Uçar Hakan, Gür Mustafa, Seker Taner, Sahin Durmuş Yıldıray, Kalkan Gülhan Yüksel, Türkoğlu Caner, Yıldırım Arafat, Kaypaklı Onur, Elbasan Zafer, Caylı Murat
Department of Cardiology, Adana Numune Training and Research Hospital, Adana, Turkey.
Turk Kardiyol Dern Ars. 2014 Oct;42(7):621-8. doi: 10.5543/tkda.2014.67790.
The strong relationship between severe renal dysfunction and coronary artery disease (CAD) is well-known. However, the association between kidney function with SYNTAX Score (SS) has not been investigated in patients with stable CAD with normal to mildly impaired renal function. We aimed to investigate the association between kidney function with SS.
In this study, 411 stable CAD patients in whom coronary angiography (CAG) was performed were prospectively included (247 male, 164 female; mean age 58.6 ± 12.4 years). Glomerular filtration rate was estimated (eGFR) by a modification of diet in renal disease (MDRD) formula. Two different groups were determined according to median eGFR values (GFRlow group <90, and GRFhigh group ≥ 90). CAG was performed based on clinical indications. SS was determined in all patients.
Patients in GFRlow group were older, and have a history of hypertension (HT) and diabetes mellitus and high body mass index. SS values of GFRlow group were higher than GFRhigh group (p<0.001 for all). Multivariate regression analysis showed that eGFR was independently associated with diabetes (ß, -0.206, p<0.001), HT (ß, -0.093, p=0.026) and SS (ß, -0.445, p<0.001).
eGFR is independently associated with extent and complexity of CAD as well as diabetes and HT. Importantly, these results may explain, in part, the increase in cardiovascular risk in with slightly impaired renal function.
严重肾功能不全与冠状动脉疾病（CAD）之间的密切关系已广为人知。然而，对于肾功能与SYNTAX评分（SS）之间的关联，尚未在肾功能正常至轻度受损的稳定CAD患者中进行研究。我们旨在研究肾功能与SS之间的关联。
本研究前瞻性纳入了411例接受冠状动脉造影（CAG）的稳定CAD患者（男性247例，女性164例；平均年龄58.6±12.4岁）。采用肾脏病饮食改良（MDRD）公式估算肾小球滤过率（eGFR）。根据eGFR中位数将患者分为两组（GFR低分组<90，GFR高分组≥90）。根据临床指征进行CAG检查。所有患者均测定SS。
GFR低分组患者年龄较大，有高血压（HT）和糖尿病病史，且体重指数较高。GFR低分组的SS值高于GFR高分组（所有p<0.001）。多因素回归分析显示，eGFR与糖尿病（β，-0.206，p<0.001）、HT（β，-0.093，p=0.026）和SS（β，-0.445，p<0.001）独立相关。
eGFR与CAD的严重程度和复杂性以及糖尿病和HT独立相关。重要的是，这些结果可能部分解释了肾功能轻度受损时心血管风险增加的原因。
