Turk Kardiyol Dern Ars. 2005; 33(2): 90-95
The prevalence of coronary artery disease, distribution of lesions, and associated risk factors in patients with chronic renal failure
, Mehmet Alparslan Küçük1
, Aylin Yıldırır1
, Taner Ulus1
, Halil Olcay Eldem1
, İlyas Atar1
, Alp Aydınalp1
, Bülent Özin1
, Haldun Müderrisoğlu1
OBJECTIVES We retrospectively investigated the prevalence of coronary artery disease (CAD), distribution of lesions, and associated risk factors in patients who underwent coronary angiography during treatment of chronic renal failure (CRF).
STUDY DESIGN A total of 112 chronic hemodialysis patients (33 women, 79 men; mean age 55.7 years) were examined by coronary angiography for angina or angina-like symptoms, ischemic findings, or for further evaluation before renal transplantation. Angiographically, significant CAD was defined as the detection of narrowing (50% or more) in at least one coronary artery.
RESULTS Coronary artery disease was detected in 80 patients (71.4%). Patients with CAD exhibited significant differences with regard to age (p=0.002), male gender and the presence of angina (p=0.03), triglyceride level (p=0.02), and diabetes mellitus (p=0.04). Isolated stenosis of the left main coronary artery was detected in one patient (1.3%); 17 (21.3%), 20 (25%), and 42 patients (52.5%) had one-, two-, and three-vessel disease, respectively. The left main coronary artery was involved in four patients (5%), the left anterior descending artery in 70 (87.5%), the circumflex artery in 56 (70%), and the right coronary artery in 57 (71.3%) patients. Though not significant, systolic and diastolic dysfunction of the left ventricle was more common in CAD patients, whereas two groups had a similar left ventricular ejection fraction (p>0.05). Multivariate logistic regression analysis showed that age (p=0.01) and male gender (p=0.02) were independent predictors for CAD. Treatment consisted of monitoring in 21 (26.3%), percutaneous coronary intervention in 15 (18.8%), and coronary artery bypass surgery in 44 (55%) patients.
CONCLUSION The occurrence of CAD is frequent in patients with CRF, with the lesions showing diffuse involvement. Treatment should not be delayed especially in the presence of risk factors.
Angina pectoris/complications; coronary angiography; coronary arteriosclerosis/etiology; coronary disease/etiology; kidney failure, chronic/complications; renal dialysis
How to cite this article
Hüseyin Bozbaş, Mehmet Alparslan Küçük, Aylin Yıldırır, Taner Ulus, Halil Olcay Eldem, İlyas Atar, Alp Aydınalp, Bülent Özin, Haldun Müderrisoğlu. The prevalence of coronary artery disease, distribution of lesions, and associated risk factors in patients with chronic renal failure. Turk Kardiyol Dern Ars. 2005; 33(2): 90-95