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Serum creatinine is independently associated with angiographic extent of coronary artery disease in patients with stable angina pectoris [Anatol J Cardiol]
Anatol J Cardiol. 2011; 11(5): 407-413 | DOI: 10.5152/akd.2011.107  

Serum creatinine is independently associated with angiographic extent of coronary artery disease in patients with stable angina pectoris

Şule Korkmaz1, Burcu Demirkan1, Hakan Altay2, Meltem Refiker Ege3, Vedat Çaldır1, Mehmet Birhan Yılmaz4, Yeşim Güray1, Ümit Güray1, Hatice Şaşmaz1
1Clinic of Cardiology, Türkiye Yüksek İhtisas Hospital, Ankara
2Department of Cardiology, Başkent University, Adana Teaching and Research Hospital, Adana
3Clinic of Cardiology, Yalova State Hospital, Yalova
4Department of Cardiology, Faculty of Medicine, Cumhuriyet University, Sivas-Turkey

Objective: Renal dysfunction has been shown to be linked to high risk for cardiovascular events. Even milder forms of creatinine elevation are associated with poor cardiovascular outcomes. We designed a retrospective study and searched the association of angiographic extent of coronary artery disease and creatinine levels in patients without overt renal dysfunction. Methods: We retrospectively reviewed 892 consecutive patients with typical stable angina pectoris (311 female with mean age of 62±10 years, 581 male with mean age of 56±11 years) at Türkiye Yüksek İhtisas Hospital and creatinine level ≤3 mg/dl without history of hemodialysis. Patients without overt renal disease were divided into 3 groups according to level of creatinine (Group A: Cr level <1.2 mg/dl, Group B: Cr level ≥1.2 and <1.5 mg/dl and Group C: Cr level ≥1.5 -≤3 mg/dl). Additionally after evaluation of coronary angiograms, patients were also classified according to those with high stenosis (stenosis score ≥16) and high extension scores (extension score >50%) versus low stenosis and low extension scores. Logistic regression analysis was performed to establish the clinical predictors of high total stenosis and high extension scores. Results: Each group of patients according to level of creatinine showed marked difference in terms of angiographic extent of coronary artery disease (p<0.001). Those in the highest creatinine group (≥1.5 mg/dl, but not above 3 mg/dl) had the highest total stenosis (17±6, p<0.001) and extension (78±25, p<0.001) scores irrespective of age and gender. Creatinine was shown to be significantly correlated with both stenosis and extension scores. Age (OR: 1.035, 95% CI: 1.016-1.054, p<0.0001), being male (OR: 1.746, 95% CI: 1.135-2.685, p=0.011), presence of hypertension (OR: 1.507, 95%CI: 1.005-2.25 p=0.047), presence of diabetes mellitus (OR: 1.865, 95%: 1.250-2.783, p=0.002), previous history of myocardial infarction (OR: 1.624, 95%CI: 1.094-2.413, p=0.016), wall motion score index (OR: 1.203, 95%CI: 1.108-1.305, p<0.0001) and creatinine (OR: 4.037, 95%CI: 2.530-6.443, p<0.0001) level were found to be independent predictors of high total stenosis score. Furthermore, age (OR: 1.042, 95%CI: 1.026-1.059, p<0.0001), being male (OR: 2.587, 95%CI: 1.794-3.731, p<0.0001), presence of hypertension (OR: 1.536, 95% CI: 1.100-2.147, p=0.012), previous myocardial infarction (OR: 6.183, 95%CI: 4.340-8.807, p<0.0001), total cholesterol/HDL ratio (OR: 1.215, 95%CI: 1.114-1.327, p<0.0001) and creatinine (OR: 3.814, 95%CI: 2.149-6.768, p<0.0001) were found to be independent predictors of high extension score. Conclusion: Serum creatinine seems to denote severity of angiographic extent of coronary artery disease in patients with typical chest pain.

Keywords: Creatinine, coronary artery disease, extension, mild renal dysfunction, logistic regression analysis


Şule Korkmaz, Burcu Demirkan, Hakan Altay, Meltem Refiker Ege, Vedat Çaldır, Mehmet Birhan Yılmaz, Yeşim Güray, Ümit Güray, Hatice Şaşmaz. Serum creatinine is independently associated with angiographic extent of coronary artery disease in patients with stable angina pectoris. Anatol J Cardiol. 2011; 11(5): 407-413


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