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Renal function and coronary microvascular dysfunction in women with symptoms/signs of ischemia

Mohandas, R and Segal, MS and Huo, T and Handberg, EM and Petersen, JW and Johnson, BD and Sopko, G and Merz, CNB and Pepine, CJ (2015) Renal function and coronary microvascular dysfunction in women with symptoms/signs of ischemia. PLoS ONE, 10 (5).

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Abstract

© 2015, Public Library of Science. All rights reserved. Objectives: Chronic kidney disease (CKD) is more prevalent among women and is associated with adverse cardiovascular events. Among women with symptoms and signs of ischemia enrolled in the Women's Ischemia Syndrome Evaluation (WISE), a relatively high mortality rate was observed in those with no obstructive coronary artery disease. Coronary microvascular dysfunction or reduced coronary flow reserve (CFR) was a strong and independent predictor of adverse outcomes. The objective of this analysis was to determine if renal function was associated with coronary microvascular dysfunction in women with signs and symptoms of ischemia. Methods: The WISE was a multicenter, prospective, cohort study of women undergoing coronary angiography for suspected ischemia. Among 198 women with additional measurements of CFR, we determined the estimated glomerular filtration rate (eGFR) with the CKD-EPI equation. We tested the association between eGFR and CFR with regression analysis. Results: The median eGFR was 89 ml/min. The eGFR correlated with CFR (r = 0.22; P = 0.002). This association persisted even after covariate adjustment. Each 10-unit decrease in eGFR was associated with a 0.04-unit decrease in CFR (P = 0.04). There was a strong interaction between eGFR and age (P = 0.006): in those ≥60 years old, GFR was strongly correlated with CFR (r = 0.55; P<0.0001). No significant correlation was noted in those <60 years old. Conclusions: Reduced renal function was significantly associated with lower CFR in women with symptoms and signs of ischemia. Coronary microvascular dysfunction warrants additional study as a mechanism contributing to increased risk of cardiovascular events in CKD.

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Details

Item Type: Article
Status: Published
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Mohandas, R
Segal, MS
Huo, T
Handberg, EM
Petersen, JW
Johnson, BD
Sopko, G
Merz, CNB
Pepine, CJ
Contributors:
ContributionContributors NameEmailPitt UsernameORCID
EditorPizzi, CarmineUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Date: 7 May 2015
Date Type: Publication
Access Restriction: No restriction; Release the ETD for access worldwide immediately.
Journal or Publication Title: PLoS ONE
Volume: 10
Number: 5
DOI or Unique Handle: 10.1371/journal.pone.0125374
Institution: University of Pittsburgh
Refereed: Yes
Date Deposited: 23 Aug 2016 14:09
Last Modified: 20 Dec 2018 00:55
URI: http://d-scholarship.pitt.edu/id/eprint/28480

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