Mildly decreased glomerular filtration rate is associated with poor coronary collateral circulation in patients with coronary artery disease.

BACKGROUND: The aim of this study was to evaluate the association between mildly decreased glomerular filtration rate (GFR) and coronary collateral circulation (CCC).

HYPOTHESIS: There would be an association between mildly decreased GFR and CCC.

METHODS: Patients who had an occlusion in at least 1 major coronary artery were included in this study. Patients with severely and moderately decreased GFR were excluded. Patient data were obtained from their files. To classify CCC, we used the Rentrop classification. Patients were classified as having poor CCC (Rentrop grades 0 to 1) or good CCC (Rentrop grades 2 to 3). We used the Modification of Diet in Renal Disease (MDRD) equation to calculate GFR. Mildly decreased GFR was defined as 60 mL/min per 1.73 m(2) ≥ eGFR ≤89 mL/min per 1.73 m(2) according to the MDRD definition. Multivariate logistic regression analysis was performed to determine independent variables.

RESULTS: The study group consisted of 299 patients. Ninety-three patients had poor CCC and 206 patients had good CCC. The frequency of mildly decreased GFR was higher in the poor CCC group than in the good CCC group (P<0.001). Also, the frequency of diabetes and dyslipidemia, and the plasma high sensitive C-reactive protein levels, were higher in the poor CCC group (P = 0.003, P = 0.018, P<0.001, respectively). Logistic regression analysis revealed that eGFR is an independent predictor of CCC (B = 1.68; odds ratio = 5.4; P<0.001; 95% confidence interval, 3.1-9.4).

CONCLUSIONS: We found that CCC was worse in patients with mildly decreased GFR compared to patients with normal GFR in patients with coronary artery disease.