Correlation of chronic renal dysfunction and albuminuria with severity of coronary artery lesions in patients with coronary artery disease.

ABSTRACT

This study was conducted to investigate the possible correlation of chronic renal dysfunction and albuminuria with the severity of coronary artery lesions in patients with coronary artery disease (CAD). Two-hundred and ninety-nine patients who had undergone coronary angiography for suspected CAD were stratified into three groups according to the glomerular filtration rate (GFR) group I included 144 patients with normal renal function GFR >90 ml/(min × 1.73 m(2)), group II included 97 patients with mild renal impairment GFR 60-89 ml/(min × 1.73 m(2)), and group III included 58 patients with moderate renal impairment GFR <60 ml/(min × 1.73 m(2)). Patients were then stratified into two groups according to the albuminuria level (0; minimal, 1+, 2+, 3+) the albuminuria negative group (negative = 0) included 171 patients and the albuminuria positive group (positive = minimal, 1+, 2+, 3+) included 128 patients. Clinical features and coronary lesion characteristics were compared among these groups. Patients with more severe renal dysfunction and positive albuminuria had a higher incidence of CAD (66.7 vs. 70.1 vs. 72.4%, p = 0.025 and 64.2 vs. 75.0%, p = 0.032), more multi-vessel disease (31.2 vs. 41.2 vs. 53.4 %, p = 0.004 and 33.3 vs. 46.1%, p = 0.015), more left anterior descending branch lesions (50.7 vs. 56.7 vs. 60.3%, p = 0.012 and 49.1 vs. 61.7 %, p = 0.009), and a higher Gensini score (42.3 ± 14.7 vs. 46.1 ± 19.9 vs. 52.8 ± 21.2, p = 0.026 and 44.0 ± 16.0 vs. 50.5 ± 20.2, p = 0.017). In conclusion, chronic renal dysfunction and albuminuria may be important factors determining the occurrence and the severity of CAD. Albuminuria was an especially significant indicator at the early stage of renal dysfunction.