Low Glomerular Filtration Rate Is Associated With High Prevalence of Vasospastic Angina

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Author(s)

    • KOGA Seiji
    • Department of Cardiovascular Medicine, Nagasaki University Graduate School of Biomedical Sciences
    • IKEDA Satoshi
    • Department of Cardiovascular Medicine, Nagasaki University Graduate School of Biomedical Sciences
    • NAKATA Tomoo
    • Department of Cardiovascular Medicine, Nagasaki University Graduate School of Biomedical Sciences
    • YASUNAGA Tomohiko
    • Department of Cardiovascular Medicine, Nagasaki University Graduate School of Biomedical Sciences
    • TAKENO Masayoshi
    • Department of Cardiovascular Medicine, Nagasaki University Graduate School of Biomedical Sciences
    • KOIDE Yuji
    • Department of Cardiovascular Medicine, Nagasaki University Graduate School of Biomedical Sciences
    • MAEMURA Koji
    • Department of Cardiovascular Medicine, Nagasaki University Graduate School of Biomedical Sciences

Abstract

Background: Although chronic kidney disease is associated with a high prevalence of cardiovascular disease, the relationship between coronary artery spasm and renal dysfunction has not been elucidated. Methods and Results: We evaluated 139 patients with chest pain at rest who had no significant organic stenosis on coronary angiograms and who underwent coronary spasm provocation tests using acetylcholine or ergonovine. The results of the provocation tests revealed that 59 patients had vasospastic angina (VSA), and that 80 did not (non-VSA). We analyzed the association between VSA and renal dysfunction using the estimated glomerular filtration rate (eGFR). The eGFR was significantly lower in the VSA group than in the non-VSA group (P=0.013). The patients were assigned to quartiles (Q) 1, 2, 3 and 4 based on eGFR (ml·min-1·1.73 m2) <64.1, 64.1-74.7, 74.8-85.0 and ≥85.1, respectively, in each of which the prevalence of VSA was 57%, 53%, 34% and 26%, respectively. The prevalence of VSA was significantly higher in Q1 than in Q4 (P=0.008). Logistic regression analysis showed that the independent factors associated with the presence of VSA were a lower eGFR (P=0.011) and male gender (P=0.001). Conclusions: Lower levels of eGFR in our study population were significantly and independently associated with a high prevalence of VSA, suggesting that a lower eGFR could be a risk factor for VSA.

<b><i>Background:</i></b> Although chronic kidney disease is associated with a high prevalence of cardiovascular disease, the relationship between coronary artery spasm and renal dysfunction has not been elucidated. <b><i>Methods and Results:</i></b> We evaluated 139 patients with chest pain at rest who had no significant organic stenosis on coronary angiograms and who underwent coronary spasm provocation tests using acetylcholine or ergonovine. The results of the provocation tests revealed that 59 patients had vasospastic angina (VSA), and that 80 did not (non-VSA). We analyzed the association between VSA and renal dysfunction using the estimated glomerular filtration rate (eGFR). The eGFR was significantly lower in the VSA group than in the non-VSA group (P=0.013). The patients were assigned to quartiles (Q) 1, 2, 3 and 4 based on eGFR (ml·min<sup>-1</sup>·1.73m<sup>2</sup>) <64.1, 64.1-74.7, 74.8-85.0 and ≥85.1, respectively, in each of which the prevalence of VSA was 57%, 53%, 34% and 26%, respectively. The prevalence of VSA was significantly higher in Q1 than in Q4 (P=0.008). Logistic regression analysis showed that the independent factors associated with the presence of VSA were a lower eGFR (P=0.011) and male gender (P=0.001). <b><i>Conclusions:</i></b> Lower levels of eGFR in our study population were significantly and independently associated with a high prevalence of VSA, suggesting that a lower eGFR could be a risk factor for VSA. (<i>Circ J</i> 2011; <b>75:</b> 1691-1695)<br>

Journal

  • Circulation Journal

    Circulation Journal 75(7), 1691-1695, 2011-06-25

    The Japanese Circulation Society

References:  32

Cited by:  2

Codes

  • NII Article ID (NAID)
    10029126777
  • NII NACSIS-CAT ID (NCID)
    AA11591968
  • Text Lang
    ENG
  • Article Type
    Journal Article
  • ISSN
    13469843
  • Data Source
    CJP  CJPref  IR  J-STAGE 
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