Reduced glomerular filtration rate and prior cardiovascular event entail similar risk for coronary atherosclerotic burden

Abstract

Background: Prior cardiovascular event and kidney dysfunction are both strong risk factor for coronary artery disease. Aim of this study is to assess coronary atherosclerotic burden in a large population of patients undergoing coronary angiography, according to the prior cardiovascular event or chronic kidney disease. Methods: We evaluated 700 consecutive patients who underwent CA. Serum creatinine to estimate glomerular filtration rate (eGFR) was measured. Clinically significant CAD was defined by the presence of a coronary lesion resulting in a luminal stenosis >50%. For the purpose of the study, the whole population was divided into 4 subgroups according to the presence/absence of eGFR <60 ml/min/1.73 m2 or prior cardiovascular event: eGFR≥60/no event (Group A), eGFR≥60/yes event (Group B), eGFR<60/no event (Group C), eGFR<60/yes event (Group D). Results: As expected, patients in group D had the worst clinical and biochemical profile. These patients also showed the highest values of ACR (p<0.001) and the lowest values of eGFR (p<0.01). One-hundred-ninety-six patients had three vessel disease. Considering group A as reference, the risk of having three-vessel disease was increased in group B (OR= 2.09; 95% CI 1.37-3.19), in group C, (OR= 1.80; 95% CI 1.04-3.14) and finally in group D (OR= 3.35; 95% CI 2.01-5.58). The risk carried by group C was not significantly different from that carried by Group B: OR= 0.86; 95% CI 0.5-1.5. Conclusions: In our study low eGFR seems to have the same excess risk of prior CV event.

CHA2DS2‐VASc and R2CHA2DS2‐VASc scores predict mortality in high cardiovascular risk population

“…In Table 1, we report the baseline clinical features of the whole population (n = 1017), divided into tertiles according to the CHA 2 DS 2 -VASc score. As already reported, 9,10 in the whole sample, men were 75% and the mean age was 68.4 ± 10.8 years. Most of the studied subjects had dyslipidaemia (71.5%) and hypertension (86.8%).…”

“…As already reported, 9,10 each subject, on the morning of the coronary arteriography procedure, was interviewed for collecting demographic characteristics, such as age, gender and smoking habits (no smoker, current smoker or ex‐smoker).…”

Low eGFR and albuminuria independently predict all-cause mortality in high-risk subjects undergoing coronary arteriography

“…As already reported [8,9], each subject, on the morning of the CA procedure, was interviewed for collecting demographic characteristics, such as age, gender, and smoking habits (no smoker, current smoker or ex-smoker) and medical history about previous cardiovascular events. Height and weight were measured, and BMI calculated.…”