Predictor of poor coronary collaterals in chronic kidney disease population with significant coronary artery disease

BMC Nephrology

Research Article

Suh-Hang Juo¹  Wei-chung Tsai²  Tsung-Hsien Lin³  Wen-Ter Lai³  Sheng-Hsiung Sheu³  Ho-Ming Su⁴  Po-Chao Hsu⁵  Szu-Chia Chen⁶ 

[1] Department of Medical Research, Kaohsiung Medical University Hospital, 100 Tzyou 1st Road, 80708, Kaohsiung, ROC, Taiwan;Medical Genetics, Kaohsiung Medical University, Kaohsiung, Taiwan;Center of Excellence for Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan;Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, 100 Tzyou 1st Road, 80708, Kaohsiung, ROC, Taiwan;Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, 100 Tzyou 1st Road, 80708, Kaohsiung, ROC, Taiwan;Faculty of Medicine, Kaohsiung, Taiwan;Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, 100 Tzyou 1st Road, 80708, Kaohsiung, ROC, Taiwan;Faculty of Medicine, Kaohsiung, Taiwan;Department of Internal Medicine, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung, Taiwan;Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, 100 Tzyou 1st Road, 80708, Kaohsiung, ROC, Taiwan;Graduate Institute of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan;Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, 100 Tzyou 1st Road, 80708, Kaohsiung, ROC, Taiwan;Department of Internal Medicine, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung, Taiwan;

关键词: Chronic kidney disease;    Coronary artery disease;    Coronary collateral circulation, Hypertension, Diabetes;   

DOI  :  10.1186/1471-2369-13-98

 received in 2012-03-14, accepted in 2012-08-22,  发布年份 2012

来源: Springer

【 摘 要 】

BackgroundCoronary collateral circulation plays an important role to protect myocardium from ischemia, preserve myocardial contractility and reduce cardiovascular events. Chronic kidney disease (CKD) is associated with poor coronary collateral development and cardiovascular outcome. However, limited research investigates the predictors for collateral development in the CKD population.MethodsWe evaluated 970 consecutive patients undergoing coronary angiography and 202 patients with CKD, defined as a glomerular filtration rate less than 60 ml/min/1.73 m2, were finally analyzed. The collateral scoring system developed by Rentrop was used to classify patients into poor (grades 0 and 1) or good (grades 2 and 3) collateral group.ResultsThe patients with poor collateral (n = 122) had a higher incidence of hypertension (82% vs 63.8%, p = 0.005), fewer diseased vessels numbers (2.1 ± 0.9 vs 2.6 ± 0.6, p < 0.001) and a trend to be diabetic (56.6% vs. 43.8%, p = 0.085) or female sex (37.7% vs. 25.0%, p = 0.067). Multivariate analysis showed hypertension (odd ratio (OR) 2.672, p = 0.006), diabetes (OR 1.956, p = 0.039) and diseased vessels numbers (OR 0.402, p < 0.001) were significant predictors of poor coronary collaterals development. Furthermore, hypertension and diabetes have a negative synergistic effect on collateral development (p = 0.004 for interaction).ConclusionsIn the CKD population hypertension and diabetes might negatively influence the coronary collaterals development.

【 授权许可】

Unknown   
© Hsu et al.; licensee BioMed Central Ltd. 2012. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.