Glomerular Filtration Rate is Associated With Burden of Coronary Atherosclerosis in Patients With Acute Coronary Syndrome

Duran, Mustafa; Uysal, Onur Kadir; Günebakmaz, Özgür; Baran, Oğuzhan; Turfan, Murat; Örnek, Ender; Çetın, Mustafa; Murat, Sani Namık; Yarlıoğlueş, Mikail; Karadeniz, Muhammed; Kurtul, A.; Kaya, Mehmet

doi:10.1177/0003319713486536

Cited by 12 publications

(10 citation statements)

References 43 publications

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“…In our study, multivariate regression analysis revealed that eGFR was negatively associated with Gensini score, which is in accordance with previous studies [24,25]. Further analysis indicated that decreasing risks of triple-vessel disease and high Gensini score were shown in increasing quartiles of PA in patients with eGFR ≥90 ml/min/1.73 m 2 , but the interactive relationships were not significant.…”

Section: Discussionsupporting

confidence: 91%

“…Impaired renal function is associated with not only the prevalence of CAD, but also the severity of atherosclerotic burden in patients with suspected CAD or confirmed ACS, as reflected by Gensini score and SYNTAX score [24,25], which is another scoring system used to assess coronary stenosis. In our study, multivariate regression analysis revealed that eGFR was negatively associated with Gensini score, which is in accordance with previous studies [24,25].…”

Section: Discussionmentioning

confidence: 99%

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Association of Serum Prealbumin with Angiographic Severity in Patients with Acute Coronary Syndrome

et al. 2017

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BackgroundSerum prealbumin (PA), which is a nutritional index, has been found to be associated with severities and prognoses of various diseases. However, there are no reports about the relationship between PA and angiographic severity of coronary artery disease.Material/MethodsThis cross-sectional study included 867 patients with acute coronary syndrome (ACS) who underwent coronary angiography. Patients were divided into quartiles of PA and coronary artery stenosis was determined by angiographic Gensini score, the presence of high Gensini score (Gensini score ≥120), and triple-vessel disease. Multivariate linear and logistic regression analyses were performed to explore the relationship between PA and disease severity in a coronary angiogram.ResultsThere was a significant and independent negative correlation between PA and Gensini score in multivariate linear regression (p=0.015). Logistic regression analysis revealed that crude odds ratios of triple-vessel disease and high Gensini score were 2.47 (95% CI: 1.66–3.67) and 1.83 (95% CI: 1.50–3.49), respectively, in the first quartile of PA compared with the fourth quartile and the results remained significant for high Gensini score after adjustment for confounding factors. In addition, estimated glomerular filtration rate, liver function, and high-sensitivity C-reactive protein (hs-CRP) had no interactive relationships in the above associations. Patients with lower levels of albumin or higher levels of hs-CRP or the ratio of hs-CRP to PA (hs-CRP/PA) also had more severe coronary atherosclerosis.ConclusionsPA is negatively and independently associated with angiographic severity in patients with ACS, indicating for potential use in estimating the burden of coronary atherosclerosis.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Association of Serum Prealbumin with Angiographic Severity in Patients with Acute Coronary Syndrome

et al. 2017

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“…Patients with IGFR have more burden of coronary atherosclerosis in patients with ACS [17]. Although there is no particular reason not to treat IGFR patients just like patients without renal dysfunction, physicians prescribed fewer guideline-recommended treatments even in the absence of contraindications [18].…”

Section: Discussionmentioning

confidence: 99%

Impact of impaired glomerular filtration rate and revascularization strategy on one-year cardiovascular events in acute coronary syndrome: data from Taiwan acute coronary syndrome full spectrum registry

et al. 2014

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BackgroundThe optimal revascularization strategy for patients with impaired glomerular filtration rate (IGFR) has not been established in acute coronary syndrome (ACS). We investigated the prognosis and impact of IGFR and invasive strategy on the cardiovascular outcomes in the ACS population.MethodsIn a Taiwan national-wide registry, 3093 ACS patients were enrolled. The invasive strategy was defined as patients with ST-elevation ACS (STE-ACS) undergoing primary angioplasty or fibrinolysis or coronary angiography with intent to revascularization performed within 72 hours of symptom onset in non-ST-elevation ACS (NSTE-ACS). IGFR was defined as an estimated GFR of less than 60 ml/min per 1.73 m2. Primary endpoint was a composite of death, non-fatal myocardial infarction or stroke at one year.ResultsPatients with IGFR (n = 1226) had more comorbidities but received less evidence-based medications during admission than those without IGFR (n = 1867). The primary endpoint-free survival rate is lower in the IGFR patients, in the whole, STE-ACS and NSTE-ACS population (all log-rank tests p < 0.01). Cox regression analysis revealed IGFR subjects had higher primary endpoint after adjusting by age, sex, medication at discharge and traditional risk factors (all p < 0.01). Kaplan–Meier curves showed IGFR patients without invasive strategy had the worst outcome in the STE-ACS and NSTE-ACS population (both p < 0.01). The invasive strategies, either with early angiography only or angioplasty, were associated with reduced primary endpoints among IGFR patients in the NSTE-ACS population (both p ≦ 0.024).ConclusionsIGFR patients suffering from ACS had poor prognosis and an invasive strategy could improve cardiovascular outcome in the NSTE-ACS population.

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“…Correlation of SS with “softer” end-points (estimated glomerular filtration rate (eGFR) in stable CAD [7] and in ACS [8], high-sensitivity C-reactive protein (CRP) in ACS [9], NT-proBNP in ACS [10], and myocardial injury post-PCI).…”

Section: Introductionmentioning

confidence: 99%

Clinical SYNTAX Score – a good predictor for renal artery stenosis in acute myocardial infarction patients: analysis from the REN-ACS trial

Burlacu¹,

Siriopol

Nistor

et al. 2017

aoms

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A b s t r a c tIntroduction: In ST-elevation myocardial infarction (STEMI) patients, multisite artery disease represents a serious issue influencing evolution, outcomes and prognosis. We evaluated for the first time the power of the Myocardial Infarction SYNTAX Score (MI SS) and Clinical SYNTAX Score (MI CSS) as predictors for renal artery stenosis (RAS) in STEMI. We also stratified the study population according to the two scores, and identified the variables correlated with the higher score. Material and methods: We used data from the REN-ACS study, which included 181 consecutive patients prospectively investigated for presence of RAS (through renal angiography), arterial stiffness (carotid-femoral pulse wave velocity, cf-PWV) and hydration status (bioimpedance). MI SS and CSS were computed. Results: Multivariate regressions indicated that the independent variables correlated with MI SS were left ventricular ejection fraction < 40%, significant RAS (> 50%, defined as RAS+), history of heart failure, and multivascular coronary disease (CAD, p < 0.03 for each), while those correlated with MI CSS were RAS+, cf-PWV, history of CAD, multivascular CAD, cholesterol, and total body water (p < 0.02 for each). In order to evaluate the ability to predict RAS+ we generated receiver operating characteristics and areas under curves, and the Youden index for MI SS and CSS. Conclusions: Both scores correlated with extensive atherosclerotic disease and presence of RAS+. A lower CSS proved to be a good predictor for exclusion of RAS+, with high specificity (85%) and negative predictive value (92%), and fair sensitivity (60%). We aim to further pursue this line of research and design a better predictor for RAS, with the inclusion of a novel biomarker in order to increase sensitivity.

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Glomerular Filtration Rate is Associated With Burden of Coronary Atherosclerosis in Patients With Acute Coronary Syndrome

Cited by 12 publications

References 43 publications

Association of Serum Prealbumin with Angiographic Severity in Patients with Acute Coronary Syndrome

Association of Serum Prealbumin with Angiographic Severity in Patients with Acute Coronary Syndrome

Impact of impaired glomerular filtration rate and revascularization strategy on one-year cardiovascular events in acute coronary syndrome: data from Taiwan acute coronary syndrome full spectrum registry

Clinical SYNTAX Score – a good predictor for renal artery stenosis in acute myocardial infarction patients: analysis from the REN-ACS trial

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