Differential associations of renal function with coronary and peripheral atherosclerosis

Stamatelopoulos, Kimon S.; Lekakis, John P.; Tseke, Paraskevi; Ikonomidis, Ignatios; Kollias, George E.; Alevizaki, Maria; Kanakakis, Ioannis; Voidonikola, Paraskevi; Zakopoulos, Nikolaos; Papamichael, Christos M.

doi:10.1016/j.ijcard.2008.03.041

« Previous Next »International Journal of Cardiology
Volume 135, Issue 2 , Pages 162-164, 26 June 2009

Differential associations of renal function with coronary and peripheral atherosclerosis

Kimon S. Stamatelopoulos
- Department of Clinical Therapeutics, University of Athens, Alexandra Hospital, Athens, Greece
- Corresponding author. 17 Maragou Street, PO Box 16675, Glyfada, Athens, Greece. Tel.: +30 6974 317698; fax: +30 210 8943232, +30 210 3381487.
John P. Lekakis
- 2nd Cardiology Department, University of Athens, Attikon Hospital, Athens, Greece
Paraskevi Tseke
- Department of Clinical Therapeutics, University of Athens, Alexandra Hospital, Athens, Greece
Ignatios Ikonomidis
- 2nd Cardiology Department, University of Athens, Attikon Hospital, Athens, Greece
George E. Kollias
- Department of Clinical Therapeutics, University of Athens, Alexandra Hospital, Athens, Greece
Maria Alevizaki
- Department of Clinical Therapeutics, University of Athens, Alexandra Hospital, Athens, Greece
Ioannis Kanakakis
- Department of Clinical Therapeutics, University of Athens, Alexandra Hospital, Athens, Greece
Paraskevi Voidonikola
- Department of Clinical Therapeutics, University of Athens, Alexandra Hospital, Athens, Greece
Nikolaos Zakopoulos
- Department of Clinical Therapeutics, University of Athens, Alexandra Hospital, Athens, Greece
Christos M. Papamichael
- Department of Clinical Therapeutics, University of Athens, Alexandra Hospital, Athens, Greece

Received 1 December 2007; received in revised form 3 March 2008; accepted 5 March 2008. published online 01 July 2008.

Abstract

Background

The aim of this study was to examine the impact of renal dysfunction on both coronary and peripheral atherosclerosis in patients with coronary artery disease (CAD) without severe renal impairment.

Methods

One hundred and eighty-seven consecutive patients referred for elective coronary angiography were enrolled. Mean IMT and the presence of plaques were measured in the carotid and femoral arteries prior to angiography as markers of subclinical peripheral atherosclerosis. The severity of CAD was evaluated by the Gensini score. Glomerular filtration rate (GFR) was estimated by the MDRD formula.

Results

Significant CAD (>50% stenosis) was identified in 139 patients. GFR independently correlated with the presence and severity of CAD with incremental value over that of IMT. Renal function was significantly but not independently correlated with carotid IMT in CAD patients. Femoral IMT and the presence of plaques did not show any significant correlations with GFR in patients with or without CAD.

Conclusions

Renal function is an important predictor of the presence and severity of angiographic CAD in patients without severe renal impairment with incremental value over traditional risk factors for CAD and IMT. The contrasting weak or no associations of GFR with IMT and the presence of plaques suggest that renal dysfunction may exert differential effects on the development of coronary and peripheral atherosclerosis.

Keywords: Atherosclerosis, Coronary artery disease, IMT, Renal failure, GFR