristics of Vasospastic Angina in Korean Patients

et al. 2015

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SummaryCystatin-C, a marker of mild renal dysfunction, has been reported to be associated with cardiovascular diseases including vasospastic angina (VSA). We aimed to investigate the impact of cystatin-C level on the prevalence and angiographic characteristics of VSA in Korean patients.A total of 549 patients in the VA-KOREA (Vasospastic Angina in KOREA) registry who underwent ergonovine provocation tests were consecutively enrolled. Estimated glomerular filtration rate (eGFR) and levels of serum creatinine (Cr) and cystatin-C were assessed before angiography.The patients were classified into two groups: the VSA group (n = 149, 27.1%) and the non-VSA group (n = 400). Although eGFR and Cr levels were similar between the two groups, the VSA group had a significantly higher level of cystatin-C (P < 0.05). A high level of cystatin-C (second tertile, hazard ratio 1.432; 95% confidence interval [1.149-1.805]; P = 0.026, third tertile, 1.947 [1.132-2.719]; P = 0.003) and current smoking (2.710 [1.415-4.098]; P < 0.001) were independently associated with the prevalence of VSA. Furthermore, the highest level of cystatin-C (> 0.96 ng/mL) had a significant impact on the incidence of multivessel spasm (2.608 [1.061-4.596]; P = 0.037).A high level of cystatin-C was independently associated with the prevalence of VSA and with a high-risk type of VSA in Korean patients, suggesting that proactive investigation of VSA should be considered for patients with mild renal dysfunction indicated by elevated cystatin-C. (Int Heart J 2015; 56: 49-55)

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Variant angina in chronic kidney disease: a case report of an unusual presentation of cardiac arrest following dialysis

Mishra

Roguin²

2017

European Heart Journal - Case Reports

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Variant angina (VA) is described as a relatively benign syndrome of unprovoked chest pain and electrocardiographic (ECG) changes. Chronic kidney disease (CKD) may be associated with this syndrome. However, the incidence of severe manifestations of VA in this patient cohort with kidney disease has not been elucidated. Also, no description has been made of coronary vasospam in relation to dialysis sessions. Our patient, a young female with CKD, had an unusual history of angina following dialysis sessions and she suffered an acute coronary syndrome complicated by cardiac arrest. The diagnosis was made on the basis of her clinical features, dynamic ECG changes, and coronary angiogram findings, and the patient was managed medically. Severe manifestations of VA may occur in chronic kidney disease, and this should be kept in mind by the treating physician. The association of coronary vasospasm with dialysis needs further analysis.

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Low Glomerular Filtration Rate Is Associated With High Prevalence of Vasospastic Angina

Cited by 12 publications

References 32 publications

A Reduction of Coronary Flow Reserve Is Associated With Chronic Kidney Disease and Long-Term Cardio-Cerebrovascular Events in Patients With Non-Obstructive Coronary Artery Disease and Vasospasm

A Reduction of Coronary Flow Reserve Is Associated With Chronic Kidney Disease and Long-Term Cardio-Cerebrovascular Events in Patients With Non-Obstructive Coronary Artery Disease and Vasospasm

Impact of Cystatin-C Level on the Prevalence and Angiographic Characteristics of Vasospastic Angina in Korean Patients

Variant angina in chronic kidney disease: a case report of an unusual presentation of cardiac arrest following dialysis

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