The Relationship Between Chronic Kidney Disease and SYNTAX Score

Abstract

Chronic kidney disease (CKD) is associated with increased risk of cardiovascular disease and death. We evaluated the association between CKD and severity of coronary artery stenosis by calculating SYNTAX Score in patients with left main coronary artery and/or 3-vessel coronary artery disease. Coronary angiograms of 217 patients were assessed. Chronic kidney disease was staged using the estimated glomerular filtration rate (eGFR, mL/min per 1.73 m(2)) prior to coronary angiography. Patients were divided into 5 groups according to the National Kidney Foundation Kidney Disease Outcome Quality Initiative (NKF KDOQI) Clinical Practice Guidelines (14). Patients with eGFR >90 mL/min per 1.73 m(2) (group 1), patients with eGFR 60 to 89 mL/min per 1.73 m(2) (group 2), patients with eGFR 30 to 59 mL/min per 1.73 m(2) (group 3), patients with eGFR >15 to < 30 per 1.73 m(2) and dialysis patients with eGFR < 15 per 1.73 m(2) were combined as group 4. The risk of significant lesion complexity increased progressively with decreasing kidney function (P = .001). Estimated glomerular filtration rate was a strong predictor of higher SYNTAX Score.

Coronary Artery Disease in Patients with Chronic Kidney Disease: A Clinical Update

“…Lesion complexity increases progressively with decreasing kidney function with GFR a strong predictor of higher SYNTAX (SYNergy between PCI with TAXUS™ and Cardiac Surgery) Score [47]. However, patients with impaired renal function are much less likely than patients with normal renal function to undergo PCI.…”

The value of the Clinical SYNTAX Score in predicting long-term prognosis in patients with ST-segment elevation myocardial infarction who have undergone primary percutaneous coronary intervention

“…may increase mortality because of the patients' complex coronary anatomy on admission and the high number of lesions. Coskun et al [17] showed in their study that low GFR values before angiography are an independent predictor of a high Sx score.…”

Impaired kidney function is associated with SYNTAX score in patients with stable coronary artery disease

“…Goodman et al [19] reported that CAD is common in young adult patients with endstage renal disease. Kılıckesmez et al [6,7] examined 216 coronary angiographies of patients with normal renal function and different stages of renal dysfunction and identified coronary lesion complexity according to the ACC/AHA lesion classification. [20] The frequency of complex lesions was higher in the renal failure group.…”

“…[4,5] A strong relationship between severe renal dysfunction, and extent and complexity of coronary artery disease (CAD) has been investigated in only a few previous studies. [5][6][7] It has been demonstrated that even a slight decrease in the GFR poses an independent risk factor for cardiovascular diseases. [8] However, this association was not investigated in patients with stable CAD and normal to mildly impaired renal function.…”