J Korean Med Sci.  2013 Nov;28(11):1615-1621. 10.3346/jkms.2013.28.11.1615.

Decreased Renal Function Is an Independent Predictor of Severity of Coronary Artery Disease: An Application of Gensini Score

• Kim IY
• Hwang IH
• Lee KN
• Lee DW
• Lee SB
• Shin MJ
• Rhee H
• Yang B
• Song SH
• Seong EY
• Kwak IS

• KMID: 1777658
• DOI: http://doi.org/10.3346/jkms.2013.28.11.1615

Abstract

Coronary artery disease (CAD) is the leading cause of death in patients with chronic kidney disease (CKD).Although many studies have shown a higher prevalence of CAD among these patients, the association between the spectrum of renal dysfunction and severity of CAD remains unclear. In this study, we investigate the association between renal function and the severity of CAD. We retrospectively reviewed the medical records of 1,192 patients who underwent elective coronary angiography (CAG). The severity of CAD was evaluated by Gensini score according to the degree of luminal narrowing and location(s) of obstruction in the involved main coronary artery. In all patients, the estimated glomerular filtration rate (eGFR) was independently associated with Gensini score (beta=-0.27, P < 0.001) in addition to diabetes mellitus (beta=0.07, P = 0.02), hypertension (beta=0.12, P < 0.001), low density lipoprotein (LDL)-cholesterol (beta=0.08, P = 0.003), and hemoglobin (beta=-0.07, P = 0.03) after controlling for other confounding factors. The result of this study demonstrates that decreased renal function is associated not only with the prevalence, but also the severity, of CAD.

Keyword

Coronary Artery Disease; Kidney Failure, Chronic; Gensini Score; Glomerular Filtration Rate

MeSH Terms

Cholesterol, LDL/blood
Coronary Angiography
Coronary Artery Disease/*complications
Diabetes Mellitus
Female
Glomerular Filtration Rate
Hemoglobins/metabolism
Humans
Hypertension/*complications
Kidney
Kidney Function Tests
Male
Middle Aged
*Organ Dysfunction Scores
Renal Insufficiency, Chronic/*complications
Retrospective Studies
*Severity of Illness Index
Cholesterol, LDL
Hemoglobins

Figure

• 

  Fig. 1 Comparison of Gensini score across the CKD groups in all patients (n = 1,192) (A), patients with DM (n = 456) (B), patients with hypertension (n = 441) (C), and patients without DM and hypertension (n = 526) (D) by ANOVA. *p < 0.05 vs non-CKD; †p < 0.05 vs CKD stage 3; ‡p < 0.05 vs CKD stage 4 by Games-Howell type multiple comparison.

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